the blind in home health aid and the elephant which is health

I was watching my father struggle to get out of bed. He leans forward, at almost an 90 degree angle to the floor. Needless to say, that's dangerous. He could easily fall over.

I think that the mechanics of this is: he's supposed to use his legs more.

Why doesn't he use his legs more? Are they too weak? Well, he's just finished several weeks of physical therapy. And, according to the supervisor in question, my father has met his goals. (Ergo, there won't be more therapy.)

Frankly, I am pissed off. I am reminded of the old parable of the blindmen and the elephant. Each grabbed a different part of the elephant, and each came up with a quite plausible view of what the thing was---plausible from the individual blind man's point of view. (If you are blind and grab the elephant's trunk, you might think it was a snake. If you are blind and grab the elephant's leg, you may think you've got hold of a tree trunk.)

However, there's something else going on here.

The money men who own the health companies in the USA want proof of results. They don't want their money wasted. That's why there are "quantifiable" goals, etc. That's why there is excessive scrutiny and control of home visits. And that's why students in the USA are weighed and measured at every available opportunity.

But, you can define your goals so that you know in advance they can be reached. (When President Johnson decided to make "war" on poverty, poverty was defined in such a way that he could reach his goals.) I don't think, for example, the PT would list as a goal: Our goal is for the patient to be able to walk more safely, to get out of bed more safely, and to move from sitting to standing more safely. A "better goal" is: the patient can walk 200 yards without getting tired.

Well, I could be wrong. I haven't actually read all the paperwork created by these home visitors.

But my doubt remains. My father has met all of his goals (as defined by the home care agency), but I don't think he is safer when he moves from a sitting to a standing position. He is not safer now than he was before all of these home visits. And if the Money Men far away in a nicer place have ultimately decided that we need reachable goals, and thereby squeezed genuine health and safety out of the picture, then I should blame them.

So, I see the same illness at work in the system of education and the system of "health care". Teachers and administrators (and parents) focus upon artificial tests, and (ultimately) jobs. But the tests do not measure creativity or freedom or open-mindedness. And the jobs that people aim at do not need creativity or freedom of thought; they need people who know how to follow orders and shut up. (And what if a loving parent has only known such a job? And what if a loving parent cannot imagine a different job for their children?---My own answer is that such a scenario would be a sort of hell. I do not know that it is reality, but it would represent my own worst fears....)

I hesitate to confront the physical therapist's assistant with this diagnosis, as she has so little power within the system. She is, after all, following orders. Moreover, my mother (and father) enjoys (enjoy) her company, and that counts for a lot.

So, in the end, I resort to blogging about the problem. I suppose my fondest hope would be if someone with a similar problem gets some insight from what I've said. It has always meant a lot to me when I learned that a problem which I faced was not just my problem, but part of a more general pattern.

After-thought:

Don't get me wrong! It is a good thing that a physical therapist has visited my father in his home. It is a good thing that the physical therapist's assistant has done exercises with my father and corrected his walking, as well as his movement from sitting to standing. It is good that my parents have not been thrown out into the snow.

Nevertheless, I think I can see features of the system which are bad. And, I think I can imagine what a better system would look like. And, I think I know who is to blame for this much-less-than-perfect system.