Broken hip, knee replacement, shoulder issues, welcome to the world of rehab or physical therapy. You’re too busy or too proud and don’t think you need the help. Do you have any idea what you’re refusing or are you just lazy and don’t care if you walk, bend or raise your arm again? Sure rehab facilities are not places where you want to stay long term; however they are good places to regain flexibility and mobility IF you apply what you learn and practice daily. If you’re fortunate you may be able to continue receiving physician and occupational therapy at home. Again, this only works IF you do it. If you’ve been active most of your life and have exercised, this will not be a big struggle for you – you’ll do the exercises so that you can get back to your previously active life. On the other hand if you’ve been a couch potato all of your life you’ll do the minimum and then wonder why you can’t get around. Maybe you’ll even have another fall or accident soon after your initial surgery that will further impair your mobility. Welcome to the world of the unmotivated. Patients wonder why physicians become frustrated when they don’t comply. Your physician sees your medical and physical future long before you. Did you realize that if you break a hip, your physician has the power to decide, based on your medical history and level of activity, whether or not you get a full hip replacement or something as simple as a pin? It’s time to start thinking about nutrition and exercise before you have an accident that inhibits your mobility.
Archive for August, 2008
You see your physician or specialist and they prescribe a new medication or treatment and you just say okay. Believe it or not, there is a generation that treats physicians like God. It’s the older generation. They do what they’re told, well maybe not when it comes to exercise and losing weight, but prescribe a pill or a procedure and most of them will acquiesce WITHOUT ASKING WHY it’s necessary. I can’t tell you how many clients I see taking multiple medications prescribed by multiple physicians and they can’t imagine why they don’t feel well. It’s simple! Medication A is interacting with medication B and since they go from physician to physician without medication lists, they are being prescribed medications that interact poorly with one another. If medication abuse was considered an accident, it would be the #1 cause of accidental death among the elderly and is the #1 reason for admittance to the emergency room. Ask your physician why you’re being prescribed medications and suggested treatments otherwise you’re contributing to your own health issues.
You’ve been seeing the same physician for 40 years. What makes you think that the same physician you saw in your twenties can treat you for the same issues now that you’re sixty? The concept of seeing a geriatrician is the same concept as seeing a pediatrician. Geriatricians specialize in the needs of older adults, however they are not specialists for the multiple other conditions you have now. A cardiologist treats patients with heat disease. A urologist treats patients with bladder disease. A neurologist treats neurological disorders including Parkinson’s and Alzheimer’s Disease. A dermatologist treats issues of the skin. A podiatrist treats your feet and trims unruly toe nails, a very common problem in older adults A nephrologist treats patients with kidney disease and so on and on. If you’re older and have multiple chronic conditions and expect good care you need to be referred to specialists who can help you. To further complicate your situation you no longer drive. Like in Monopoly, pass New York square and go to jail. You’ll need to access public transportation or hire a driver. Or in some cases, consider the PACE program where all of your needs can be taken care of at one location
The difficulty with getting older and needing assistance is that there are no perfect solutions. At the point where we believe everything can be done perfectly we’re made out to be a liar. The reality is that when we get older and need assistance or services we must become more astute, more flexible and more tolerant because healthcare and associated systems are imperfect. Let’s start with medical offices. Consider yourself lucky if you receive 15 minutes of undivided attention from your physician. And this is after waiting for she or he for an hour in the waiting room because another patient or phone call took some of your time. If you came unprepared without a current list of medications and questions you waste precious minutes. And if you don’t understand what the doctor is asking you, more lost time ticks away. You find yourself ushered out the door without your questions answered or concerns addressed (remember it was you who came unprepared) and the doctor only has so much time. You didn’t bring a notepad and can’t even remember what was discussed. Welcome to medical visits of today. If you want to survive you must plan and prepare for your medical visit. Better yet, take a family member or advocate with you so that if you can’t remember your questions you have a backup plan by having another mouth and set of ears. It’s no wonder most older adults either don’t go see their doctors or are constantly going back and forth.
The practicality of aging involves not only planning for where and how we will live, it includes the financial reality of health care and other costs. Years ago when families lived together the need to plan was not as significant as it is today. Unfortunately, many of our parents have not planned as well as they should and now rely on family members and their children to fund their cost of living and care, according to the article, “Five Ways to Avoid Financially Supporting Parents”.
We’re born fearless and as we go through life we learn fear. We have an accident of some sorts and are then afraid to do the activity that caused the accident. Older adults today have many learned fears that prevent them from living fully active lives, according to the article “ Fears Associated With Aging Increase Exponentially As We Age”.
We often hear that we need less sleep as we age. This may be a myth. In the article, Getting a Full Night’s Sleep, the article mentions that older adults have a more difficult time getting all their sleep at once, http://www.cdh.org/News.aspx?id=120762. Additionally, increased medical problems may result in an individual’s ability to sleep well.
An internet site called Care Calls at www.parentcarecall.com is available for families to record and send messages by telephone to family members. Examples of ideas for usage include medication reminders and wake up calls. The idea is to help older adults maintain independence with assistance from family members. The cost to sign up is a one time activation charge of $99 and a cost per call averaging 50 cents.
An internet site called Lotsa Helping Hands at www.lotsahelpinghands.com is available FREE for caregivers and families to communicate care needs. There are areas for: announcements, a calendar, photo gallery, resources, well wishes and helpers. For example, your mother is in the hospital for surgery and will be coming home shortly. You are the main caregiver and take the initiative to set up the free website and then contact other family members and friends to have them assist with her care and learn what she needs. Other users can log into the site and volunteer for specific projects.
I had a discussion the other day with several clients about the need for “specialists”. The general physician we’ve had for years may not be the physician we need as we age. Mothers send their children to pediatricians, why would you send your mother to a general practice physician and not a geriatrician? I have one client who sees not only her general physician but a cardiologist, nephrologist and a hematologist. Since implementing what may seem like numerous medical appointments, the health of my client is much improved. I’ve had similar experience with other clients. The fact is that as we age, caring for ourselves requires more attention from physicians who specialize in different areas, especially if we have various chronic illnesses.
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