Oh, the memories of going through Mom's medical situations, health care crises & hospitalizations come rushing back as I read Ashton Applewhite's This Chair Rocks: A Manifesto Against Ageism.
Although Mom was basically healthy, her doctor kept an eagle eye on a potential heart condition - a periodically irregular beat would land her in the hospital for a day or so. Nothing nail biting, just rebalancing & observation.
During one such stay, in hMom's upper 60s, her family doctor stopped by for his daily visit. Talking to her, he said, "As long as you're in bed, why don't I do a breast check?" Which is how he came to find a teensy lump.
The first oncologist they set her up with was a no-go. Too clinical, with no intention of involving Mom in her own care. Great story behind it, involving myself, my sister & a brilliant friend (a French professor, dean at a local college ~and~ a trained psych nurse) breaking her out of the hospital. For now, let's leave it at the hospital realized she was NOT happy & found her a new oncologist - her beloved Dr. Domkowski, who treated her like the Queen of Sheba.
Long story short, he did a modified mastectomy (American hospitals didn't do lumpectomies back them), was sure he got all the tumor, she never needed any chemo, never recurred.
Mom's first experience with getting medical care as an older patient started out rocky, ended up with a great outcome.
Mom's next major hospitalization was in her 80s. Again, she was admitted for a heartbeat readjustment. Her physician put her under a cardiologist's care, assuming she'd be back home within 36 hours. If only.
This time, Mom's condition morphed into something serious. Her cardiologist - an older doctor who seemed more martinet than healer, set in the old school mantra of "The doctor knows best." - blamed her body for the negative outcome of the meds he'd prescribed.
Will never forget him saying, "They were the right meds - your body reacted wrong!"
Thought about that amazing pronouncement as I read Ashton's observation, "Physicians often fail to account for age-related changes in the way older bodies absorb medications, to check for side effects, and to consider the effects of being on multiple medications." That sounds familiar!
I was beside myself. The arrogant sob would not, could not see Mom's condition, only what he considered the best treatment of her symptoms & could not restrain his fury that she hadn't reacted appropriately. The fault was on her.
In the meantime, Mom's GP didn't realize she was still in the hospital, so hadn't stopped by to check in on her. He was stunned when I called to ask, "Where have you been?" - he'd assumed she'd been discharged after a day, that he hadn't gotten the paper work yet. The cardiologist's staff hadn't informed him of her nose dive.
During Mom's earlier experience with the subpar oncologist, she had no fewer than three advocates - Mim, Margaret, moi. During her heart problems, she had a different three - Mim, moi & her awesome granddaughter, Whitney, who could, in spite of her petite stature, got answers & action by pinning nurses against the wall better than anyone I've ever seen. During subsequent situations, the role of advocate fell primarily to me.
Mom always had at least one advocate, often more. And she learned to build on her instincts of being her own advocate.
That is, sadly, not the norm for most people, especially for most older people. Older patients have multiple whammies when it comes to getting appropriate health care, beginning with the fact that our country has a rapidly expanding group of folks over 70, while the number of doctors specializing in their care is shrinking.
Too many geriatricians tend to treat the age, not the presenting symptoms. There were doctors who made assumptions about Mom's health & treatment plans based on her age, not on the chart in their hands.
Ashton notes that medical personnel often discount symptoms like poor balance, bowel problems, memory challenges, aches & pains as "inevitable consequences of advanced age," rather than as treatable.
Mom was blessed to have some great doctors, with only a few so-so. But whether they were awesome or ho-hum, there was always an advocate in front of them. Mom.
Mom never left home for an appointment of any magnitude without two lists in her handbag - her symptoms (she knew how easy it was to forget the most robvious thing) ~and~ questions. She didn't leave the office until they were reviewed & answered. There were times she - or the doctor! - asked me or John, if he had taken her, to join them.
Looking back, I can't remember that many older people in the waiting room who were there with younger family or friends. Usually, they were by themselves or with a passive care partner.
This is my MEGA shout-out for oldsters to have someone who serves as his or her life & health advocate. Confession - I do NOT, so this posting is a huge wake up call to initiate discussions with John, to get our wishes documented, to bring in a back up who has an image of what makes for an effective advocate, who can ask ask ask for clarity & well-considered options.
Do the older loved ones in your life have a life & health care advocate who knows what's important to them? What are their wishes in case of a health care crisis, are they written down & signed off on? If you are not uncomfortable asks questions of medical professionals, either learn how or bring an experienced advocate on board. Make sure there is someone line up & available if YOU need care.
The difference between having a patient advocate for yourself or someone you love, particularly a person who's past 70, can be the difference between an optimum outcome or much less.
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