Sunshiners: Frail Old People Living At Home

As of June 1, 2023 I have a separate site for my Mental Capability Consulting work. There you will find a description of my experience, the scope of the capability evaluation consultation, the us...

https://sunshiners.ca/2023/06/01/new-mental-capability-assessment-site/

The pieces are slowly falling into place for my near-total retirement from clinical work (clinical means work associated with seeing and treating patients). Once that’s over I will be posting a...

https://sunshiners.ca/2023/05/05/retirement-kind-of/

I’m embarrassed at having said nothing here since January of this year as if either nothing has happened or I’ve just given up. Neither of those is correct. The “Shared Care” activity tha...

https://sunshiners.ca/2022/11/04/home-care-3/

In 2017 I self-published a book on diet, which I posted about working on here in 2013. The book was privately published as Forbidden Food. It hasn’t sold even as well as A Bitter Pill my book o...

https://sunshiners.ca/2022/01/11/diet-and-health-an-update/

The last sentence of my previous post in October scares me because I really meant to show progress on getting practical home care of frailty going on the Sunshine Coast in a few weeks. It’s a f...

https://sunshiners.ca/2022/01/11/care-at-home-progress/

October 2021. It’s been awhile since I’ve posted and for me lots has changed. I’m now 2½ years into part-time practice in a much more rural setting (BCs Sunshine Coast) than where I was fo...

https://sunshiners.ca/2021/10/24/5197/

NB: this note was posted and updated March 20-26 2020. Big changes will no doubt occur to make much of what I’m saying simply wrong in the near future. Sounds like the title of ER doctor Dan Ka...

https://sunshiners.ca/2020/03/19/pandemic/

About four years ago I had a meeting with a dear and trusted colleague and a bunch of Vancouver Coastal Health administrators. The chief executive officer and her group said “We have a culture ...

https://sunshiners.ca/2019/11/22/careful-what-you-wish-for-or-creating-a-monster/

For over 10 years my wife and I have lived in two places. We’ve travelled back and forth each week between our home in Roberts Creek on BC’s Sunshine Coast and an apartment in Vancouver...

https://sunshiners.ca/2019/06/27/ive-moved/

A couple of very good friends in Vancouver somehow convinced the Canadian College of Family Physicians and Canadian Geriatrics Society to give me an award for innovation in geriatrics. I don’t ...

https://sunshiners.ca/2017/11/24/fmf-award-acceptance-speech/

I post this here having already put it in my “Reviews” website because I think it’s well worth reading and I take a slightly different message than most reviewers from it. Kalanithi, Paul. ...

https://sunshiners.ca/2017/08/12/a-very-interesting-medical-book/

April 2017 I’ve been working in Canadian primary health care now for almost 40 years, and it seems to me that while in many ways we’re making progress, in others we keep making the same mista...

https://sunshiners.ca/2017/04/22/healthcare-mismanagement/

I work with a multidisciplinary emergency room team that tries to stop unnecessary hospital admission of frail old people. Again and again at the busy Vancouver General emerg family doctors who g...

https://sunshiners.ca/2016/09/04/a-fool-and-his-money/

I ran across a recent review in the New Yorker by Canadian journalist Malcolm Gladwell, commenting on The Death of Cancer, a book by Dr. Vincent DeVita. Dr. DeVita is a leading cancer specialist ...

https://sunshiners.ca/2016/01/31/policy-and-people/

A few weeks ago our team, normally focusing in the emergency room on avoiding unnecessary hospital admission in over-70s, was asked to see a 45-year-old lady who had come to the ER for the second...

https://sunshiners.ca/2015/11/27/type-casting/

Working in a big emergency room as part of a team that tries to intercept unnecessary hospital admissions of frail elderly people, I seem to find there are fewer elderly people who call an ambula...

https://sunshiners.ca/2015/08/28/when-nothing-works/

You can follow the string of my “Geriatric Doctor-In-Law” stories by searching through the posts here. Basically my wife Robin’s mum Liz and dad Nigel became quite frail over the last sever...

https://sunshiners.ca/2015/03/01/final-adventure-of-the-geriatric-doctor-in-law-6/

CKNW radio reporter Jessica Gares interviewed me a few months ago. You can hear the content here.

https://sunshiners.ca/2015/01/26/dr-sloan-on-local-radio-again/

Well it’s Christmas. And I the sorry lapsed and sentimental secular Christian can’t resist childhood-retrospective feelings. But although I know the suicide rate probably doesn’t really inc...

https://sunshiners.ca/2014/12/16/lost-sheep/

I’m very lucky to be part of several groups of committed and capable family physicians doing care of the frail elderly. One of these is our (University of British Columbia) Family Practice comm...

https://sunshiners.ca/2014/08/23/bringing-family-practice-training-up-to-date/

Such outrage about awful healthcare! Too many mistakes, too many adverse drug reactions, hospitals making people sick, accidents in the operating room, arrogant doctors, costs going through the r...

https://sunshiners.ca/2014/06/28/airline-industry-healthcare/

GM “Gord” is 87. He is a proud and accomplished man who was born in the 1920s in small-town Saskatchewan with birth injury to his arms and legs. As a child he could walk and move his arms but...

https://sunshiners.ca/2014/06/11/another-jailbreak/

Mrs. N. will be 107 at the end of the year. She has lived for over 60 years in the same rented apartment, initially with her husband but for the past several decades on her own. She is an absolut...

https://sunshiners.ca/2014/05/23/housecalls-10-its-never-too-late-for-a-hospital-jailbreak/

Munsch was popular when my kids were young and I read them his books. It’s just been announced that the original illustrations from Love You Forever are about to go on sale, and I’m reminded ...

https://sunshiners.ca/2014/03/16/robert-munsch-and-putting-sentimentality-to-work/

Are there times when rules should be broken, or just ignored? This can be hard to decide, rules being rules and presumably set for everybody and for good reason. But one of rules’ limitations i...

https://sunshiners.ca/2014/03/16/housecalls-9-an-end-run-around-the-rules/

The online Globe and Mail picked up my short article on salt. Andre Picard kindly tweeted it which resulted in a near-record number of hits here on Sunshiners. As I said before I have mixed feeli...

https://sunshiners.ca/2014/02/24/second-op-ed-on-diet-hits-the-toronto-big-time/

I was surprised at having my op-ed article on dietary sugar “Sweet Nothing” promptly picked up by the Vancouver Sun. I’m sure it will generate a fair bit of controversy recognizing as I do...

https://sunshiners.ca/2014/01/15/op-ed-on-diet-hits-the-local-media/

Bearing in mind the story of Mrs. Forsyth which seems to keep repeating itself, I have been meeting for about a year now with the generous and hard-working administrative people at Vancouver Coa...

https://sunshiners.ca/2014/01/13/house-calls-8-more-on-home-support/

Here’s a fictitious story of a problem with home support. Mrs. Forsyth age 92, mildly memory-impaired, under treatment for heart failure and dependent for mobility on a walker because of arthri...

https://sunshiners.ca/2013/12/15/house-calls-6-supporting-home-support/

Somebody said we change jobs every five years whether we know it or not. You may be a high school math teacher for four decades but in reality you do eight fundamentally different things during t...

https://sunshiners.ca/2013/11/08/diet-a-new-direction/

I’ve worked in a few provincial and federal government healthcare agencies: a pharmacy plan and veterans’ services for example. I understand how difficult it must be to allocate public funds ...

https://sunshiners.ca/2013/11/08/putting-out-fires/

Gertrude (not her real name of course) is a just-about-90-year-old lady with red hair living alone in a small one-bedroom apartment overlooking the beach. The place is… not cluttered exactly, b...

https://sunshiners.ca/2013/08/24/housecalls-6-jailbreak/

Welcome, Family Practice residents. This post provides access to materials for our upcoming session. Viewing them may work better if you save them to your machine rather than running them on the ...

https://sunshiners.ca/2013/08/11/fp-res/

Here’s an anecdote to illustrate one of my favorite principles: trial of therapy, not high-tech investigation leading to cookbook care. Mother-in-law Liz has not been that great lately. Quite c...

https://sunshiners.ca/2013/06/30/737/

I’m branching out. I’ve had a book-reviews page on my Sunshiners website for a long time, but I wanted to separate health care of the elderly from other interests, so there’s a new site for...

https://sunshiners.ca/2013/06/22/new-website/

I’ve found another video on YouTube of me addressing a small audience about care of frailty. Click here .

https://sunshiners.ca/2013/04/25/dr-sloan-speaking-2/

Getting on in a medical career, especially caring for elderly people whose priorities don’t tend to be technically-based or even specific, I sometimes suspect that my value to people if any is ...

https://sunshiners.ca/2013/04/20/permission-not-to/

Mrs. Hii is an 85-year-old Chinese lady who speaks Mandarin when she speaks at all. She lives in a big condominium apartment with her husband who is a long-retired health professional. Poor Mrs. ...

https://sunshiners.ca/2013/04/19/house-calls-5-cross-cultural-crossed-wires/

It’s been awhile since I’ve posted about my in-laws, Liz and Nigel (awhile since I’ve posted on anything…). They’re doing fine, in some ways. But having them close to us and being our r...

https://sunshiners.ca/2013/01/28/further-adventures-of-the-geriatric-doctor-in-law-4-is-this-reality/

There are a lot of wonderful things about general medical practice, but like anything else it occasionally gets, well, tiring. A fourth worried-well general physical exam at the end of a long aft...

https://sunshiners.ca/2012/12/22/tired-eyes-2/

I’ve held off posting about Dr. Dennis McCullough, whom I visited back in September, because I wanted to finish his book and also hear him speak. He visited us in Vancouver this past weekend an...

https://sunshiners.ca/2012/11/30/dr-dennis-mccullough-and-slow-medicine/

In September I did another holiday-cum-healthcare-research road trip, this time to those northeastern US states referred to as New England: Massachusetts, Rhode Island, New Hampshire, Maine, Verm...

https://sunshiners.ca/2012/10/07/new-england-programs-i-full-circle-america/

A friend of mine is interested in trust. Not the kind that lawyers and bankers deal with, but the strong intermolecular force that makes human interaction possible. If you catch a lawyer or banke...

https://sunshiners.ca/2012/08/25/whats-trust/

We are now many months into the bold experiment of looking after Robin’s frail parents in their Roberts Creek home. Avid readers will recall our success at getting Nigel out of a nursing home a...

https://sunshiners.ca/2012/07/02/further-adventures-of-the-geriatric-doctor-in-law-3/

My campaign to encourage what I see as common sense in care of frail people gets tangled up with another interesting controversy.  It’s got several names: patient-centered care, patients’ ri...

https://sunshiners.ca/2012/06/25/a-different-slant-on-science/

Nothing’s perfect. But I don’t think it’s too much to expect for things to work out acceptably, at least some of the time. There follows a sad story with only an ambiguous and implied moral...

https://sunshiners.ca/2012/06/11/house-calls-4/

When I was working in a small hospital in the city many years ago, nursing administration decided that all nurses were to rotate through all the services. Operating room nurses had to do a shift ...

https://sunshiners.ca/2012/04/23/the-fragmented-faces-of-care/

I’ve been impressed by (and I’m envious of) some physician authors I’ve read lately, including Abraham Verghese and Nortin Hadler. But I was particularly dazzled by Harvard surgeon Atul Gaw...

https://sunshiners.ca/2012/04/16/house-calls-3-when-the-doctor-makes-a-mistake/

Whatever the social and psychological consequences may be, I’ve signed up for Twitter today. It’s taken me a while to decide to do this because somehow I associate the facility with kids tryi...

https://sunshiners.ca/2012/04/15/dr-sloan-is-on-twitter/

Readers of my website will understand that over the last couple of years I’ve had a dose of care of frailty from the consumer’s side, once removed. My wife’s parents, Liz and Nigel (both in...

https://sunshiners.ca/2012/04/07/further-adventures-of-the-geriatric-doctor-in-law-2/