TAKING CARE OF A LOVED ONE - PART ONE

I’ve come to the conclusion that getting old can sometimes really suck. It shouldn’t but it can. My mother will be 91 in August and still has a tremendous will to live. There is so much she wants to do in her life and she talks about it all the time. This is a good thing.

However saying you want to do something and actually doing it are two completely different things. Mom is partially bionic. She’s had both knees replaced and just last year she had a full shoulder replacement as well. The last surgery was probably the most difficult on her. She has never fully bounced back. Mom has pretty constant chronic pain and, given the choice, would prefer to stay in bed all day long. (She doesn’t have that choice too often as I try not to let her.)

We have the technology to keep people alive but the problem appears to be that we may just be living too long. There are many older people who, after living long, healthy, productive lives are seeing their brains start to basically shut down. They may be able to handle day-to-day functions but their short term memory starts to go. (I know – that happens to a lot of us but this can happen more frequently to the elderly.) Weakness sets in so that, although they may wish to go out for a coffee every day, they are not physically capable of doing so. And the more they give in to their aches and pains and baby themselves by staying in bed, the weaker they get.

Some give in to it totally and give up. Their lives consist of staying in bed and going to doctor appointments – even though there is no reason for them to do so because there is nothing wrong with them. Their doctors tell them this but television and magazine advertising by pharmaceutical companies seem to be a bigger persuader than the doctors.

Then you get someone like my Mom who really doesn’t want any more medications and would rather be doing stuff but just can’t. The lack of strength, etc. becomes even more debilitating. Getting Mom dressed and downstairs each day is a chore when she is feeling well. When, as now, she is feeling poorly, it is close to impossible.

It doesn’t help that over the last few years several of her friends have passed away – the majority of them younger than her. Although she denies it, it has to be depressing.  

                Over the past few weeks Mom has woken up with what are called “night sweats.” She’ll phone me (we use my cellphone and her landline as an intercom system in addition to a baby monitor) and I’ll go in to dry her off. Her temperature, oxygen intake and pulse are all healthy/normal yet she doesn’t feel right.

           Last week I took her to see her primary care physician who said that perhaps she had a “hidden fever.” He prescribed an antibiotic to fight the wheezing she’s been having along with her shortness of breath. Since then she has had some more episodes of shortness of breath and wheezing which could be attributed to the very humid weather we’ve been having. However today she was adamant that I get her to the hospital – something she is not fond of doing.

                The upshot is that she went to the Emergency Room where we spent most of the day. Tests showed nothing wrong but, again the diagnoses of “hidden fever”  was given. I will say that after getting some fluids via IV she seemed to bounce back so, even though the bloodwork did not show dehydration as a cause, maybe she still had a touch of it.

                Believe me, it is as frustrating to the doctors as it is to us. And all I can do is observe her and report back to her doctors what I observe. This does help them a bit – whether it’s to rule out things or just to try and narrow things down.

                So, just like with a child that might get ill, if you have a parent or other elderly person in your household who starts complaining, remember to observe and keep careful notes so that you can discuss it with that person’s doctor when you make an appointment (or the ER doctor if it comes to that.) Many seniors will, when they talk to the doctor, only tell him/her about what is troubling them at that moment.

I have noticed this with my mother. I’ll make an appointment about her feeling dizzy but, when we get to the doctor’s office her knees are bothering her from her arthritis then, when the doctor enters and asks what is wrong she will concentrate on her knee pain.

                Many seniors will also either be constant complainers or they will be stoics. You will either be constantly subjected to a litany of what’s wrong with them or you will notice that they are in pain or something is wrong and they won’t discuss it with you until the pain or whatever it is becomes unbearable. This is another area where being extremely observant is important.

                 Now I keep saying to be observant. It is important that you also be as objective as possible. This may include having friends of yours over to see if they notice the same things. When you are a caregiver you tend to get overinvolved with the person you are caring for. This means you may become a bit subjective and see what isn’t there. The trick is to take a big step backwards regularly and make certain that what you think you observe is really what is there.

                With most of today’s medical practices and the constraints put on the doctors by insurance companies here in the U.S., many doctors cannot practice medicine the way they would like to. That is – they cannot spend as much time as they would like with each and every patient. Where I live we are lucky – many doctors will spend as much time as they can with each patient and they also follow up with phone calls (or have a staff member do it) in order to be sure everything is OK.  By keeping accurate observations and even writing them down to hand to the doctor when he/she walks in you can make the best use of their time and the patient’s time as well ensuring better care.

                Another thing to have and bring extra copies to every office and ER/hospital visit is a printout of every medication the person is currently taking (including temporary medications and herbal supplements) along with a list of allergies. Additionally bring along with a medical history to the best of your/the patient’s ability.

                You can save a lot of time, and earn the respect of medical staff, if you keep these lists on your computer, update them regularly and bring a printout with you to each visit. If it is a trip by ambulance to the ER then make THREE copies: one for the ambulance personnel as they may need it for insurance filing or other reasons, one for the ER personnel (which you can hand to the ambulance people saying “one is for you and the other for the ER” and one that you bring with you in case anyone has any questions and hasn't seen the printout.

                Tomorrow we will deal with four important issues that should be addressed to ensure smooth health and end-of-life care for everyone.