Tag Archives: doctors

Caregiving tip: Change isn’t easy for seniors

I’m sure we’ve all heard of the saying, “She is set in her ways.” This tends to become more true as one ages. Our elderly loved ones have a certain schedule, or a certain way of doing things, and a disruption of that schedule can cause them great stress.

I’m a little like this already and I’m only 40!

But what made this clear to me was spending time with Mom this past week. We still have not figured out what is wrong with her, but we finally were able to see the specialist. He wants to rule out the return of cancer, so he has ordered a colonoscopy (ugh) and an EGD. Mom wasn’t thrilled with the idea of more testing and the preparation involved for it but knows it is necessary.

question mark box

If there is no cancer, her abdomen muscles can be surgically repaired so her stomach doesn’t protrude, which seems to cause her constant discomfort. But first, we have to increase Mom’s weight and strength. She is down to 100 pounds (has lost a shocking 30 pounds in 8 months.)

The specialist is a young guy that is into natural supplements in addition to medicine. While I truly embrace this approach, when he recommend my 77-year-old Mom start juicing, I had to force myself not to laugh. While I don’t doubt the benefits of fresh juice (though I do think the benefits are overstated and the high sugar and low fiber in juice is a concern), the doctor clearly needs to consider a patient’s age and situation when making care recommendations.

He knows Mom lives alone, and to ask a frail old lady to go buy a bunch of produce, wash it and process it through a juicer, and then go through the tedious clean up progress is totally overwhelming. I purchased her some pricey but convenient organic juice mixes instead.

The doctor also recommended spirulina supplements. After researching I’m on the fence about the benefits, but at least this is an easy step for Mom to take (comes in capsule form.)

He also recommended upping her daily Ensure drinks. I found a Boost very high calorie variety that has 530 calories. Also I got her a flavorlees calorie supplement that you mix into food. These are small steps that Mom can handle on her own.

Still, when I called her after returning home, she was overwhelmed by the new medications ordered by the doctor and the supplements I had sent. She said she knows everyone is trying to help her, but it is a lot to process.

And so it is. Just something to keep in mind when we introduce change to our loved one’s routine. Try to make it as simple and smooth as possible, and take time to explain why the change has to occur. Change can be hard for anyone, but as caregivers we can try to soften the blow.

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Doctors dropping the ball on nursing home transfers

Anyone who has spent any time in a hospital, whether as a patient or a caregiver knows that seeing the doctor is like finding the holy grail. I remember endless hours just waiting for the elusive doctor to appear, just so he could take a cursory glance at my mom or dad, flip through the chart, and then provide the signature we’d been waiting all day for. This is especially frustrating during hospital transfers.

hospital hallway

A recent University of Missouri survey of that state’s nursing home staff members found that there is poor communication between the doctors at transferring hospitals and physicians on staff at the admitting nursing homes. The survey also found that orders are often incomplete and difficult to read. The transfer process can take hours, creating a frustrating experience for both staff and families.

I wrote recently about the guilt I felt about Dad’s last minutes in this world. His DNR order had not transferred from the hospital to the skilled nursing facility, so the nursing home staff were legally required to take all measures to save his life when he collapsed in the shower. The result of that failure: my dad suffered broken ribs as he died.

The blame for this failure is not just on the doctors, hospitals and nursing homes. As family members for loved ones who are ill, we become patient advocates. I remember wondering if the DNR order for my dad had transferred, but I never inquired with the staff at the skilled nursing facility. It had been so difficult to get Mom to agree to the DNR at the hospital, I frankly did not want to deal with that drama again. I hoped Dad would pass quietly on his own, but as many of you know, that often doesn’t happen.

So yes, as patient advocates we need to demand better communication between the hospital staff and nursing home staff. But we also need to check behind them, and then double-check, to make sure medical care orders are recorded properly. Dealing with these issues may be frustrating, but it is much better to know that you tried than to have to live with a lifetime of regrets.

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Doctor disconnected

We saw Mom’s surgeon today for a followup visit. I think he’s good at what he does, and I like the fact he’s honest and does not offer false hope.

But there is still that disconnect. Mom had questions about colostomy care, and I could see the doctor shrink back. “Well, we don’t handle any of the colostomy care issues here, there are nurses that handle that.”

Certainly I don’t expect the doctor to be changing bags, but it seems odd that he washes his hands of anything beyond the actual surgical procedure. The doctor creates the need for the extensive and complicated aftercare, but leaves it to strangers to figure out his handiwork.

A similar thing happened with Dad near the end of his life. Doctors who knew little of Dad’s health were prescribing medications without concern for side effects. They would see him once, scribble on a piece of paper and they were done.

This disconnect is nothing new, but when it involves family members, you really feel it.

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One day at a time

The doctor stopped by to visit my mom today. She’s still recovering pretty well, but the doctor is waiting on a few signs to happen before moving her to the medical floor, and then back home. The road to recovery always has stops and starts. There’s a plan for the day, but things don’t always go as planned.

When Dad had his emergency gallstone surgery, there was no returning home for him. His mental decline, along with his weakened body, made returning home impossible. He went to a skilled nursing facility, then an assisted living facility.

For Mom, the plan has always been to return home. And I believe that will happen, but I also think she will need more care than the home health service may be able to provide. As to be expected, major surgery takes a lot out of an older person. I have to accept Mom may never regain that spring in her step.

Or maybe she will surprise us all and come back strong. I hope for her sake she can stay as independent as she can for as long as she’s able to comfortably. With Dad, placing him in an assisted care environment was different, because he had lost sense of what home was. Mom still knows, and while she is the model patient, I don’t think she would be happy in a group home environment.

But as the doctor said today: “One day at at time.” It’s good advice, yet hard to follow.

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