As I reflect on my geriatrics experience, I’m left with a sense of amazement to the strength of the spouses and families I met throughout the month. Every patient I had the opportunity to visit was accompanied by a spouse, sibling, or other loved one that was able to recount the activities of the past year in a detailed manner leading to a meaningful visit for both the patient and physician alike. Never did I encounter a family member frustrated with the task of taking care of their loved one, and for this reason, it is essential for the physician to provide gratitude every visit to the loved ones. I can only imagine the degree of difficulty it is to manage the daily life of an elderly family member with cognitive deficits, and the families I met do this on a daily basis. I can only hope that I’ll be able to provide the same level of care to my loved ones when the opportunity to do so arises.
Wednesday, March 13, 2013
Older adults often need a treasure map to navigate the medical system, a map that rather than leading to treasure, actually just leads to the truth. They, like the rest of us, deserve to know the truth about their medical care and their functional status and their prognosis. They deserve to know.
I recently heard a classic example:
Mrs. K went to her optometrist and was told her eyesight had worsened and now would prevent renewal of her license… unless her cataracts were removed.
The cataract doctor said her cataracts would prevent renewal of her license… unless a specialist performed a procedure.
The retina specialist (after months of waiting for an appointment) said her eyes would prevent renewal of her license… period.
A horrible thing to hear. An isolating, dehumanizing, depressing thing to hear.
But she finally has an answer. She can finally plan. And she isn’t being sent (mind you, driven by others becauses he can’t see well) all over town to be repeatedly given a glimmer of hope when one doesn’t exist.
She finally has an answer. And she finally has a plan.
Just Say It…
The one thing that unites all human beings, regardless of age, gender, religion, economic status or ethnic background, is that, deep down inside, we ALL believe that we are above average drivers.
-Dave Barry, "Things That It Took Me 50 Years to Learn"
I recently sat through a clinic appointment where the staff physician had to tell a patient that it was not safe for him to drive anymore. The patient had been an Army Infantry officer in the Korean War, he had worked into his 70’s and now he was having memory loss. He was very angry at the news, and I could not help but think about how I would feel when not be safe to drive. I imagined that I would feel the same way. What does driving mean to us?” Words that come to mind include: Freedom, Independence, and Being Grown up, Going places, Excitement, Fun, Adventure, Protection, and Status.
As we age, our physical faculties diminish; we can lose now only our hearing, eyesight, focus, processing and reaction time and physical strength. When we have to stop driving because it is not safe anymore we lose the intangible things including a part of our identity.