Sometimes it seems we fight insurance companies, physicians, hospitals, care facilities and on and on. It can be a battle just to get a prescription refilled or to get a medical appointment in a timely manner. We’re all just so busy and it’s easy to lose a temper. I always remember someone in my family saying, “you catch more bees with honey” or “patience is a virtue”. It certainly is, a virtue sometimes lost. However, making the same request ten times because I’ve been transferred to ten different people, sometimes it’s difficult to speak with a honeyed tongue. Or when I know more than the customer service representative on the other end of the telephone. This is the time when I take a break, go do something pleasant and come back to the phone with a pleasant tone of voice asking for help.
Archive for June, 2008
Many times caregivers become frustrated and just give up. Most caregivers are friends or family members who are untrained to provide care. It’s no different than a lay person trying to repair a car engine. A car mechanic can get the work done in half the time with accurate results and at a reasonable cost. Sometimes caregivers just spin their wheels. When you are frustrated and ready to give up, ask for help. Consult a professional, go to a support group, ask for help, find a way. You don’t have to be an isolated caregiver and you might be surprised just how reassuring help can be.
Thank heavens for friends and neighbors. They help most of the clients I serve. It if were not for them, many of my clients could not get along on a daily basis. This assistance has pluses and minuses. Friends and neighbors help with tasks like grocery shopping, laundry, errands, meal prep and the like; assistance that many older people need. The downside is that sometimes the older person becomes totally dependent on the friend or neighbor and will not act independently even if they are able for fear of losing the help or the friend. If the friend or neighbor cannot continue to help, anger, nagging and many negative emotions sometimes result. Sometimes it’s best to help but not do everything. Discuss other options for assistance like paid help. Let’s face it, most caregivers who are family or friends donate about 13 hours per work, unpaid. Rejoice in the friendship and not the work by talking to your friend about hiring some paid help to supplement your assistance. This may help them appreciate you more and may save your friendship in the long term.
Continuing yesterday’s subject of leaving a care facility. I recently had a client who was told he could not go home due to a medical condition. Interestingly, the medical condition kept recurring and were treated over and over again. One question was never asked, “why is the medical condition recurring and what can we do so we don’t have to keep treating it?” Answering this question would have been too simple. It would have actually resulted in a possible solution and my client would then have been able to go home. But, solutions to medical conditions are not necessarily the responsibility of a care facility. The responsibility of a care facility lies mainly in helping individuals maintain health, not necessarily improve. Sure this sounds callous. There are many wonderful care facilities, however as with any specialty they are limited in their scope of services and treatment. Again, if you want to take charge of your own health, become educated about your health and your rights.
Ever know an older adult who was having difficulty being released from a care facility, a nice word for a nursing home? This happens more and more frequently. “Mr. Smith, you can’t go home without 24 hour care or Mr. Smith you can’t go home at all”. “Mrs. Doe your care needs exceed what you can receive at home.” Sometimes it’s true. Sometimes it’s the dollar talking. You’ve passed your Medicare days and you’re paying the facility the 21-100 day co-pay of $128 per day in 2008 or you’re paying a full ride. Of course the care facility wants you to stay, you represent revenue. Nevertheless it is possible to go home even when you are told otherwise. The best way out is to become educated and know your options, better yet, call me and I’ll be happy to help.
One of my clients was taken to the emergency room several weeks ago because she was non-responsive. I rushed across town to meet her and felt like I was watching the television show, “Grey’s Anatomy” (one of my favorites). My client was in a triage room surrounded by six or seven people in scrubs. After hours of tests, we thought she had a stroke, it was discovered that a medication she was given three days ago had a major negative reaction with her system and practically resulted in a coma. Medication issues are a major cause of admission to the emergency room for older adults. Not taking medications as prescribed, or taking too many medications. Combining medications and over the counter treatments. Know what you’re taking and ask your physician about combining medications. Make sure all of your allergies are listed at the pharmacy so the pharmacy can trouble shoot if a physician prescribes something that may cause a negative reaction.
Taking prescriptions, just one list of things many of us do every day. Which reminds me as I sit here that I forgot to take my multitude of evening vitamins; vitamin C, fish oil capsules, multi-vitamins, multi-minerals, glucosamine and of course calcium. I take more vitamins than most people but they’ve seemed to serve me well over the years. Back to prescriptions drugs, most of my client have no idea what they are taking or what the little yellow pill treats. Sometimes they take pills that counteract with each other because they come from different physicians who don’t know another is also prescribing medication. Major recommendation, research the prescriptions you take and ask questions.
I always ask my clients if they’ve looked at their medical history or charts. Most haven’t. So when I begin working with clients and I pull their medical history many times they are surprised to learn they have congestive heart failure, kidney disease or another ailment. Actually on many occasions, they are shocked and say something like, “why didn’t my doctor tell me?” My response is usually that the doctor told you but maybe you weren’t listening or perhaps it was stated in a language you don’t understand or maybe the physician talked around the issue. After all, most doctors don’t want to give news that isn’t going to be received well. Sometimes they coat it with statements like “your kidneys aren’t working like they used to but at your age this is common”, here’s a prescription. So we take multiple prescriptions for reasons we’re not sure.
Physicians diagnose conditions and illnesses. This is their specialty. This is their job. But what about all of the other things like recommending vitamins or supplements? Or discussing the fact that a patient should lose weight, stop smoking, exercise, eat better, laugh or smile more? Patients need to hear these bits of wisdom and recommendation from their physicians. Heaven knows that these words out of the mouth of a family member are taken with little regard and may be seen as nagging. But have a physician tell a patient what to do and they listen, or at least sometimes they listen. We just wish they would tell us more practical things we can easily understand. Like, patient, if you continue to smoke you are at risk of a stroke or heart attack or worse even bypass surgery or lung or bladder cancer. Make the action real and the consequences even more real. Get our attention before it really is too late.
Caregiving is challenging enough without the challenges of having to work through the medical system. For an older adult just having to contact an insurance company to ask a question can be challenging, for a family member or friend it’s just plain frustrating. The “phone trees”, press one for this, two for this, three for this are on almost every medical line one calls. What happens when you don’t know what number to press so you press nothing? You are disconnected and have the pleasure of starting over again. It’s not wonder people just give up and the insurance companies win. I’m sure that’s what they hope; it probably reduces money paid out in claims.
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