May 292012

Elderly Parents and Their Doctor: How to have a more effective visit:

1. Leave your cell phone in your vehicle. You do not need it in the doctor’s office. The people in the waiting room do not want to hear your conversation. And please do not be one of those people who will answer their phone while the nurse is getting your blood pressure or the doctor is trying to talk with you and/or your parent.

2. Write down your question’s and concern’s ahead of time. Do not rely on your memory. Do not be afraid to ask your questions even if the doctor seems to be in a hurry. You might also ask the nurse some questions. If he or she can not answer them, they will tell you to ask the doctor but chances are they can answer some of them.

3. Tell the nurse and the doctor all the concerns you have at the start of the visit. (Again, write them down.) Different symptoms may be related or not. By knowing all your problems the doctor can prioritize.

4. If your doctor ask you how you are doing the proper response is not, “You tell me.” No one knows how you feel but you. It is up to you to tell the doctor how you feel. In the case of a parent who can’t communicate, it is up to you to tell the doctor how they are doing. You are with them every day, you notice any changes.

5. Describe your symptoms clearly using descriptive words even if you think it sounds weird. How long have you or your parent had this symptom? How severe is it? Does it interfere with your ability to eat, sleep, work, or perform any normal activities?

6. If you have expectations, state them up front also. Sometimes you may be right on target, other times you may need some education.

7. Tell the truth. If your elderly parent drinks two six-packs of beer every night, or uses illegal drugs, these are a few of the health risks their doctor needs to know about. If do not feel you can trust their doctor with this information, find a doctor you do trust.

8. Bring all medications and supplements, or a list of them, to each doctor visit. Bring the ones actually being taken and remember those that are only as needed (or prn in medspeak). If the doctor prescribed a medication and you stopped giving it, let him know. (Actually, you should have called him first to before stopping the medicine). For instance if you stopped taking potassium because it was burning your stomach, the doctor may need to change you blood pressure medication.

9. Make sure you doctor knows every doctor your parent is seeing. This enables them to share test results and treatment plans, prevents duplicate or conflicting medication prescriptions as well as duplicate tests.

10. Bring a record of your parent’s medical history and any medical records you may have such as test results or images from scans or x-rays. (I don’t get copies of all my mother’s labs and tests unless something is really weird. But if we are going to a specialist, even though her doctor’s office will fax the information, I get a copy.)

11. Don’t be afraid to disagree with your doctor. If they are recommending a medication and you do not want to take it, tell him and tell him why. If the medication is too expensive there maybe less expensive alternatives. If you think your parent needs to see a specialist, say so.

12. Do what the doctor tells you to do, take the medication he tells you to take! There is nothing more frustrating than the person who keeps coming to the doctor with numerous complaints but will not take their medication because they do not like to take pills. Why are you wasting their time and your money?

May 282012

I sat on the front porch yesterday as the sun was going down and the trees cast long shadows on the ground. There was a breeze blowing the leaves creating a rustle as if someone were passing through. The birds were chirping, heralding the ending of the day as the crickets and frogs joined in.

There was contentment in moment as I felt you sitting beside me once again. We were back on that Georgia mountain you loved so well, sitting on the front porch watching the firefly’s come out as the Bob White’s called out and sad sound of the whip-poor-will answered back.

Your eyes were twinkling as you told a story as only you could, with your unique expressions that were always so descriptive. Memories of conversations and dulcimer playing arise, happier times, when life was simpler.

Memorial day is a day we set aside to remember those who have given their lives for our country. This year, I can not help but remember those who, like you, stayed home and made sure they had a country to come home to.

You raised two daughters while Grandaddy served in the Navy during WWII. Your stories of how you and your sister Sybil got by made it sound more like an adventure than a struggle. Then again, you almost always found a silver lining and turned it into gold.

Ever the lady, you got courtesy and respect wherever you went. Your warmth and genuine interest in people gained you many friends. Sadly you outlived all your siblings and friends, making your last few years lonelier than they should have been.

But you kept going, kept finding a reason to get up every morning. You always had something you wanted to do around the house or something new to make or a new recipe to try. You never gave up. Death had to sneak up on you in your sleep because that was the only way to catch you.

I thought it might get easier after the funeral, that the pain of loss would ease a bit. But at odd moments memories kept surfacing. I could get nothing done.

I gave up and went outside, called by memories I could not stop. I sat down in the rocking chair and within moments I knew you were there. You drew me down the path of memories then we returned to the present and I finally understood.

I could be with you again anytime, for you would be with me on any porch I ever sit on. And if I listen closely, I can hear you laughing as you tell another story.

May 042012

Elder Parents and Dignity

“My daddy always told me, ‘Once a man, twice a boy,’ and I guess he was right. Now I’m wearing diapers like a baby.” His voice broke on the last words and it was all I could do not to cry with him. Watching this man slowly becoming weaker, becoming more hunched over, his food being pureed because he had no teeth and couldn’t afford dentures, and now incontinence taking the last of his dignity, was painful. He went from walking with a cane to a wheelchair before finally becoming bedridden at the end.

To most people he was a cantankerous old man. I had originally met him when I was seeing his wife, trying to get her blood pressure under control and teach her about her medications. She was as sweet and pleasant as he was ornery and hardheaded. He did not take to me at first, in fact it took several weeks before one day he asked me, “Aren’t you gonna check my blood pressure too?” I was shocked since usually he was more of the, “When you leaving?” kinda fella. Once he decided he liked me though, that was it. No other nurse could come out.

I have no idea why he decided to trust me but nearly every home care nurse has a patient that will trust only them. Perhaps it is because this nurse is the first person to actually see them as an intelligent adult in quite some time. For our older adults this is a refreshing change of pace.

Too often our elderly are treated as if they are simple-minded and ignorant. I have had more than one person ask me a question about my mom when she was sitting right there, as if she isn’t intelligent enough to understand the question. I always make it a point to turn to her and let her answer for herself.

Our society tends to shove older people aside and ignore them at the first sign of declining health. The prevailing attitude is they are behind the times, stuck in the past and of no use to society any more. Nothing could be further from the truth and I suspect all us self-absorbed baby boomers are about to get a reality check as we rapidly enter the senior population ourselves.

The truth is that most seniors today are healthy and active late into life. They are still learning and contributing to the world around them, if only the world would notice. Our current elders who are 70 and older lived through WWII and put a man on the moon. They gave us rock and roll, color television, microwave ovens and the first computers, among many other contributions too numerous to name.

Retro Life

The very least we can do is treat them with the dignity that aging is so cruelly trying to take from them. You never want to see your loved one crying because they feel like they are a child or baby.

They have some interesting stories to tell and a lot of knowledge. Listen to them even if you’ve heard them before. Ask their opinion and advice.

If you notice they forgot something do not jump to the immediate conclusion that they are getting senile. You ever walk into a room and forget what you went in there for? Or run into someone and completely forget the their name? I thought so. If you really think there is a problem, discuss it with them and have it checked out. In the elderly, something as simple as an infection can lead to confusion.

Let them make their own decisions if they are mentally competent. If you think they are making the wrong decision, explain to them why you think so but remember it is their decision, not yours. Respect their choices even if you do not agree with them.

If they have a mental impairment encourage them to make choices such as what they will wear that day or what they will eat. Make sure you keep the alternatives to two or three, such as, “Do you want apple juice or orange juice?”

Maintain their privacy especially if they need assistance with personal care. No one wants their naked body exposed for the whole world to see or to have their incontinence problems discussed with others.

If they have incontinence problems use the term briefs, not diapers. If they must have clothing protectors while eating, do not call the bibs. And if you use a room monitor, do not call it a baby monitor.

Don’t talk down to them as if they are children, they are adults and deserved to be treated as such.

Caregivers often complain about their loved ones behavior, accusing them of doing it on purpose. Understand that much of their annoying behavior may be a result of them trying to exert some control over their own lives. Control you have likely taken from them.

Sure, they move slower now, but these are the same people who held your hand and patiently walked beside you when you were small. The same people who taught you manners, how to use utensils and brush your teeth. Be patient with them, allow them the extra time they need to complete tasks. You probably need to slow down a bit your self.

One more thing to think about. You are demonstrating to the next generation how you want to be treated when you get older.