Doc: Please Treat Me Like I’m Human!

Posted on August 28th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Health Insurance,Helping Seniors,Medical,Prevention,Senior Care Management

doctor patient relationshipA colleague of mine (Ross) relayed a recent experience he had while seeing a medical specialist.   Ross had a tiny growth in his mouth that needed to be diagnosed and removed.  So he was referred to an oral surgeon by his dentist.  Ross dutifully made the appointment and arrived on time.  He patiently waited for 30 minutes before being seen.

Finally he was led into the exam room.  The surgeon came into the room shortly thereafter.  The surgeon took a peek at the growth and then stood behind Ross scribbling his notes in a chart and occasionally making a comment to Ross from behind the chair.

Ross valiantly asked questions regarding the growth, its cause, and potential for greater harm. The surgeon, however, was abrupt and dismissive.  The whole appointment lasted less than five minutes.

At the end Ross was led to a counter outside the exam room and sat down with an office staff person.  This person presented him with information about the cost of the procedure he needed as well as various methods of payment they accepted.  She reviewed insurance information and office policy.  She made the appointment for him to have the growth removed.  She was professional and courteous throughout her discourse.  She spent significantly more time explaining payment than the oral surgeon had spent diagnosing and educating Ross on his problem.

Ross began to feel his anger rise.  He related his thoughts to the office staffer.  She listened courteously and he felt she understood what he was trying to say.  She offered to get the surgeon back to better explain his diagnosis and the procedure.  Ross declined her offer but did agree to speak with the office manager.  Unfortunately the manager only defended the surgeon and the policies of the clinic.  For example, the charting table was behind the patient chair.  For this reason, she quipped, the doctors could not look at their patients and write at the same time.  Ross wanted to suggest that doctors use a clipboard so they could sit next to the patient while they charted, but he thought attempting any reason would not be successful so he simply left.

As Ross drove home, his anger abated, and he decided to try another oral surgeon.  He researched other providers and selected one that his dentist assured him was more consumer friendly

At the first clinic, Ross felt like just another wheel rolling off the assembly line.  Even though you typically don’t develop a long term relationship with an oral surgeon, he wanted to be treated as a human being.  He felt he was worthy of being addressed face to face and have his issues explained.  He knew he would feel better with a little reassurance that things were going to be OK!

Finally, because Ross is a gerontologist and works with senior citizens, he knows the importance of taking time to explain the unfamiliar and provide reassurance.  So often the elderly are brushed aside in such a manner and it is just plain wrong.

As a care manager and care giver, I always stress the importance of attending medical appointments with seniors for this very reason.

Have you any similar experiences?  Please share………………….

 



Our State Fair

Posted on August 21st, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Helping Seniors,Senior Care Management

State Fair PosterThe Minnesota State Fair begins today.  Excuse me if I brag, but, it’s the “best state fair in our state”!  OK!  So I stole that line from the Rodgers and Hammerstein musical “State Fair”.

But really it is true!  Minnesota’s state fair is spectacular.  It draws hundreds of thousands of visitors during it’s ten days.  The fair is a microcosm of the state’s demographics.  From youngest to oldest.  From rural to urbane. For this reason it is often referred to as “the great Minnesota get-together”.

It also provides a juxtaposition of old fashioned and cutting edge:  affording attendees comfort of the familiar alongside excitement of what is new.

Not surprisingly, food is a focal point of this cultural event.  Minnesota state fair food (from pickles to pork chops) is commonly served on a stick.  This leads to anticipation each year of what could they possibly put on a stick next?

Unofficially, the state fair also signals the end of summer and back to school.  It foretells of winter and waning daylight hours.  It is part of the rhythm of life here in Minnesota. Comforting somehow.

But this year I feel wisps of melancholy.  Last winter was a doozy!  Extremely cold with deep deep snow.  The challenges of harsh weather added to the challenge of care giving the elders I love.

But although the state fair is a harbinger of things to come, it is also an augury of Autumn, the most breathtaking season of all.

And so it is that I push away any thoughts of sadness and prepare to enjoy the glorious beauty of the Fall and the familiar tempo of my life.

Our state fair……..

 

 



Depression: The Deadly Disorder

Posted on August 14th, 2014

Categories: Caring For Elderly,depression,Gerontology,Grief,Helping Seniors,Prevention,Resources,Senior Care Management

Mental HealthThere has been much discussion this week about the death of actor Robin Williams.  His death made more poignant because of reports indicating apparent suicide.

From the outside, we wonder how could this be?  He was a well loved comedian and actor.  He had a wife and three children.  Presumably he did not want for the necessities of life.  So, again, how could this be?

Sadly Mr. Williams was apparently haunted by the specter of depression.  Depression menaces it’s victims.  It is more than sadness.  It is pervasive and all encompassing.  It is an illness as real as cancer or heart disease: but far less understood.

As a care manager for the elderly, I have known that suicide rates are often the highest in elderly folks.  However, a recent article by the Washington Post indicated that there is a dramatic increase of suicide rates in middle age people.  I immediately took note of this fact because so many family care givers of seniors are indeed middle aged.

Depression is a deadly disorder.  Mr. William’s death has brought this fact into a new light.  Depression is a dangerous and overwhelming opponent.

But if you or someone you know is struggling with depression, treatment is available.  If you think someone is suicidal – seek immediate help.

National Suicide Prevention Lifeline:  1-800-273-TALK (8255)

 

 

 



Aging: The Bitter and the Sweet

Posted on July 31st, 2014

Categories: Gerontology,Grandparents,Grief,Helping Seniors,Senior Care Management

IMG_0212An elderly friend of mine recently sold her vacation home in Vermont.  It was a charming place built in 1910.  It was actually an old schoolhouse that was converted into a home.

She and her husband spent many pleasurable autumns there.  They arrived each September and watched the maple leaves change from green, to red, then orange,  and finally golden.  From the tops of mountains to the deep valleys below.  Like molten lava slowly exuding downward in resplendent beauty.

Breathtaking she would exhale!

Family members would visit the house too and enjoy the beauty of Vermont in all of its seasons!  While her children grew to young adulthood, Vermont trips (though far) were not out of the question.

The dream was that the Vermont house would stay in the family to be enjoyed by generations to come.

But as often happens, life interfered with dreams.

First the grandchildren were born.  And the children (with grandchildren in tow) moved to the West Coast.  And then the grandchildren became the primary draw for visitors.  And then my friend’s husband passed away.  And shortly thereafter she became too frail to travel.

And the Vermont house sat empty for 2 years in a row.

So it is my friend made the difficult decision to sell the Vermont house.  The dream had faded so she listed the house for sale two months ago.  It sold this week.

To forgo the dream is a bitter pill to swallow.

May it be relieved by the sweetness of a lifetime of happy memories.

Aging:  the bitter and the sweet…



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Different Kinds of Sandwiches

Posted on July 24th, 2014

Categories: Caring For Elderly,Gerontology,Helping Seniors,In-Home Care,Senior Care Management

generations of peopleWhen I was in graduate school for Gerontology, we often discussed the “Sandwich Generation”.  The phrase referred to that group of typically middle aged people who find themselves in the role of care giver for their children as well as their aging parents.  The care givers were “sandwiched” in between both generations.

But in my work as a geriatric care manager, I have seen other kinds of sandwiches worth noting.  As society changes, so do the roles of caregivers.

  • For example, early onset of dementia is striking more and more people in middle age.  For some caregivers, this means that they are caring for aging parents, sick spouses, and children all at the same time.  Can you imagine?
  • It is also not uncommon for middle aged people to take on the role of parent to their own grandchildren while still caring for their aging parents.  This is often the case when an adult child is sick in some way and there is no spouse in the picture.
  • Another scenario I have seen is in families with just one adult child amongst siblings.  That child cares for her own children, her own aging parents, and in addition for several aging aunts and uncles.

As society becomes more complex and families follow suit, our definition of “Sandwich Generation” must expand.  After all, different kinds of sandwiches hold varying ingredients!

Finding the right support for caregivers involves honoring the uniqueness of their family situation.

So much of what is best in us is bound up in our love of family…..”  Haniel Long.

 

 

 

 

 

 

 

 



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Power of Attorney, Medical Directive – What does it all mean?

Posted on July 17th, 2014

Categories: Active Senior Living,Aging Advocacy,Caring For Elderly,Resources

Five wishesAdvocate on Aging Deborah Dolan’s job is to facilitate conversations about care giving between families and loved ones – not control it. She is simply included in order to start and direct discussions, especially when it comes to difficult topics such as legal issues, death and dying. Certain topics are typically more difficult to discuss without a neutral facilitator, such as assigning powers to designated individuals. Deborah stresses to her clients that every caregiver should know the differences between a general power of attorney, and a healthcare power of attorney. Here’s what you need to know when it comes to these powers:

A fiduciary or general power of attorney is in place to handle financial assets including property, money, life insurance, and investments. Whether a person needs to have property sold to pay for their care, have bank accounts changed in any way, the assigned general power of attorney has the same ability to handle all financial transactions that the owner of the asset has. It is important to remember that this power ends with the death of the person granting the power, and the executor of the estate takes over. Deborah sees some clients, who are afraid to designate a power of attorney because they fear losing control over their assets, or that someone will take their money and they won’t have it when they need it. Deborah facilitates these discussions in order to help the elder and their families address these issues before the powers or information is needed and not in crisis. Although Deborah is not an attorney, she is able to refer her clients to attorneys and recommends that an attorney assist in writing this document.

A healthcare power of attorney is usually included in a healthcare directive and designates an individual who, in Deborah’s words, “gives voice to the wishes of how a person wants to live and how he or she wants to die.” This healthcare power of attorney agrees that if the person giving the power becomes ill or incapacitated and is unable to speak, they will honor and direct that person’s care as written to the best of his or her ability. Unlike the financial power of attorney, a healthcare power of attorney and directive does not have to have an attorney involved. There are resources available online which are legally binding and honored when the signature of the person assigning the power is notarized or witnessed by two non-interested parties. Two such forms are Five Wishes and Honoring Choices Minnesota.

There is much to do and many decisions to make when a health crisis occurs. Giving the gift of information needed to carry out personal wishes when you are no longer able to speak for yourself is a gift of love and peace.



Take Me for a Ride: The Importance of Grandchildren

Posted on July 10th, 2014

Categories: Gerontology,Grandparents,Senior Care Management

open book“Take me for a ride in your story”  Edwin Honig

When I first heard these words, it took my breath away.

The words describe my relationship with my grandchildren to a tee.  I hitched a ride in their story, and they wonderfully in mine.

I have attended hockey games and plays galore.  I’ve baked countless batches of my famous chocolate chip cookies.  I snuggled and tickled and read to them for countless hours.  Time spent with them is magical!

As they grow older, I have had to balance my joy with some worry.  My grandchildren will not be spared from sorrow as I would like them to be.  They will have disappointments and failures.

But I will not be mired in such thoughts.  Because they will have happiness and health and success in abundance as well.

I know they are my happiness.  I know I am some of theirs.

I am a part of their story.  They are a part of mine.

#prayforWyatt

 

 



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We hold these truths: Caregiving and Life

Posted on July 3rd, 2014

Categories: Dementia,Grief,Medicare Part A,Prevention,Senior Care Management,Uncategorized

july4th1Happy 4th of July!  It is once again a celebration of the birth of this magnificent country, the United States of America!  While far from perfect, it is a blessing really to live in such a country as ours!

For some reason, this year I have chosen to read again important documents such as the Bill of Rights and the Declaration of Independence with great care.  Not surprisingly, the words are far different in meaning now than when I first gazed at them through the eyes of a child.

The idea that we are endowed by our “Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness“.

I am a care giver as well as a care manager.  I think about “Life” all the time.

For the elderly, upholding the sanctity of life is wholly enmeshed with what we loosely refer to as the “health care system“.  This system is so very complex and unwieldy that families not familiar with it come to me for support to figure it out.  Their goals are:

  • “Life” for their loved one.
  • Care that supports the “life” of their loved one.
  • Services that support the “life” of their loved one.
  • Medicine that supports the “life” of their loved one.
  • Physicians that support the “life” of their loved one.
  • Hospitals that support the “life” of their loved one.

The one thing I have learned as a care manager that causes me anguish is that access to health care is not equal among all our citizens.  It is an ugly truth that is often batted away by politicians unwilling to look it square in the face.  But I see it day in and day out in the work that I do.

The right to life may sometimes mean the need for health care.  Life is an inalienable right.  Adequate health care is not available to all.  Why has the disconnect become politicized?

Yes the world is far more complex than in 1776.  But the message is not.

Do we really hold these truths as self evident?  Do we really?

 

 



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Senior Patient Beware: Credit Cards and Health Care

Posted on June 26th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Health Insurance,Healthcare Advocacy,Helping Seniors,Medical,scams,Senior Care Management

credit card fraudLast week I went to see a health care specialist after a referral by my primary care physician.  No big deal.  Or so I thought.  The specialist I saw was professional and knowledgeable and took care of my medical problem flawlessly.

But it was his financial policy that I took issue with.  I was required to submit a credit card and to agree to allow him to charge that credit card $250 per month after my health insurance claim was paid.  Unfettered access to my credit card!  I also had to leave a $100 balance before he would treat me (even though I had no deductible).  I balked at this requirement.  I told his office assistant that I am north of 50 years of age and had never run into this kind of financial policy before.  To which she responded that it is “done all the time”.  I hemmed and hawed before I finally acquiesced because I only needed one treatment and because I have the capacity to monitor the situation.  No one will take advantage of me!

I asked for a copy of their financial policy, however, and took it home.  It has gnawed at me ever since.  I can only think of the many elders that I care for and love.  Many of whom are just so vulnerable to financial exploitation due to illness, memory issues, or simply their age.

I have perused the internet to find out more information about such policies.  Sadly, I encountered even more nefarious health care credit card tactics.

The Consumer Financial Protection Bureau (CFPB ) in December 2013 posted an online article about deceptive health care credit card practices.  Doctor and Dentist offices were actually enrolling patients into credit cards that patients assumed were interest free.  In reality, the credit cards were accruing high interest rates the whole time and patients didn’t see the interest charges until the promotional period ended.  Fortunately, the CFPB in this case ordered the credit card company to refund $34.1 million back to consumers that had been harmed by this practice.

So it is that I am compelled to ring the warning bell for caregivers of the elderly that there are new concerns over senior finances.  Sadly, they stem from people that our elderly loved ones trust almost implicitly.  Their physicians.

I understand the need for physicians to get paid.  But there’s got to be a better way!

What say you?

 



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My Cup Runneth Over – Can You Help me Catch the Drips?

Posted on June 19th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Helping Seniors,Senior Care Management

coffee

Nothing makes one feel so strong as a call for help” Pope Paul VI.

If you are a caregiver, my guess is you probably like to help.  Helping is what we do.  We definitely provide care for our aging loved ones.  That is our priority and how we define ourselves in the care giving role.

But, if you really take a look at your life, I’ll bet you care for a whole lot more than your elders.  Think about your neighbors.  I bet you do kind things for them.  Do you occasionally shovel their snow or mow their lawn when they are sick or injured?

How about your kids? Did you think when they were growing up that some day all the cares they required would be gone?  Did you envision your reward would be sitting on the front porch in a rocker reading stories to blissfully happy grandchildren?

Did you see your career as this beautiful arc that would send you toward a well deserved retirement at the dutiful age of 65?

If you did, you are not alone!  But it turns out that life is never how we envisioned it when we were young. We are still helping.  Everyone still needs us.

And that is OK because it is often sweeter and more gratifying to have it that way.  Better really than we could ever have imagined!

But the contentment can sour quickly when there are too many demands on our resources.  Sometimes the opportunities to care can overtax the precious resources we have.  Often when this occurs, we take from our health, our security, our sanity to keep giving to others.  If this continues for very long, we become sick and unable to give anything to anyone!

As care givers, we are not good care takers!  It is just so natural for us to say yes I can help!  Saying yes I need help is unnatural; even impossible for us to imagine.

I am like you.  I will continue to help my parents, husband, children, grandchildren, friends and neighbors.  We are who we are.

But when my cup runneth over with the needs of others, I have to ask for help.  There, I said it.  I sometimes need help.

I remind myself that I receive more than I give when I have helped another person.  It is why I became a care manager and gerontologist.  It is why I have chosen the care giving role in my family.

I am also reminded that when I reach out for help, I give another person the opportunity to give to me so that they may receive their own reward through giving.

So for all you care givers out there:  don’t be afraid to ask for help.  Share the joy of not only giving help to but also receiving help from others.

My cup runneth over!

 

 

 

 

 

 



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