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LETTER TO THE EDITOR |
Medical Unit for the Acute Care of the Elderly Poliambulanza Hospital and Geriatric Research Group Brescia Italy
Address correspondence to Renzo Rozzini, MD, Geriatric Research Group, via Romanino 1, 25122 Brescia, Italy. E-mail: renzo.rozzini{at}iol.it
To the Editor:
We read with great interest the letter by Robert Kane on the need to formally establish a group of professionals with personal experience in chronic care (1). The letter stimulated a debate among us in an effort to pick up the meaning of Kane's message. We propose the following.
We feel more than in the United States the "tragic" incompatibility between our chronic care system and the needs of one of the oldest countries in the world (i.e., Italy). The demand for better care is supported only by a few professionals (physicians and nurses), and we lack strong consumer advocacy groups. Moreover, politicians are particularly insensitive to the problems of frail elderly people.
Good professionals must have a personal experience of suffering to interpret the difficulties of their patients and their families. As chronic diseases are characterized by a long-lasting relationship between patients and physicians, usually with a high risk of frustration and burnout, a rigid relationship excluding moral involvement is unrealistic. The critical point is the definition of limits.
In the field of chronic care, we need new ideas to avoid the tired repetition of old models. The proposal of Robert Kane is at the same time simple and ingenious. In particular, it is important to compare theories with everyday practical problems; in this way, his proposal is an empirical translation in the real world of formal studies.
In a society with a progressive decrease of "social capital" ("bowling alone" as a generalized experience), we should give to the patients and their families the feeling that professionals approach their problems not only with the highest level of technical expertise but also with a humane and generous attitude in an effort to deeply understand their burdensome difficulties.
One of the undersigned had, in the past, a similar experience to that of Dr. Kane. After a few years, it may be stated that those events have helped in suggesting better solutions for the care of persons with chronic diseases. Professionals in middle age (with old parents) have the peculiar responsibility to lead their younger colleagues, who because of their age are not personally involved in these problems, toward a broader comprehension of their patients.
Reference
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