Senior assistance

Growing up, I was fortunate to have the opportunity to live with my grandparents for the first three years of my life. Personally, I don’t think there exists a more special bond than that of a child and their grandparents. Our time together may not be considered all that awe-inspiring to you, but my memories of those encounters are priceless. In my mind, I can still see that pig-tailed little girl feeding the cows with her grandfather or watching her grandmother bake the most delicious teacakes in the world. So, it should come to no surprise how highly I regard seniors and how disgusted I become when I feel as if they are not being cared for in the manner in which they deserve.  

A few months ago while working with the residents on the inpatient service, we cared for a sweet little lady who fell while gardening at her home and fractured several ribs. She was in moderate to severe pain and required hospitalization simply for management of her discomfort. As we were preparing her for discharge, we learned that she lived alone and she was apprehensive about how she would perform her routine activities of daily living. However, per the standards of today’s healthcare system she did not meet criteria for continued care in a hospital setting. Therefore, we contacted her son and made him aware of his mother’s disposition since no one had inquired about her at this point. We asked the son if he or his brother would be able to help their mother and explained the situation thoroughly. The son finally came to the hospital but told his mother he would only be able to drive her home because he had plans to go to the lake that weekend. This poor patient then asked, “What about your dear old mama?” 

Needless to say, the entire medical team was completely repulsed by this encounter, yet we tried to maintain our professional demeanor to the best of our abilities. Really, the lake? But, I guess I should not have been that surprised by the son’s behavior since I often see other atrocities like this on a daily basis in my outpatient practice as well. 

The population of adults aged 65 or older in the year 2050 is expected to be 83.7 million people. This estimate is twice that of the estimated population of 2012. With an increasing proportion of seniors, healthcare providers and policy makers will be presented with greater challenges. For instance, each year, millions of older adults fall. Per the CDC, falls are the leading cause of fatal and non-fatal injuries among older adults.  

Not only are falls a serious health hazard for our seniors, but memory lapses become a huge barrier to optimal care as well. I cannot begin to count the numerous times seniors have come to office visits alone, who in my opinion, needed someone to be with them. Even though most practices with electronic health records provide an after visit summary, if the patient has memory issues, they may just discard that paperwork accidentally and therefore be uninformed about medication changes, referrals to other specialists, etc. 

Per my experience, I would have to rank medication errors high on the list of potentially dangerous situations for seniors. Too many of my older patients are either not taking the recommended medication at all, taking too much, or too little or taking duplications. Much of our limited time together is spent trying to reconcile the medication list, calling the pharmacy to verify if the meds were even picked up and trying to help the patient remember information from their other doctor visits. 

So how can family members improve the care of their senior loved ones? Number one on my list would be advocacy. Having someone advocate for seniors is vital for adequate continuity of care, particularly in individuals who are showing cognitive impairment. Secondly, take notes. With each doctor’s visit, make sure you obtain a summary of the encounter, preferably typewritten.  Third, ask questions. If the instructions are unclear, please have the nurse or the provider to clarify. Lastly, seek assistance if needed – physical therapy, home health nurse, hospice or long-term care facilities. 

As seniors age, family members must be willing to take a more hands-on approach to their care.

Yours in Service,

Denise Hooks-Anderson, M.D.

Assistant Professor

SLUCare Family Medicine

yourhealthmatters@stlamerican.com