ORANJ
2008 Fall Plenary Meeting Attracts Largest Ever Audience
About 125 people attended the Fall, 2008 meeting of ORANJ on October 15 at Arbor Glen. In welcoming the audience, James Wells, the CEO of the CCRC commented on a number of positive changes that he had noted. These included the greater empowerment of residents along with greater involvement of residents in governance of their CCRC. He also said that “the ears of management are more open.”
The morning speaker was Carol Ann Campbell, Medical Staff Writer at the Star Ledger since 1998. She has received awards for her articles including those on medical mistakes, iatrogenic (hospital based) infections, and treatment at the end of life. She noted that end-of-life issues are especially troublesome in NJ, in part because of the heavy marketing by pharmaceutical companies, who are very prominent in NJ, and intense public relations efforts by hospitals. As a result, we spend more during the last six months of life than any other state. In searching for information on outcomes she found that people in NJ are more likely to die in intensive care, to have more tests and to see more specialists and yet do not live longer or feel better than people in other states. When she studied the lives on real people, she found that New Jerseyans are more likely to die alone with heavy bruises from testing and treatment.. In addition, NJ has a greater percentage of people receiving nursing care in hospitals, rather than in nursing homes, an unnecessary expense. Because doctors spend little time talking to patients or their families, they do not have sufficient information to write effective “Living Wills.” Without the necessary information, many patients’ families suffer needlessly about whether to “pull the plug” at the end of life. She called it a “conductorless train” where no one is looking at the big picture.
She contrasted the situation in NJ with that of Utah where minimal end of life treatment is the norm. In that state, nurses try to get patients out of the ICU (intensive care unit) as quickly as possible and to encourage effective communication with physicians. As she pointed out, for many patients it is more important to have a conversation than just another round of chemo. Because most people die from chronic illnesses, we are wasting money with futile treatment. In many cases, a hospice program that offers palliative (comfort) care is more appropriate and much less costly.
A major culprit in the current medical climate is the specialization of medicine. We are moving constantly to more specialized, more hospital based care when studies have shown that less care can lead to better outcomes. For example at the Mayo Clinic, medical care is low cost and ranks high in patient satisfaction. To illustrate her points, Ms. Campbell described patient care in Utah, where end of life treatment is minimal. “Slow Medicine” is commonly practiced, where patients are maintained at home as long as possible. Along with hospice, patients receive “high touch” care which can provide more comfort than high tech testing and interventions. She described one patient who told his hospice care givers, “All I want is two Texas wieners and a bubble bath.” Hospice provided both and he died, contented, within a week.
The afternoon session was devoted to energy issues and was given by John Shure, President of NJ Policy Perspectives. He described the challenges and goals of the energy master plan of NJ. The four challenges are that (1) the growth in supply of electricity is less than demand, (2) energy prices are rising, (3) global warming is increasing, and (4) NJ has less control over supply and demand. The five goals are (1) to maximize conservation and efficiency, (2) to reduce peak hour demand by 20%, (3) to obtain 22.5% of electricity from renewable energy sources (we have 2% today), (4) to develop power plants with higher carbon energy effectiveness, and (5) to invest in clean technology.
To meet these goals we need another nuclear power plant to create electricity at reasonable cost. We also need to dramatically reduce consumption and one of the best way to achieve this is to change the current building codes. In addition, we need to build offshore power generators with wind farms. We don’t need to build them where they irritate inhabitants. We can build plants 20 miles off shore that will yield enough power to supply thousands of homes. We can also encourage the construction of solar panels on rooftops. NJ does not have to rely on natural gas from Texas. No one is happy with the status quo and a master plan may help. We are already a leader in harvesting wind and solar power and both political parties believe that nuclear energy must be part of the solution for NJ.
-Ellen Handler
