Tuesday, November 3, 2015

Dare Mighty Things

"The contents of this [blog] are personal and do not reflect any position of the US government or the Peace Corps."

I left the Peace Corps conundrum last time discussing how I think that the benefit that I will have given my patients will far outweigh any negative experiences. And yet, lo and behold, I just read a study about nursing home populations and I may be re-thinking that.

The study looked at four groups, one in which the residents received no visitors and the second where visitors were unannounced and occurred sporadically without warning, the third where there were visitors but they could not control when the visit occurred but knew that it would and the last was when they could decide when the visit occurred. And while the group that received no visitors did the worst, the two groups where there was some level of control or predictability had significant improvements in their function and health.

So that's a good thing right? I'm creating some structure, autonomy and social interaction in patients, many of whom have had very little of any of this over the years. The pitfall is what happens when I leave?

The follow-up of the above mentioned study was looking at follow-up function and health status of the groups. Did the groups with the structure and predictability return to their prior levels of function and health? Nope. They actually got worse. Those groups actually dropped to levels worse than the group that never had any visitors.

So that answers that: It is better to never love at all then to love and lose. 

Or does it? I still like to think of Teddy Roosevelt's quote:
 Far better is it to dare mighty things, to win glorious triumphs, even though checkered by failure... than to rank with those poor spirits who neither enjoy nor suffer much, because they live in a gray twilight that knows not victory nor defeat.

To love and lost still may be a better option.

Better still is to love and keep that love. That's the plan for my patients. I am going to work as hard as I can to instill upon my coworkers the necessity for continuity of care and to lead by example so hopefully there is no rebound effect but rather that these patients just keep getting better.

Until next time,


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