The life experiences of two characters in Skloot's The Immortal Life of Henrietta Lacks can help us understand more about the role of the geriatric DPN. Both Henrietta and her daughter are black women from poor families, lacking in education. For both of them, poverty and ignorance are major obstacles to health care.
Henrietta died from advanced cervical cancer, a disease that is treatable if caught early. In her case, both the distance from medical care and the alien quality of the generally white male medical establishment formed obstacles to her care. Lack of communication and her tendency to regard medical staff as authoritative rather than responsive both were obstacles to care. For the DPN, this suggests that social factors are as important in care as purely medical ones. To treat patients like Henrietta, the DPN needs to offer accessible care in local communities rather than just care in distant urban hospitals. Also, the DPN needs to take the time in consultations to ensure that the patient really understands the medical issues in full, rather than just assuming that nodding and agreeing means understanding.
Deborah suffered from diabetes, and her discussions with Skloot show the issues of management of chronic diseases in poor, uneducated rural people. The geriatric DPN is often engaged in treating chronic diseases such as diabetes, high blood pressure, coronary diseases, cancer, and dementia. For these diseases, preventive medicine, regular testing, and patient compliance with treatment plans are often a key to disease management. Patients such as the Lacks family do not have a network of middle class, educated family members to support their care. Thus much of the focus of the DPN needs to be on making care and medication easily available on a regular basis, educating the patient, and having some way of monitoring compliance, perhaps through mobile apps and perhaps through coordination with social services. The main lesson the geriatric DPN can learn from this book concern how the social and economic circumstances of the patient can affect care.
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