Tag Archives: elder care

How to Survive Medical Care

A guy walks into the doctor’s office …

While there has been little to laugh about in the healthcare debate, it has caused a spike in jokes on late night television and the Internet.  Gallows humor, you might say.  But here’s something you should know about that is no laughing matter: getting sick (or sicker) as the result of medical treatment, aka iatrogenic illness, is on the rise.  In 2000, a presidential task force labeled medical errors a ‘national problem of epidemic proportions,’ and put the cost at $29 billion annually. The Institute of Medicine’s report, To Err is Human: Building a Safer Health System, released the same year concludes errors during hospitalization kill between 44,000 and 98,000 people each year.

Then there is the problem of antibiotic resistance caused by “inappropriate or improper use of antibiotics by physicians,” according to Dr. Philip Tierno, director of clinical microbiology and diagnostic immunology at NYU Medical Center. Dr Tierno finds that of the 90 million prescriptions written for antibiotics, “50 million are absolutely unnecessary or inappropriate.”  Could be why antibiotic-resistant staph (MRSA) is a major problem for hospitals.

So how can you protect yourself?  Short of taking the approach of a friend of ours who steers clear of hospitals and doctors entirely, you can do two things.  1. Make self-care and preserving your health a top priority, and 2. If you need medical care and/or are hospitalized, resist becoming “a passive, dependent, childlike person who will not question or oppose authority,” says Lawrence LeShan, Ph.D., psychologist, author and pioneer in the psychotherapy of cancer support.

Here are more tips adapted from How to Survive in a Hospital from Dr. LeShan:

Have a friend or relative who can be your advocate (or be an advocate for your hospitalized elder).  An advocate is someone who is not afraid to make a fuss and ask difficult questions.  For example:

  • Who is the physician overall in charge of the case?  Make sure that there is someone who has an overview of the patient and the symptoms.
  • What is the diagnosis, and how certain of it is the physician?
  • What is the usual course of the disease, both with and without therapy?
  • What are the side effects of the therapy?
  • What alternatives exist?

When tests are prescribed, it will be important to know how painful they will be, what side effects they will have, and most important – whether they will make a difference. Will the physician’s course of action change depending on the results of the test(s)? If not, there is no reason to proceed.

More information:

Kimberly-Clark Health Care’s website on Healthcare-Associated Infections (HAI) http://www.haiwatchnews.com/
American Iatrogenic Association

God’s Waiting Room

Last week, as I visited my mother (91 in June) in a nursing home in Western Canada, the reality of what lies ahead for our elders and perhaps for ourselves was so in-my-face, I found myself hyperventilating (yoga training notwithstanding) and struggling to keep my spirits up, for her sake and mine.

In truth, I have a lot to be grateful for. My mom’s facility is as good as it gets: dedicated, kindly staff (if too few of them in oil boomtown Edmonton); clean, comfortable, well-equipped rooms; carefully calibrated meds for pain and depression; and lots of what we used to call extracurricular activities to help residents be more independent and social. Today, for example, a neighboring animal shelter had brought in puppies for petting. Sometimes, it’s nursery school children who are wonderful with old and disabled people. Last week while I was there, they had pub night when residents enjoy some wine and live entertainment.

When it was clear that my mother’s medical needs had become beyond our ability to provide for (geography didn’t help much), we choose this place also for the mix of age groups and levels of disability. So, my mom can socialize with a lovely 50-something woman named Sherry who suffers from MS, but who is also bright, friendly and also interested in jewelry and clothes. There are residents who play Scrabble and cards. And recently, a beautiful nurse-trainee from Brazil in body-hugging uniform, with fashionable haircut and great personality, was assigned there for a few weeks, and everyone perked up. All this costs about $30K/year, or less than half for a comparable facility here in Florida, and some of the expenses are tax-deductible.

But most of the population there are elderly so you can’t fight the God’s Waiting Room atmosphere, and I’m no better at staring that in the eye than the next person. So I spend most of my time amusing my mom: she adores Scrabble and Rummy 500, pizza and sushi, and a new brightly-colored dress. I can focus on these things because she already has her so-called affairs in order: personal directive and living will are all set; she gave me power of attorney a couple of years ago. I know what she wants for final ceremony and exactly where she wants her ashes strewn. Sure, she would rather be traveling to visit her great-grandchildren and spending the winter where it’s warm. But she has found a was to be happy in the moment. If you think about it, that is all we really have.