I can’t seem to wrangle anything coherent out of my brain, so I bring you a collection of the writing that’s intrigued and inspired me this past week:
I found myself thinking of the various traumas of care work as I read about the moral injuries experienced by refugees. It's an especially interesting read if you're struggling with guilt and anger. The concept has already been applied to doctors who comply with the demands of corporate medicine.
“Resist the temptation to confuse control for care.”
From The Atlantic's review of Jennifer Pahlka's latest book: “We have a penchant in the United States for holding civil servants accountable not for the quality of the public services they provide, but for strict compliance with programmatic requirements. When the inspector general comes knocking, that’s what’s evaluated. So, too, with courts. It’s not their job to take a holistic view of whether the agency is doing its job effectively. They ask whether the agency has jumped through the prescribed procedural hoops.”
“price changes in fact account for very little of the increase in health care spending. Even at today’s prices, we could easily afford the medical procedures that were available forty or fifty years ago.”
“I want to speculate that a reason many are leaving jobs in social care is not just about pay, or status, but because their sense of job fulfilment is being undermined. That in understaffed care homes relying increasingly on remote technology to monitor people, or in rushed 10-15 minute ‘care visits’ where every second counts and is monitored by technology, the things people value about the work are sidelined in the pursuit of efficiency and productivity.”
Why are there such lax requirements for the doctors deciding which insurance claims to deny? “One way to shut it down,” said Hurley of the rampant payment denials, “is to apply the same level of accountability that I have as a physician, when I have a practice, to the physicians who are making the decisions on the insurance side. When you apply that level of accountability – you can make that decision, but you’re going to be liable for it – then it shuts down very fast.”
How Sweden balances social responsibility with individualism.
This is about memoirs about illness by the ill person. I imagine the advice holds for caregivers, too.
“two years ago, when in the months that my partner and I knew he was going to die, I bought a stack of books to try to help prepare for what was being asked of us both. They sat, unopened, for those months, and beyond. I was desperate for some wisdom or guidance to help make sense of what was happening, to help me become who I needed to be for him. But when I tried to open them — while he slept or read next to me — I saw the letters shimmer and coalesce on the page and could not absorb anything, to the point I gave up, and instead just lay there and watched him breathe.”
“For the addict, the drive towards oblivion is partly the drive to escape from the self, to forget our pain and live, at least momentarily, in the now. I tried to see what awaited my father in this way. As his disease progressed, I knew it would claim more of his autonomy and independence, but maybe it would also take him towards a different kind of freedom, one of unencumbered consciousness. A life without regret or anxiety, lived in the present.”
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I read with interest your links. The concept of care as surveillance is one I feel enmeshed in as I support an ailing elder to ‘stay at home’ despite some credible risks. If I fail at surveillance, the elder is at risk. I am not sure this relationship is what either of us wants at this point. But, to the elder, anything is better than the dreaded ‘residential care’.