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A Bitter Pill: How The Medical System Is Failing The Elderly Paperback – Sep 28 2009

4.7 out of 5 stars 3 customer reviews

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Product Details

  • Paperback: 272 pages
  • Publisher: Greystone Books; 1st edition (Sept. 28 2009)
  • Language: English
  • ISBN-10: 1553654552
  • ISBN-13: 978-1553654551
  • Product Dimensions: 16.5 x 1.7 x 21.9 cm
  • Shipping Weight: 363 g
  • Average Customer Review: 4.7 out of 5 stars 3 customer reviews
  • Amazon Bestsellers Rank: #138,889 in Books (See Top 100 in Books)
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Review

There is real anger in his newly released book . . . Sloan's experiences of seeing energetic patients transformed into near-zombies because of over-medication after trips to the hospital, have led him to call for radical changes to medical treatment for the elderly—including keeping them out of the hospital, if at all possible. These seemingly common-sense recommendations are radical because they swim against the stream of modern medicine. —The Province

(2009-11-28)

Sloan's experiences of seeing energetic patients transformed into near-zombies because of over-medication after trips to the hospital, have led him to call for radical changes to medical treatment for the elderly—including keeping them out of the hospital, if at all possible. These seemingly common-sense recommendations are radical because they swim against the stream of modern medicine. —The Province

(2009-11-28)

Frail old folks gobble up health-care resources—and too often gain no benefit. That's the message in Dr. John Sloan's provocative new book, A Bitter Pill: How the Medical System is Failing the Elderly. A Vancouver family physician, Sloan has spent the past 15 years doing home care exclusively for old people. —Toronto Star

(2009-12-03)

The good news is that at least a few Canadian physicians have developed a way to practice medicine that is tailored tothe unique needs of [the elderly], an approach that increases comfort and dignity, allows the frail elderly to stay at home in comfort longer and choose the terms of their final days. John Sloan is the Vancouver-based general practitioner and UBC Medical School professor who has pioneered this new approach, which is long on common sense and kindness and notably short on high tech interventions and expensive multiple medications. He makes the case for it in his 2009 book A Bitter Pill: How the Medical System is Failing the Elderly. —The Tyee

(2010-07-26)

Dr. Sloan treated the elderly at home for many years. (Yes, he made house calls!) His recent book, A Bitter Pill, is an utterly convincing indictment of the way we're wasting money on useless care for the elderly, while making their lives worse. It's essential reading for anyone who's interested in health-care reform, as well as for anyone who's responsible for an elderly person or anyone who is or will become one. —Globe & Mail

(2010-11-11)

About the Author

John Sloan, MD, is a senior academic physician in the Department of Family Practice at the University of British Columbia and has spent most of his thirty years of practice caring for the frail elderly in Vancouver. He has lectured throughout Canada and in Europe and the United States, and is sought after as an inspirational speaker on geriatrics. He lives in Vancouver and Roberts Creek, B.C.


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Format: Paperback Verified Purchase
In our pursuit of healthcare reform in Canada we need to seek models of what is good and what failures exist. John Sloan has shone a powerful
light on the care of the elderly and found it wanting. He proposes an attractive alternative based upon his own working experience. During these times of diminishing resources his suggestions for change must be considered by all those concerned. It is a win for all concerned!
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Format: Paperback
While Dr. Sloan tends toward the repetitive, this book is a must read for anyone who provides care for the fragile elderly. The focus of this book is on how medications can adversely effect the functioning of the fragile elderly and how the fragmentation of the medical system can contribute to a decline in their quality of life. Dr. Sloan's practice is focused on the elderly and is home based. He sees the effects of prescribed medications which follow the protocols developed with younger people in mind. He makes the case that medications very often cause side effects which adversely effect function and therefore the quality of life of the fragile elderly while likely doing little of benefit. He warns that a trip to hospital can often exacerbate impaired function when multiple specialists prescribe multiple medications without communicating with general practitioners. If you are involved in the care of a fragile elderly person, this book is for you.
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Format: Paperback Verified Purchase
Sloan provides practical guidance for the elderly and those who love and support them about how they can gain the greatest benefit and avoid the worst impacts from a high quality medical industry. From his own experience he sets out the challenges of frailty and fragility, suggests broad insights and principles about where medical care can help but what problems it can cause, and highlights the changing circumstances and capacities of aged people and of each aged person individually. I bought a copy while supporting my own 96 yo mother, then bought several further copies for my brothers and friends who are also supporting elderly parents - all of whom read it, often compulsively, and passed it on. Perhaps this is one of the books of our generation, happily appearing for us just as we need it.
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Most Helpful Customer Reviews on Amazon.com (beta)

Amazon.com: HASH(0xa15d5630) out of 5 stars 8 reviews
13 of 13 people found the following review helpful
HASH(0xa15e81c8) out of 5 stars Makes me want to stand up and cheer Nov. 1 2010
By Kristi Swede - Published on Amazon.com
Format: Paperback Verified Purchase
As a person who takes care of the frail elderly in a hospital setting every working day, Dr. John Sloan's book makes me want to stand up and shout! It is as if he looked over my shoulder to see the insanity I deal with every day - elderly people who'd be better off at home, yet are now in a system designed to "rescue" the critically ill and injured, but only put them at risk while wasting valuable resources.

Some days, I can hardly bear to see what we do to/for our elderly, or what is considered the standard of care for people who are too frail to benefit from preposterous and potentially harmful interventions, yet aren't offered even the simplest kindnesses or basic interventions - hot tea, a warm blanket, an appetizing meal, or prompt toileting.

Dr. Sloan is no easier on the system which is sagging under the weight of care to a full house of those frail elderly who cannot and do not benefit from gee-whiz medicine, and daily regimens of three dozen pills, as the critically ill pile up in the ambulance bay and emergency room hallways.

Dozens of solutions are proposed every day. One of the simplest is offered here - compassionate, thoughtful, appropriate care of the elderly. Facing some very hard truths about what aging really involves, and how it inevitably ends, no matter how you intervene. But as Dr. Sloan shows, how you intervene does matter, but it doesn't always have to involve the heavy machinery of modern medicine.
7 of 7 people found the following review helpful
HASH(0xa15e8414) out of 5 stars THE NEEDS OF THE FRAIL ELDERLY May 31 2010
By W. Sheridan - Published on Amazon.com
Format: Paperback
The North American population, along with the rest of humanity, is ageing at a predictable rate. Longevity is increasing, and the median age is on the rise. The United Nations predicts that the challenge of ageing will be one of the most important social issues of the 21st century. Most countries are NOT adequately preparing for this challenge.

Amongst the elderly, some are healthy and robust, but many are not. Dr. Sloan visits and attends to those seniors who are both frail and ill. Their numbers will only grow as longevity continues to increase and medical intervention continues to innovate. Regrettably however, conventional medical practices do NOT serve the needs of the frail.

As Dr. Sloan sees it, there is a radical disconnect between the methods of conventional medicine and the needs of the frail elderly. In most cases these people are suffering from multiple pathologies, their systems can no longer benefit from standardized medication, and their primary concerns are to maintain simple functions and gain some degree of comfort. More tests, more procedures, more drugs - none of these will any longer help.

What WILL help is to listen effectively to their articulated needs, and administer the kind of assistance that will restore functioning (walking, eating, etc.) and produce comfort (easing pain and constant worrying). None of this is really very hard to do - BUT it will only likely happen in the context of an understanding of both the benefits AND the limits of conventional medicine.

This is the case that Dr. Sloan makes. The available evidence clearly indicates that his is correct. The demographic trends now underway suggest that the current situation will only worsen. Both medical care givers AND the elderly themselves need to read this book, and then pass it onto someone in a policy-making role. Only through the coordinated actions of the elderly, medical practitioners, and health policy-makers can the true needs of the frail elderly be administered to, and the costly mis-application of resources be corrected.
7 of 7 people found the following review helpful
HASH(0xa15e8654) out of 5 stars Required Reading Sept. 22 2010
By M. McConnell - Published on Amazon.com
Format: Paperback Verified Purchase
Dr. Sloan relies on his wealth of patient care experience and specific examples to articulate what is wrong with how we care for our elders. He does this without preaching or seeming condescending and I think that is a reflection of the passion and compassion that seem to have been the motivation for this work.

I highly recommend this to anyone in health care (like me) who cares for the elderly, is elderly, or has plans to become elderly.
4 of 4 people found the following review helpful
HASH(0xa15e87f8) out of 5 stars Very humane book Aug. 13 2011
By S. N. Rivera Burgos - Published on Amazon.com
Format: Paperback Verified Purchase
Very humane and inspiring book. Lots of ideas about caring for elders and for ourselves when the time comes. Dr.Sloan is totally dedicated to visiting his patients in their homes, he also cares about all the elderly, wherever they are and whoever they are. It's a beautiful book. Thank you Doctor!!!
2 of 2 people found the following review helpful
HASH(0xa15e86cc) out of 5 stars Practical, caring insight for elder support Dec 21 2013
By Richard D. Mckellar - Published on Amazon.com
Verified Purchase
Sloan provides practical guidance for the elderly and those who love and support them about how they can gain the greatest benefit and avoid the worst impacts from a high quality medical industry. From his own experience he sets out the challenges of frailty and fragility, suggests broad insights and principles about where medical care can help but what problems it can cause, and highlights the changing circumstances and capacities of aged people and of each aged person individually. I bought a copy while supporting my own 96 yo mother, then bought several further copies for my brothers and friends who are also supporting elderly parents - all of whom read it, often compulsively, and passed it on. Perhaps this is one of the books of our generation, happily appearing for us just as we need it.


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