Trust is an essential factor in healthcare. When patients receive any kind of therapy management, they are expecting that the professionals in charge of their care are not only knowledgeable but truthful in all aspects of care. It is important as healthcare providers, that we remain transparent with patients and understanding of not only their physical health, but emotional and mental wellbeing as well. As a community pharmacist, I have had many interactions with patients that allowed me to gain a more in-depth notion of each individual that I treated. For example, if there were patients who were on a fixed income, I would be able to look at their medication therapy and recommend alternative medications that would fit their budgets and still be effective. I was able to do this because patients were comfortable enough to trust me with their financial situations in order for me to help them. Sometimes there is a giant disconnect between providers and patients. Patients are often times intimidated by healthcare providers and afraid to express their issues. Sometimes older patients who are experiencing pain, side effects or mental and emotional issues are not transparent with their providers about these conditions. This creates a barrier that makes providing great healthcare much more difficult. My grandfather was one of the proudest, most hard-working people that I’ve ever been around. He worked as a farmer and mechanic throughout most of his life. He would talk to anybody who came across his path and believed that any ailment could be prevented with a teaspoon of castor oil and a good night of sleep. Once he became older, he started to experience frequent chest pain and tightness. He refused to go to the doctor because he had the belief that if he did, then he would never return home. This is a common fear amongst people in our community. Many people have a distrust of providers and believe that either most are only concerned about the prospect of making money, or they simply do not care about their wellbeing. This is a stigma and barrier that is the responsibility of us in the healthcare community to overcome. Patient-centered care is the backbone and foundation of the proper care of patients, and this idea must not be forgotten. Patients as well as their families have the responsibility of making sure that every important detail of the patient is given to their caregiver. For example, if it is an elderly person who is in a nursing home or assisted living facility, the caregivers must be aware of all medications, both prescription and over-the counter, that are being taken, as well as physical ailments and mental/emotional wellbeing. This ensures that they are given the best care possible, which also gives peace of mind to those involved. Trust is the key factor that establishes these points. Patients must not only trust the competency of those in charge of care, they must trust that the best care will be given. For all patients to receive the best care possible, trust is not only needed, its essential to the foundation of healthcare.
Technology has become a great connector in society. In many respects, grade-school children have become more adept in using smartphones and iPads than their parents. Young teenagers solely accustomed to social media have never experienced a world without Snapchat filters and IG story posts.
People now more than ever are dependent on technology.
How many times a day do you check your phone, scroll through a timeline looking for the latest news, or check out a blog for the latest health and wellness tips?
You might be surprised to learn that this shift has also begun to occur within the senior community. Compared to other age groups, seniors may still use technology at a lower rate, but they are more engaged with the digital community at a much higher pace than before.
As of now, almost 4 in 10 seniors own a smartphone, and internet usage is also rising. Seniors between the age of 65-70 are the most likely to be using technology as well. 34% of Americans ages 65+ use social networking platforms such as Facebook or Twitter. So, what does this mean?
Technology affects people of all ages.
As its impact on society increases throughout the years, so does the likelihood that older people will not only be tech-savvy, they will rely on it just as much as their younger counterparts. The world continuously changes and coincidently so does technology. It is absolutely essential that all people, no matter the age group recognize this and grow with it.
At one point in history, driving a car was seen as innovative. Typing on a typewriter attached to a large screen was unheard of. Now, these are daily tasks that many of us cannot live without, including our seniors.
Social Media is seen as the most innovative and important platform to find breaking news and important information, and its ability to share life updates and important information regarding family and friends is essential in our daily lives.
It is the daily newspaper of the 21st century and much more. Most news outlets report faster on their social media sites, then on the television. Therefore, in addition to increased smartphone usage, seniors have begun to look at social media and the internet as a way to keep up with the everchanging landscape of society. Seniors have begun to engage with gaining information from digital outlets versus traditional forms such as television and newspapers.
Some barriers remain between seniors and technology.
Older seniors over the age of 75 are less comfortable with technology and are unfamiliar with how to properly use electronic devices. A poll from the Pew Research Center discovered that only 26% of internet users over 65 feel confident when using computers, smartphones, or tablets, and 28% of seniors say they have health problems or disabilities which may prevent them from engaging in activities.
These seniors are less likely to engage with digital devices as well. Despite the challenges, the overwhelming trend is that increasing access to technology can be seen as a positive step in assuring that the senior community remains informed and knowledgeable about the world and current events.
As time goes on and technology remains a fundamental part of society, its impact will only continue to increase with the older generations and continue to be a key tool to keep seniors active and engaged.
What exactly is home health and how does it benefit my loved one or my family? This is a question that over 65 million adults ask themselves each day when they are juggling work, family, and the care of an elderly loved one. Everyone has a busy schedule yet want to make sure that the best care is given to their family member. Many people are uncomfortable with the idea of their senior living in an unfamiliar nursing home, so as an alternative home health has become a realistic option. So why choose home health? Here are a few reasons that may make your decision a little easier.
Better Patient Centered Care
One of the better benefits of home health is that trained nurses and therapists are able to make visits to the home and deliver quality individualized care to each patient. Often in nursing homes, a nurse is responsible for each floor of the hall and may not be able to notice immediate changes in patient’s wellbeing or response to different medications. Also, these facilities may have various nurses throughout the day tending to each patient, so it’s more difficult for each resident to connect or develop relationships with the nurses which is essential to effective care. Also, home health nurses are better able to manage the medications that patient’s may be taking from several doctors or any over-the-counter medications that they may not have brought into the nursing home. They are able to monitor for side effects and consult with the patient’s primary care physician. Some agencies have consultant pharmacists that may help manage medications as well. Also, the same skilled nursing that occurs within the nursing home will be delivered in the patient’s home. In addition, home health agencies often offer a wide range of services from skilled nursing care to assistance with daily tasks as well as speech, occupational or physical therapy. In addition, patients are able to request a nurse or therapist remain in charge of their care throughout the duration of their home health stint, which creates better communication and relationships. The more comfortable a patient is with their caregivers, the better the care.
In general, senior care can be expensive, and dependent on the level of care needed for each patient. However, for the most part home health care is less expensive than nursing home care. A home health agency may charge up to $130 per each visit to a patient’s home, but these visits can be scheduled around a family’s needs. So, the nurse may visit the patient daily if required or a few times a week. Depending on the care needed and amenities offered at a skilled nursing facility, cost may range from $250 to $500 per day. For patients with severe dementia and Alzheimer’s, this may be an option as these patients may be prone to wandering off.
No one likes to feel restrained. In the nursing home setting, some residents feel like their independence is taken away. The transition of living independently to a nursing home is often too much for some patients to deal with. This leads to increased anxiety and depression for many patients. In the home health setting, patients are able to continue to live their daily lives, but with assistance. Seniors are able to maintain their independence for as long as they are able. They also respond better to treatment and therapy within the home. The familiarity and comfort of being at home Is something that is important to many seniors and their families as well. Those patients who experience Alzheimer’s or dementia may respond better to therapies within the home due to its familiarity as well. These choices highlight that home health may be an option for you and your loved one.
The month of August usually represents an end to the summer, and a return for school age children back to their buses, school lunches and after-school programs. However, a recent outbreak of a long-forgotten disease has parents, teachers and the elderly population on high alert. According to the US Centers for Disease Control and Prevention, 107 cases of measles have been diagnosed in 2018 along throughout over 21 states and the District of Columbia, including Texas. Compared to recent years, the number of reported cases is slightly higher and not tied to a single large outbreak like the record number of cases from 2016. The most startling news is that most people who contracted measles did not get vaccinated. Measles is a contagious infection that is caused by a virus. The infection stage occurs over a 2-week period, and during this time there are no signs and symptoms. Once its effect takes place, several symptoms including persistent cough, runny nose, fever may occur. Eventually, the most hallmark sign of measles, the rash of small red bumps, covers the body and increases the fever. The measles, mumps and rubella (MMR) vaccine is very effective against measles with nearly 93% success rate. So how does this work? Think of the vaccine as a study guide for a test, or a blueprint to a house. It prepares the body to fight against a disease, without being exposed to the actual symptoms. Vaccines are made of weakened or dead antigens of the disease. When administered, it causes the body to produce antibodies which fight the weakened antigens and prevents an infection from spreading. The immune system then stores this information for future use. Once a person is affected by the actual disease, their immune system will recall the antigen and know exactly how to combat the disease, which is how a person becomes immunized. Although measles was considered to be eliminated in America in 2000, it is one of the leading worldwide causes of death for children. The World Health Organization estimates 450 children die each day due to measles and nearly 20 million people contract measles each year. Those children who were not vaccinated as infants have a higher chance of contracting the disease. With August being National Immunization Month, it is important that not only children reporting back to school are being protected from diseases, but our senior population as well. Seniors are often overlooked when it comes to immunizations, but because of age, their immune systems may weaken and be more susceptible to certain diseases. Also, if they have other diseases such as diabetes, their immune system may be even more compromised and susceptible to viruses. Even if a person was vaccinated earlier in life, the effectiveness of the vaccine decreases over time, so it is important that booster shots may be given in order to increase the chance of the body fighting back against the disease. Also, when people in general are vaccinated against a disease, it decreases the chance that our children and senior population get affected as well, even if they are unvaccinated. This is known as herd immunity. This concept shows that it is not also imperative that our most vulnerable populations are vaccinated but that everyone becomes protected as well. This ensures that an outbreak does not occur, and a few cases are contained. Vaccinations not only protect yourself, it protects our communities.
Without a doubt, one of the hottest health topics is the Keto Diet. The keto diet focuses on the consumption of high fat foods, adequate protein and low carbohydrate intake. However, did you know that the keto diet actually started off as a way for doctors to treat pediatric epilepsy? First, let’s talk a little bit about how the Keto diet works, and how it came to be. So, in normal people, the body decides to burn carbohydrates for energy usage, which causes fat to be stored. When on the keto diet, the body, being deprived of carbohydrates, produces ketones which are formed from the liver breaking down fats. These ketones become the primary energy source of the body. Therefore, the goal is to lower carbs and increase fat and therefore ketones in the body. What does this mean? Naturally if fats are being burned, then there will be weight loss rather quickly, and since less carbs are being consumed, less insulin is needed in the body which also helps control blood sugar. In addition, studies have shown that higher ketones indicate improved mental focus, and improved energy. Unsurprisingly, these traits have led the Keto diet to become one of the most popular dieting trends for adults. However, before it became popular as a quick summer dieting tool, or a way to lose 10 pounds before a big event, it began as a treatment for pediatric epilepsy. Epilepsy is a brain disorder in which a person can experience frequent, unpredictable seizures. This occurs because of irregular activity in a person’s brain. It also can affect different people in many ways. Some people may have brief, less life- threatening seizures, while others can experience crippling, disabling seizures which may be more serious. Although epilepsy affects people of all ages, children suffer the most. The Columbia Department of Neurosurgery suggests that nearly 4% of all children experience epilepsy, as well as nearly 3 million adults in the United States. The keto diet was originally designed in the 1920’s to combat this issue. Despite its early success with patients, the diet fell out of favor due to the development of anti-seizure medications as well as difficulty in continuing and remaining compliant with the rules of the diet. However, after several studies over the past 20 years which showed the significant decrease of seizures in several pediatric patients, including some patients who reported little to no episodes, the reemergence of the Keto Diet has come back to the forefront. Further long-term studies are needed to establish the key link to the diet and the decrease in epilepsy, but there is no doubt that it has helped many patients, both children and adults, especially those who have difficult seizures to manage. Today, many people use anti-seizure medication to control epilepsy, but as an alternative or addition to medication, the keto diet may be the answer. Be aware that it may be more effective with some children more than others as well. Therefore, if it something that you may be interested in or if you have a loved one suffering from epilepsy, talk to your doctor or dietitian, as well as monitoring how effective the diet is working.
“Drifting on a melody… Ain’t no place I’d rather be, than with you.” When Mr. Washington, a 71-year-old US Army veteran from Waco, TX heard these lyrics from The Isley Brothers, it instantly took him back to a simpler time, when he and his wife would spend Sunday’s in the park, eating snow cones and talking about their future lives together. Today, Mr. Washington suffers from dementia, but for that brief 5-minute period that those lyrics drifted from the speakers, it was as if he was transferred back to his youth, and all was right with the world. Music therapy is one of the most effective forms of dementia and Alzheimer treatment in healthcare. The Music & Memory Organization is a non-profit organization that provides iPods to senior citizens in order to “vastly improve their quality of life.” They are most famous for the viral YouTube clip of a man named Henry who barely spoke but upon listening to music from his era, erupted with life. So how does this happen? Why does music somehow reignite a person’s learning ability, communication, and overall happiness? According to Dr. Laura Mosqueda, Director of Geriatrics at the University of California, Irvine School of Medicine, “music affects so many parts of the brain that it touches areas that may not be damaged by the disease and brings those pathways to the forefront.” When this happens, it is as if a light switch is turned on, and an “awakening” occurs. Synapses and pathways that were once thought to be lost are suddenly rediscovered. In senior living communities, residents are often encouraged to engage in musical activities and more social interaction. These patients are therefore happier, have fewer behavioral issues as well as have reduced usage of anti-psychotic and anti-anxiety medication. They also show improved energy, increase cognition skills and higher self-esteem. Sometimes seniors who suffer from dementia or other mental health issues have trouble communicating thoughts or expressing their feelings. This often times leads to perceived behavioral issues, which may not be the case. Music has the ability to act as a key that unlocks memories and helps these seniors be able to engage and recall what may have been previously lost. For most people music is not only important, it is essential. During every key moment or memory in life there is usually music associated with it. The song that a mother sings to their young child; Or the first song that a husband and wife dance to at their wedding. These things are embedded in our memory banks forever, and often lead us back to a happier time or specific moment. No matter what, whenever I hear “Never Too Much” from Luther Vandross, or “As” by Stevie Wonder, it takes me back to Saturday mornings, cleaning the house with my mother and sisters. Dancing and singing the whole day away without a care in the world. As we age, these moments become even more essential and necessary for our mental, emotional and physical well-being. These are the moments and memories that we draw to when times become difficult and life becomes stressful. This is even more critical for our senior citizens, as they are already dealing with the natural decline of their health due to age. So, for people like Mr. Washington, music is not only something to listen to and enjoy, it is the bridge to a once-forgotten life.
Talk about the impactful work that you are doing in the community when it comes to your “Doing it Well” movement?
I come from an under resourced area outside of New Orleans, and I saw how beautiful it was, even though the media and outsiders tried to tell me that it was not. I had a dream of becoming a physician, but I knew that I wanted to redefine what it meant to be a doctor. I wanted to know what it meant to become a doctor for my people, and there’s not a template for that. I wanted to take medicine and deliver it in a palatable, respectful way and make my community feel like they were special just like everybody else. So, my goal is to create impactful community oriented mental health programs and be creative with it. I’ve always had a love of art, music and creativity and I wanted to merge all three together to create healing. I have traveled all over the country, talking to kids about coping skills and improving the mental health literacy of kids in under resourced communities. I’ve made a hip-hop relaxation album with my buddy Mike Brown and also have done a yoga video with my friend James Woods. I created a hip-hop mentorship program, which used hip hop as a springboard for kids to exercise critical thinking and to address mental health in a positive safe space which was super dope and fun. I think for the first time in my life I was inspired to not only come up with ideas but follow through. My goal is to help those who live in a space that is constantly defined as negative, be able to take hold of their own narrative and define themselves.
What are your thoughts about the current state of mental health stigma in our community? Where did it come from in your opinion?
First, we have to talk about white supremacy and acknowledge that its real. The social identity of being white historically has been looked at as being better than, smarter than, and prettier than black. This permeates through medicine. This notion leads to why there’s disparity in health, education, etc. as well as identifying that there is an unbalanced power dynamic that heavily favors white social identity. Minorities who are in these underserved areas have traditionally been viewed as less than if they don’t adhere to the White standard. In my opinion, these people in these neighborhoods are beautifully human; just because they wear their hair a certain color or dress a certain way does not mean that they are bad or wrong, it’s just different. It’s a subculture, and subcultures are supposed to be different. We have to expand the notion of what it means to be beautifully human, to appreciate the urban culture and to connect with it.
Let’s talk about the difficulties that minorities have when discussing emotional wellness and mental health… Why do you think that is? What can we do to change that stigma?
Going back to the white supremacy argument, there is a distrust in America because of Black people’s horrible experiences with medicine in America, particularly in psychiatry. Even some governing bodies in psychiatry have said horribly, racist things about black people. So black people historically are not comfortable with medicine and discussing mental health in America. During one of my TED talks, I talked about how the Tuskegee Experiment lasted from the 1930s to the 1970s! That was not that long ago. I mean think about it, they were being dishonest and letting people die from a disease that was easily treated. Racism in medicine is a problem. However black America, has a role in the stigma as well. In our society, historically since blacks have always been looked at as less than, we have to overcompensate and look like we are extra strong. If society is telling us that we are less than, we have to be like “oh were stronger and I don’t need help! I don’t have no mental health problems!” Sometimes that even carries over to asking for medical help as well. When you live in a society that tells you that you are weak it is easy to become overly sensitized and hesitant to ask for help. I believe we must stop being reactionary to societal biases; We must stop internalizing the idea of white supremacy and to begin to value ourselves and our lives even more. Be more supportive of one another and treat each other with respect and value as well. Medicine needs to be more respectful of our community as well. If people begin to have better experiences with doctors, they will become more willing to ask for help.
Discuss the importance of minorities, accepting themselves in relation to their own mental health and success?
I recently wrote an article in Blavity, stating how it is important for people to bring their “whole selves” to work in spaces that weren’t designed for that. For example, in many professional spaces, whether its school or work, those places were designed at a time where people of color were not thought of. So, if you go to work in a finance agency, the cultural boundaries of those places were primarily made with white men in mind. If you go to an ivy league school, only white men designed the spaces. Minorities in general have done a good job getting into these spaces, but the spaces themselves have not transformed. So, we have to “code switch” to fit into these places, and if I have to do that when I am in these environments, it’s harmful to mental health. It’s almost like we are admitting that we are less than. You lose yourself every time you have to code switch and not be who you are. If I go to school at Yale, and I think that the only way I can be excellent is to transform into what a person at Yale is supposed to be like, that image is inherently wrong because it was created at a time when only white men were in mind. In order to fight this, we as minorities must identify our own source of excellence. See black excellence as just excellence, see Latino excellence as excellence. Our own brilliance should be enough for us to succeed no matter where we come from. We must recognize that when we “code switch” it’s because we are adapting to the current power structure, not that it is only the true example of excellence. I tell people that it is risky to come into these spaces being their “full selves” because it’s a threat to the power structure, but it’s gotta be done. In the past folks couldn’t wear their hair a certain way, or dress a certain way, but now you see people wearing dreadlocks and bringing culture to work. It’s a risk, but it’s a risk worth taking. When you can be your full self, I think you will be more productive, more engaged and more successful.
What can health care professionals do to encourage people to break the stigma in our community?
Medical professionals need to gain cultural sensitivity. So, if we are serving a group of people, we need to, regardless of ethnicity, go into those communities. Go eat in those communities, volunteer, and experience it. We need to gain a reverence and appreciation for the community. That will help reduce some of the biases that get us into trouble. Also, white doctors working with minorities should help make their patients feel more comfortable. This means letting patients know that you may have “blind spots” in helping treat them because of the cultural differences; and that you are open to learning what those things are in order to help treat the patient. Make sure that your patients feel heard, that they are connected and respected. Have them ask questions, and make sure they have a full understanding of their diagnosis. Ask about medication compliance and things that may inhibit them. Even as black doctors don’t assume that you have all black culture figured out. Black culture in Southside Chicago, is different from black culture in South Central LA. You still gotta do the work just like your white colleagues have to work. You have to do the work to appreciate a group of people and maximize the potential to make an impact on their lives.
Gun shots in foreign battlefields thousands of miles away. The sound of screams and wails piercing the sky. A soldier comes home after a long stint at war overseas and has trouble readjusting to the life that he once knew. These are usually some of the first images that most people are accustomed to when the term PTSD, or post-traumatic stress disorder is brought up. However, what most don’t realize is that PTSD and anxiety occur regularly within our own communities. Every day in America, people of color experience societal “microaggressions” and traumatic experiences that shape beliefs which then may be passed down through the generations. Recently, there have been many examples of microaggressions, whether it is the police being called on African-Americans barbecuing in a park in Oakland or reporting a young black child “illegally” selling water in San Francisco without a permit. Although microaggressions are considered subtle hints of racism, they along with socio-economic inequality and overwhelming traumatic experiences, contribute to the overlying issue of PTSD and anxiety within minority communities. Spend 10 minutes watching the local news and you can be assured that there are going to be stories about a young black or brown person being killed or involved in either a criminal or violent offense. As a result, the community becomes deeply affected and its residents develop paranoia and distrust of outsiders or authority figures. For 4 years, I worked in East Flatbush, Brooklyn often considered one of the most dangerous and crime ridden parts of New York. Although I loved my time there and became deeply connected to the culture and local community, the evidence of PTSD and anxiety throughout was evident. Many residents are of Caribbean descent and live on fixed incomes in areas that can be prone to violent crimes. There are less job opportunities and more overcrowded subsidized housing. These factors breed highly stressful environments which can lead to trauma, anxiety and depression. According to the National Comorbidity Survey, 48% of men and 49% of women who were diagnosed with PTSD also suffered from depression. In dealing with these stresses, many may also turn to alcohol and substance abuse to cope. These experiences are then transferred throughout the generations and become cyclical. As a result, our neighborhoods may feel like an urban battlefield; Navigating lack of resources, higher crime activity, substandard housing and higher negative police encounters can be comparable to a soldier walking through a minefield trying to avoid trip wires and explosives. That nervous feeling that occurs when a police officer drives by, or the paranoia that arises when a black person is suddenly in an all-white environment, are very real characteristics and mindsets that have been learned and repeatedly hammered home by society. We also must identify that these experiences are not limited to simply being “poor and black”. Many minorities from all different backgrounds experience varying amounts of trauma. Although I am a health care professional with a doctorate and no criminal record, I too have been harassed while visiting friends in nice neighborhoods, as well as being questioned as a suspect because I “fit the profile”. I have gone to the funerals of childhood friends who have been lost to gun violence and visited family members who are serving life sentences. When I see flashing blue and red lights in my rearview mirror, my chest tightens, and adrenaline flows with anticipation of what may happen next. I drive with my wallet in my cup holder, so that just in case I get pulled over, I won’t be mistaken for reaching for a weapon. My story is not unique, as there are many other minorities who experience the same, if not greater levels of psychological stress. This illustrates that it is important to acknowledge that being a black or brown person in American can be a traumatic experience. That no matter what your socio-economic status, it is still possible for anyone to be affected, and accepting this fact is another necessary step in continuing to battle the mental health stigmas in our communities.
Comedian Dave Chappelle once stated, “The worst thing to call somebody is crazy. Its dismissive, I don’t understand this person so he’s crazy. That’s bull***, these people are not crazy, they’re strong people but maybe their environment is a little sick.” Crazy. The buzzword that raises eyebrows and makes people cringe. Being associated with “crazy” or “mental illness” is like wearing the Scarlett Letter, and in minority communities this idea is even more prevalent. For most minorities, mental health is treated as a taboo subject; the giant elephant in the room that is almost never talked about. In most of these neighborhoods, depression was seen as a “white issue” and being bipolar meant that you were just crazy. Having suicidal thoughts meant that you were weak-minded. Growing up, I was taught that the sole treatment for most mental issues was going to church and relying solely on prayer. The stigma of mental health was like that faded stain in your favorite shirt; no matter how much you try to scrub it and clean it, it still shows up. 1 in 5 Americans will experience a mental health issue, yet most will not seek treatment. According to the National Alliance of Mental Illness (NAMI), the leading mental health advocacy organization in the country, African Americans and Hispanic Americans only seek treatment at half the rate of their White counterparts. However due to the recent alarming increase of mass shootings and celebrities making controversial, shocking statements, mental health is now in the consciousness of most Americans, and more specifically the black community. The key is treating mental health just as one treats diabetes, hypertension or any other chronic condition. Mental wellness is a large, complicated issue and it may require treatment from mental health professionals (i.e. therapists, psychiatrists) who can help diagnose symptoms and develop successful treatment plans similar to a person with heart issues going to visit a cardiologist or having a cavity and going to visit the dentist. Normalizing the idea of mental health treatment through education not only helps the affected person, it teaches society how to treat them as well. Social acceptance, general encouragement and support from friends and family may help keep people on the right track as well. Making mental health normal is not only necessary, it’s the first step in erasing the myth that you have to be a certain skin color or belong in a selective tax bracket to be affected. In addition, most people who are struggling with mental illness feel alone. They feel isolated and disconnected from society. It is a huge burden for a person to carry and can only lead them further down the rabbit hole. These individuals should be encouraged to share their experiences with others who are going through the same illnesses. During my senior year in high school, my 3-year-old nephew was shot and killed in an accident and as a result, I struggled with depression for several months. Blaming myself for his loss. I hardly slept and could barely eat. It felt like I was sleepwalking through life, trapped in a constant fog of sadness, helplessness and anger. Why did it happen? Why didn’t I do more? I had questions that I felt no one could answer. It was only after talking with others who experienced the pain and heartache of loss, as well as going to therapy with an open heart and mind, that I was able to recover and release. Confronting my emotions and doubts instead of burying them. I had to reteach my brain that accepting help is ok and that we are all vulnerable sometimes, and that sometimes your greatest strength comes from being weak. I had to unlearn lessons which my community taught me; That as a black man, you keep everything inside and show no emotions. Our community must learn that talking about mental health is not a “white thing”, or a “rich people” or a “woman” thing, it needs to be for everyone, regardless of where you come from or the color of your skin; and this is the first step that we can take to not only break the stigma, but permanently delete the stereotype.
Relationships play a major role in our daily lives, whether it is between family, friends, your boss or your favorite (or least favorite) coworker. In the health care world, the relationship between patient and caregiver is essential in ensuring that each patient receives the best care possible. Recently, a story about a patient being denied her medication from a pharmacist has grabbed national headlines and in turn, highlighted the importance of creating a productive patient-caregiver relationship. A woman who just experienced a miscarriage drops her prescription to the local pharmacy to get it filled. She returns the next morning to discover that not only was the medication not filled, but that the pharmacist on duty decided that filling the medication, which can sometimes be used for abortion, conflicted with his personal beliefs and decided not to fill the medication. He then transfers her medication to another pharmacy, which in turn fills the medication for her. Was the pharmacist right in his beliefs? Should he be fired? Should pharmacists just shut up and fill whatever medication was prescribed? When it comes to healthcare, there is no black and white; no eternally right answers, no sure fire right way to do anything. No decision is ever clear-cut and in essence we use our discretion and judgment on a daily basis, whether patients know it or not. The problem is when that discretion comes under fire, it then has to be defended. Trust is the backbone of health care, patients must trust caregivers and vice versa, but in this unfortunate situation, that trust was shattered. As an ethical professional, establishing trust and effective communication is not only a priority, it’s a necessity. Now let’s start with the facts. Contrary to popular belief, pharmacists are not robots, and companies technically cannot force them to fill or dispense medications. In a sense, healthcare professionals are independent contractors; they may work for an entity but because they are individually licensed, they are free to use their discretion. Many times, pharmacists use this discretion to question medications from a suspicious doctor, question whether a drug interaction is safe, or question whether a prescription is legitimate. However, with this discretion, comes great responsibility. It is not the role of the healthcare professional, to play judge and juror. It is merely our role to be reasonable and to take care of patients. Transparency, compassion, and gaining patient’s trust is essential and unfortunately none of these goals were accomplished in this incident. Compassion for others and empathy for those who are vulnerable must always be considered. In this situation, instead of speaking to the young woman in front of a busy line of patients, the pharmacist perhaps could’ve escorted her to a private consultation area, showed empathy and concern, been transparent about his beliefs and made a conscious effort to ensure she was taken care of. It’s possible that the patient would not have felt belittled or embarrassed and would have been more open to an alternative solution. After suffering a miscarriage, clearly the young woman was in a vulnerable state, so making her recall her painful experience in front of strangers only escalated the situation. My mother, who was a kindergarten teacher for 30 years, always used to tell me, “it’s not what you say, it’s how you say it.” In my experience, I’ve dealt with many patients who were going through various situations and I learned that effective communication solves many problems. Unfortunately, basic communication is a lost art. Because of the lack of the communication, a minor situation was escalated into a national story. In the future, hopefully healthcare professionals continue to foster solid relationships with patients built on trust, mutual respect and compassion.
By Dr. Charles Johnson Pharm. D