Posted tagged ‘Health Care Crisis’

Guest Post: Michelle Sipics on Trouble in the Zoo…

June 19, 2008

With this post Inverse Square launches what I hope will be an expanding part of its repertory. The goal of this blog is to probe the intersection of science and public and daily life. That’s a big beat, the biggest — and it is much more than any one person could hope to cover.

So with the following work, Inverse Square’s first guest post we see the beginnings of what I would like to see become a community of insight into the ways science penetrates our experience at every level.

Your poster, Michelle Sipics, knows what she’s talking about in the piece below (and much besides). After deciding that her two degrees in computer engineering from Drexel weren’t enough, she came to MIT to join the Graduate Program in Science Writing, where she spent a good part of her year working on issues of geriatric mental health. Right now she’s writing and thinking in her beloved Philadelphia — and lending her formidable intelligence, wit, and style to all of us over here in the first of what I hope will be many future conversation-starters. (I don’t need to add, but I will, that Michelle was one of those students that make teachers want to keep teaching.)

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When my gracious host first offered to let me guest-post on this blog, one thing worried me more than anything else: what would I write about? Could I come up with topics that would interest readers, generate discussion, and actually be informative simultaneously? Sometimes even attaining two out of three is difficult enough.

But earlier today, as I was browsing through my bookmarks to make sure that none were garbled during my transition to the lovely and fabulously improved Firefox 3 (note: they all survived), I came across an article that I bookmarked several months ago in a state of severe agitation. It was a story from my local paper, The Philadelphia Inquirer, with the somewhat self-explanatory but still vague headline “Philly Zoo deals with aging animals.”

I could lie and say that I don’t know what made me click on this headline and read the article. Yes, I like animals, and I’ve been to the Philly Zoo–as zoos go, it’s not bad, and I went there with my cousin’s kids a few years back. But I’m not particularly interested in animals or zoos. Instead, I clicked on the link because I had a vague impression that something infuriating was waiting for me in the article, and I admit it: I sometimes enjoy getting fired up. Hey, sometimes getting angry about something is the first step toward improving a situation.

So, I clicked. And what did I find out? Well, let’s look at a few excerpts:

A few weeks ago, Philadelphia Zoo keeper Mandy Fischer heard a small cough.

It was Spot, 25, a grandmother and matriarch of her group of spectacled langurs.

X-rays and ultrasound showed that the elderly Asian primate is not just losing her teeth. She has advanced cardiac disease.

Ok. That might not seem terribly interesting, but here’s why it caught my attention: we’re talking about a zoo monkey who was given–without having to file paperwork, wait a month for a doctor’s appointment, or fight an insurance company to have a claim paid–X-rays and an ultrasound. If you read on, you’ll find out about a giraffe that gets arthritis pills hidden inside bananas. An emu (24-year-old “Mrs. Emu”) gets anti-inflammatory medication to treat her arthritis. And then we find this little three-sentence, three-paragraph gem:

Philadelphia has adapted living spaces for the elderly.

A tree kangaroo that could no longer climb her pole got handrails and ramps.

A snow leopard with failing vision got brighter lights.

You might still be wondering why this article irritates me so much. Well, it’s not the article that irritates me; it’s the fact that animals are getting immediate medical attention and treatment while elderly human beings have to fight to be seen by a doctor, struggle to pay for life-saving medications, and find a way to cope with diseases like Alzheimer’s, which the doctors and researchers that I’ll collectively refer to as “science” can’t claim to understand. Let me be clear: this is not a rant against scientists or doctors. Most of them are doing their best to keep up with the impending massive increase in the elderly population in this country as the Boomers turn 65, and are fighting against a lack of funding and–at least until recently–a general lack of interest in geriatric research. This is also not a rant against zoos, zookeepers, animal lovers or the animals themselves. The zookeepers are just doing their jobs, trying to keep the animals healthy; and the animals have a right to be kept healthy, I’m sure. But if a monkey can get arthritis medication, why is it so difficult for elderly human patients to receive good medical care? As the linked Washington Post article states, “The quality of care received by vulnerable elderly Medicare, Medicaid patients is barely acceptable.” To wit:

The study found that vulnerable elderly patients — those at risk of death or functional decline — received only 65 percent of tests and other diagnostic evaluations and treatments recommended for a number of illnesses and conditions, including diabetes and heart disease.

And less than a month after running the homegrown story about the Philly Zoo animals, the Philly press picked up an AP story detailing the impending crisis (note to AP: I came up with that phrase before I noticed that it was part of a quote in your story; please don’t sue me) in geriatric health care. In brief: there’s a shortage of geriatric specialists; there’s a shortage of available training; most of the people who DO work in the field are underpaid and stressed with a workload of too many patients; and Medicare doesn’t allow for a lot of the treatment and care that its patients require.

And this is referring to general health care; it doesn’t even discuss the dire state of affairs that is geriatric mental health in the US. I’ll leave most of the details on that situation for another post, but if I may briefly quote from a document I prepared as a student back in 2006, I will point out that several years ago, Anita Rosen, then-chair of the Mental Health and Aging network of the American Society on Aging, addressed the Policy Committee to the White House Conference on Aging, and pointed out drastic shortages in the number of professionals specializing in geriatric mental health:

[Rosen] reported that as of 2002, only 5 percent of social work practitioners listed aging as their primary area of expertise, and that only 1,115 Masters-level social work students specialized in aging. In contrast, the [National Institute on Aging] issued a report nearly 20 years ago emphasizing the need for 60,000 to 70,000 social workers specialized in aging by 2020. Despite two decades of warning, experts fear that the actual numbers will fall drastically short of the predicted need.

Why? Rosen lists bias and stereotyping as major issues, both for aging and for mental health. And it gets worse:

Rosen also cited shortages in the number of psychiatrists providing specialized care for the elderly. At the time of her testimony to the White House conference, less than 7 percent of the 38,691 practicing psychiatrists in the U.S. specialized in aging. According to Rosen, given the existing trends in medical schools and the retirement of current practitioners, there will be 5,682 older adults with psychiatric disorders for every one geriatric psychiatrist in America by the year 2030.

Meanwhile, kangaroos get ramps and handrails, emus get X-rays and arthritis medication, and I get really, really ticked off.

Image: August Macke, “Great Zoological Garden, Triptychon,” 1913. The reproduction is part of a collection of reproductions compiled by The Yorck Project. The compilation copyright is held by Zenodot Verlagsgesellschaft mbH and licensed under the GNU Free Documentation License. Source: Wikimedia Commons.

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