Hospitals & Medical Settings
These early institutions offered custodial care, not cure, to people without family support, including those considered "immoral" and "incurable."
What is an almshouse?
This form of elder care is preferred by most older adults, even though it is difficult to finance and find reliable workers.
What is home care/aging in place?
This emergency technology became mainstream not because it works well, but because it gives families and clinicians a sense of having done everything possible.
What is CPR?
Under Medicare rules, hospices risk losing money if patients live beyond this timeframe, incentivizing them to enroll patients with predictable disease trajectories.
What is six months?
Most of long-term and hospice care is provided by these certain individuals and not by institutions.
What are family members?
or women, immigrants?
These early hospitals emerged to care for the "deserving poor," but only as long as they weren't chronically ill or contagious.
What are voluntary hospitals?
This financial dynamic forces middle-class older adults to deplete their savings for what kind of assistance?
What is the medicaid spend-down requirement?
To qualify for long-term care coverage.
Emergency departments and ICUs regularly participate in this sociological process, which frames death as explainable and meaningful--often through highly interventionist medical action.
What is death brokering?
This short-term level of care supports caregivers by temporarily admitting the patient elsewhere.
What is inpatient respite care?
Although now legal in states such as Oregon, California, Vermont, this practice still faces opposition, especially from the AMA, which maintains and ethical stance against it despite shifting professional attitudes.
What is medical aid in dying/physician-assisted suicide?
This two early medical breakthroughs, also known as the two main enemies of early hospitals, dramatically reduced hospital mortality and helped shift the hospital's reputation from a place of death to a place of cure.
What is germ theory/antiseptic measures and anethesia (ether)? Or what is pain and infections?
Despite being highly profitable, these facilities lack meaningful government funding and often rely on à-la-carte billing systems that push costs onto residents, reinforcing a stratification in elder care.
What are assisted living facilities?
What is the technological imperative?
In 2018, 27.9% of patients in hospice receive this many days of care.
What is 1-7 days?
She founded the first modern hospice, St. Christopher's in 1968 England.
Who is Dr. Cicely Saunders?
Due to lack of government regulation, this 20th century shift meant hospitals became less community-oriented and put more focused on efficiency, technological acquisition, acute illness, patient selection, and financial sustainability.
What is corporatization of hospital care/profit-driven hospital management?
Diamond describes how regulatory requirements--such as charting "units of nutrition"--can shape care by prioritizing documentation over residents' lived experiences, illustrating this concept.
What is the commodification of care?
This national movement pushes families to talk before a crisis, challenging the assumption that proxies will "just know" a patient's values, and countering the medical system's tendency to overtreat in the absence of explicit discussions.
What is The Conversation Project?
This type of hospice care accounts for more than 98% of all hospice services and is most often provided at home.
What is routine hospice care?
These three population trends drive the demand for long-term care.
What is more women working, fewer children, and higher geographic mobility?
What is medical technology changes like lower mortality, improved living conditions and nutrition, immunizations against childhood illnesses, safer childbirth, life-saving technology.
Similar to the experience in nursing homes, these institutions diminished personal identity by subordinating individuals to organizational routines and bureaucratic control.
What are total institutions?
This is a specific example of a model of long-term care that aims to replace large institutional nursing homes with small, home-like environments where elders live in groups of 10-12.
What is the Green House Project?
These are three examples of advanced directives that allow an individual to take control over their own end of life care.
What is a living will? What is a durable power of attorney for healthcare? What is a DNR?
Name two to three of the different levels of hospice care.
What is routine hospice care? What is continuous home care? What is general inpatient care? What is inpatient respite care?
Only __% die at home, and about __% in a hospital, and the rest in a nursing home or long-term care facility.
What is 25% and 60%?