Time to start working towards palliative care in DR

Dolores1

DR1
May 3, 2000
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DR needs to drastically improve its palliative care services
The Dominican Republic has the lowest ranking of all Latin American countries surveyed in the 2015 Quality of Death Index, released on 7 October 2015 by The Economist Intelligence Unit (EIU). With a relatively young population, the issue of aging with dignity has not been a priority on public health agenda.
The ranking measures the quality of palliative care in 80 countries around the world. Its ranking is due to comprehensive national policies, the extensive integration of palliative care into the national health service, a strong hospice movement, and deep community engagement on the issue.
The report determined that there is no government-led strategy for the development and promotion of national palliative care.
Other Latin American countries ranked are Chile (27th), Costa Rica (29th), Panama (31st), Argentina (32nd), Cuba (36th), Uruguay (39th), Ecuador (40th), Brazil (42nd), Mexico (43rd), Venezuela (45th), Puerto Rico (46th), Peru (49th), Colombia (68th) and Guatemala (74th).
The Economist Intelligence Unit (EIU) developed the index in 2010 to assess the availability, affordability and quality of end-of-life care in 40 countries, expanding it to 80 countries for 2015 and focusing on palliative care for adults. The study, commissioned by the Lien Foundation, was the first that objectively ranked countries in the provision of palliative and end-of-life care.
The Quality of Death Index is meant to be used as a framework in identifying palliative care issues at the national level, with the opportunity for countries to compare provision with countries in the same region or income groups. It can also be used to assess demand for palliative care, which can support planning of future quality and affordable palliative care.
Download the complete report at:
http://www.economistinsights.com/healthcare/analysis/quality-death-index-2015
 

Kipling333

Bronze
Jan 12, 2010
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I really do not think that there is any organised palliative care system in the DR . Instead of consisting of a team of doctors,nurses , masseurs and domestic help as is offered in richer countries , it is difficult to find even a full time professional minder in the DR. To those people who have not experienced a close family member struggling after a stroke or a bad accident or with debilitating cancer , it may be difficult to understand how wonderful it is to have assistance just to turn the patient over in his bed, or to change sheets, clean the room ot to massage the limbs.
I am a widower and live mainly alone and I have recently been giving this question some serious thought and quite frankly I do not know the answer . It is a golden opportunity for some entrepreneurial people to set up a good business in providing palliative care to the infirmed and elderly . It seems to me that there are openings here to invest in retirement villages that have resident nurses and doctors .
 

william webster

Platinum
Jan 16, 2009
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Kipling, we used to talk about that quite a bit here.... one of us has a background in health care.

Elderly or palliative care is a hot button.

Where are you located?
In my area, we have no trouble finding people to care for the ill..........
I haven't needed it, but I know it's there.
 

william webster

Platinum
Jan 16, 2009
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JD, wouldn't you say that the families look after their own here in RD?

Kip is talking about retired/older gringos who need care.

Yes, I agree, should be easy to do....
Look at all those abandoned hotels sitting around.... not hard to rehab one
 

william webster

Platinum
Jan 16, 2009
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Understood.....

Everywhere in the world = same problem.

The RD advantage is the labor cost and the fact they are generally a caring people.... I find

When I was sick (dengue) the nurse care was great and my own people came regularly to help....
My wife was away - I was alone....

not much fun but well cared for
 

DRob

Gold
Aug 15, 2007
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One would think setting up a facility here to care for older folks would be a piece of cake. The ones I know of run on next to nothing.

That's not saying it's the right way to do it, but a smoothly running place should definitely be doable.

Think there was a discussion on it several months ago. The main issue is that most stateside senior care facilities receive substantial funds from state and federal governments (via medicaid and medicare), and funding from those programs isn't permitted outside of the country.

So, in PR it's a fabulous idea, in DR, you'd have to rely on private funding.
 

Kipling333

Bronze
Jan 12, 2010
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Kipling, we used to talk about that quite a bit here.... one of us has a background in health care.

Elderly or palliative care is a hot button.

Where are you located?
In my area, we have no trouble finding people to care for the ill..........
I haven't needed it, but I know it's there.

I am in the capital but next year I will put my house on the market and move to la Romana which is more central for my sporting activities . I am now moderately fit but am well over 70 . I have had the same staff with me for more than 10 years and they do a very good job but have their own families to care for so do not have much extra time to look after me when ill as I have been at various times after cancer treatment. I have had various additional help but they have not been very good. I will try to find the thread relating to pallative care
 

Kipling333

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Jan 12, 2010
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Yes I have many friends here in the DR, have been here for yonks ,I want to have home care rather than hospital care but ,as I have remarked here , the basis of the community in the DR is very family orientated rather than neighbour or frind orientated . I have little doubt that my friends would visit me when I am in my last years but I think I may need a little more than visits .
 

dv8

Gold
Sep 27, 2006
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i believe dolores was referring to public health system in DR and its problems regarding palliative care: lack of facilities, lack of medication, under trained staff and so on. those with money have means to care of their elderly with more ease than folks in europe, lets say. round the clock nurse care is relatively cheap and a person can still fell safe and happy being at home.

as far as the treatment of the elderly... recently few newspapers run articles about abuse and abandonment of the old folks so clearly there are exceptions to the family oriented closeness of dominicans. but the government seems to notice the problem and is trying to tackle it. there is a project of a law permitting parents to ask their kids for "alimony" of sorts.

there are hogares de ancianos in many cities here and i do not think it's all that cheap to run them. i remember recent article about some sort of care home for kids in POP costing cool 300,000 pesos a month. it would not be that different for elderly: staff, medicine, equipment, entertainment, basic bills, food.
 

william webster

Platinum
Jan 16, 2009
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I am in the capital but next year I will put my house on the market and move to la Romana which is more central for my sporting activities . I am now moderately fit but am well over 70 . I have had the same staff with me for more than 10 years and they do a very good job but have their own families to care for so do not have much extra time to look after me when ill as I have been at various times after cancer treatment. I have had various additional help but they have not been very good. I will try to find the thread relating to pallative care

The thread was more elder care - old age rather than palliative care.

You should be able to find somebody in La Romana.

My wife & I keep the elder care idea in the back of our minds - me more than her.

One idea is to get like minded people in the same vicinity and share the staff costs...
A labor pool , if you will..... like the communes of old days (chime in here MA)
 

william webster

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Jan 16, 2009
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That's not it.... quite a while back...CB was in it.
He's the one with the health care background

Would have been 2010//11 -------- is my guess, 2012 latest I think
 

Hillbilly

Moderator
Jan 1, 2002
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I remember that exchange, and yes Cobraboy was/is quite versed on the subject.

I also remember chiming in on the fact that 30+ years ago my step-sister saw that opportunity here. It would be a fabulous idea.
Still is, in fact.

Dorotea: I think that cost must be RD$30,000..per month...That is a figure I have heard.

As far as the OP original point, palliative care, kind, but untrained nurses are available, and, at least here in Santiago, there is a group of nuns that are specialized in palliative care. All they ask for is transportation and a donation. They took care of my mother in law during her last months.

And yes, William, it would be a very good business to get into. You will notice the increase in private cemeteries??? Oh yes. The business of dying is gaining traction.

HB, not ready to pack it in just yet.
 

william webster

Platinum
Jan 16, 2009
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HB, What ? No bags packed ? Stacked at the door ? hahaha
Not checking out todavia??

Yes, CB had the background.
It is a really good opportunity.... Canada can cost $10-15-20,000/month.... depending.

I'll keep thinking.... it needs $$$$... lots of it to get started

I am enjoying reading your posts...... anew !!!!
Always did ..........

Your Nun suggestion is a perfect church idea/solution.... I had never thought of it.
 

william webster

Platinum
Jan 16, 2009
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HB

The business of dying.... is very much alive !!

How's that ??? for juxtaposition............?? contradiction ??
 

Kipling333

Bronze
Jan 12, 2010
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There is a bit of difference between palliative care and hospice care . I am not thinking of my last dying days but rather my last dying years when I am more decrepid and more arthritic than I am now .
There are also opportunities here for crematoriums and gardens where the ashes are placed under a tree or in a brick wall . I know that we are a Roman catholic country and most people are buried , but I think Blandino Cremations does a roaring business !! but then the ashes are scattered.
 

dv8

Gold
Sep 27, 2006
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Dorotea: I think that cost must be RD$30,000..per month...That is a figure I have heard.

sorry, i think i did not express it well, i meant the costs of running that institution (small house for mentally and physically challenged kids in POP). in terms of paying bills, medicine, food, clothing and so on. the patients themselves pay nothing.
sorry about confusion.