Helping your aging parents before a crisis

I recently heard Dr Dr Alicia Arbaje from the John Hopkins School of Medicine discuss 10 new years resolutions for older adults. These resolutions are appropriate and timely regardless of the New Year and may include some things you can help an aging parent with. I think of them as “prevention resolutions” because most of them have to do with being proactive to prevent problems as we age.  By helping your aging parents before a crisis like a fall, medication error or case of pneumonia you will save both you and your parents a lot of stress

1) Get vaccinated. Not just for the flu but pneumonia and possibly shingles and tetnus.

2) Get screened. Screening for osteoporosis and vitamin deficiency.

3) Clean house to prevent falls. Look for things like throw rugs and not having a grab bar in the bathroom.

4) Improve sleep patterns. Talk to your doctor about getting off of sleeping medications.

5) Do advance directives. Talk with your family about what is important to your quality of life and what your wishes are.

6) Volunteer.  Good for preventing depression.

7) Update health records. Make a list of all your medications, and the names and contact information for your doctors.

8) Schedule a medication check-up. When you see your primary care go over all your medications including over the counter.

9) Decide if you need a geriatrician. A geriatrician has advanced training in treating older adults.

10) Get moving. Include a variety of exercises that help with strength, balance and flexibility.

It is easy to ignore these details but from the point of view of a patient advocate I can tell you that helping your aging parent before a crisis by doing these 10 things will save you from picking up the pieces once a crisis hits.

 

Long Distance Caregiving

Over the holidays I had the opportunity to visit with some high school friends that I hadn’t talked to in years. The topic of conversation wasn’t focused on our kids, jobs, or travels but rather our aging parents. The theme was the same: memory loss, concern about driving, unwillingness to move to a senior community or downsize, worries about falling and poor follow through with medical care and recommendations from their doctors. After spending the holidays with their parents they were all acutely aware of the declines since last year and were all unsure where to turn or how to best help. Long distance caregiving is not for the faint of heart.

The New Year frequently brings to the forefront concerns about our parents’ safety and health and the need to take action, get help or make changes before “something bad happens”.

These concerns aren’t unique to the holidays but when you are in the midst of long distance caregiving it is easy to have a false sense of security. It is not uncommon for aging parents to downplay their problems or concerns. They don’t want to worry their children. They want to believe they are capable and independent. They often don’t understand or remember what their doctor tells them.

A large part of our advocacy business involves taking patients to appointments and facilitating the communication with the doctor. We have a conference call with the adult children, make a prioritized list of questions and concerns and make sure the doctor addresses them. We then report back to the children and discuss how best to support their parents based on the doctor’s recommendations. For those who are long distance caregivers, we use Skype or FaceTime to talk about the issues facing the seniors and their families

Do they need a memory disorders evaluation? a home safety check? a medication dispensing system? tests or screenings? Regardless of what the issues are, having everyone on the same page can reduce the chance of accidents or problems down the road.

Patient Advocates help navigate the system, find resources, facilitate communication and alleviate some of the stress of long distance caregiving. If you have an aging parent that you are concerned about call us today, 303-756-8436.. We offer a free, in person consultation to learn about your needs and discuss how we might help.

Denial is common when it comes to aging parents

As Patient Advocates we know everyone has a story. Most stories we hear from clients are related to adult children struggling to do the right thing for their aging parents.

I recently talked with an old friend who told me about her 90-year-old father who was living alone in the house where she grew up. Her dad had to go up and down stairs and had trouble getting in and out of the bathtub. He still drove, but only to the store. He had recently been diagnosed with dementia and was taking 7 medications for a variety of chronic diseases.

My first thought was “This is an accident waiting to happen! Why hasn’t my friend done something sooner? Why wasn’t she anticipating what he would need and making plans?” This scenario is not unusual.

We tend to think of our parents as they were when we were growing up. They were in charge. They knew what to do. They put up baby gates, made sure we wore our bike helmet, and knew when to call the doctor. But things have changed. We don’t need them to take care of us anymore. We are taking care of our children now. So why aren’t we making sure our aging parents are as safe as they made us? Having aging parents is something most of us weren’t trained to handle. We don’t want to think about our aging parents being anything but capable and high functioning.

It is easy to push any worries or thoughts away and tell ourselves everything is ok. When we had our children, we were always thinking ahead. Which daycare?, when is the next check-up? which summer camp?, what activities would be a good fit for them? But when it comes to our parents it is hard to think ahead. It is daunting and confusing so we just don’t do it. Patient Advocates help families’ sort out the “daunting” and “confusing” every day.

We know what options are available and what questions to ask. We know what to be carful of and why finding quality resources and care can make the difference between unsure and confident. Learning about options ahead of time makes the decisions so much easier when the time comes. Preventing a crisis by being prepared not only helps us feel less anxious, it also helps our parents.

My friend could find hire a Patient Advocate to help her find a new community for her dad to live where he would have people around to help him and watch out for him. If he refused to move, she could hire a non-medical home care agency to help with bathing, running errands and to make sure the house was safe for him. A Patient Advocate could attend doctor appointments with him and make sure the doctor understood the problems and concerns of the patient and family and that the doctor’s recommendations were understood and followed. A Patient Advocate could research options so she and her father could make informed decisions.

All crises are not avoidable but if you could do a little planning you might avoid a few of them and make life easier on your parent and yourself.

Start the Conversation with your loved ones and your advocate

April 16th is more than just the day after the deadline for filing your taxes  It is also National Healthcare Decisions Day.  What does that mean?  If you have ever gone to a hospital, the admission representative probably asked you if you had a Living Will or Advance Directive.   National Healthcare Decision day is the perfect day to start the conversation with your loved ones about your wishes if you are seriously ill or injured and unable to speak for yourself.

As Ira Byock, MD explained, “I have an advance directive not because I have a serious illness, but because I have a family.” Advance Directives or Living Wills aren’t just for seniors.  All adults should have one.

So, how do you get started? If you are working with a patient advocate they can help you. There are many different Living Will documents.  We recommend “Five Wishes,” an easy to complete booklet which addresses medical, personal, emotional and spiritual needs.

Five Wishes is meets all legal requirements in 42 states and can be attached to state required forms in the other 8 states.  More than 18 million people around the world have completed Five Wishes.  Today is a great day to start the conversation.  http://www.agingwithdignity.org/five-wishes.php

Can a Patient Advocate help with your aging parents?

As Patient Advocates we know everyone has a story. Most stories we hear from clients are related to adult children struggling with doing the right thing for their aging parents. I recently talked with an old friend who told me about her 90-year-old father who was living alone in the house where she grew up. Her dad had to go up and down stairs and had trouble getting in and out of the bathtub.  He still drove, but only to the store.  He had recently been diagnosed with dementia and was taking 7 medications for a variety of chronic diseases.

My first thought was “This is an accident waiting to happen!  Why hasn’t my friend done something sooner? Why wasn’t she anticipating what he would need and making plans?”

This scenario is not unusual.  We tend to think of our parents as they were when we were going up. They were in charge.  They knew what to do. They put up baby gates, made sure we wore our bike helmet, and knew when to call the doctor.

But things have changed.  We don’t need them to take care of us anymore.  We are taking care of our children now.  So why aren’t we making sure our aging parents are as safe as our children?

Having aging parents is something most of us aren’t prepared to handle.  We don’t want to think about our parents being anything but capable and high functioning.  It is easy to push any worries or thoughts away and tell ourselves everything is ok.

When we had our children, we were always thinking ahead.  Which daycare?, which summer camp?, what activities would be a good fit for them?  But when it comes to our parents it is hard to think ahead.  It is daunting and confusing so we just don’t do it.

Patient Advocates help families’ sort out the “daunting” and “confusing” every day.  We know what options are available and what questions to ask.  We know what to be careful of and why finding quality resources and care can make the difference between unsure and confident.  Learning about options ahead of time makes the decisions so much easier when the time comes.  Preventing a crisis by being prepared not only helps us it also helps our parents.

My friend could find hire a Patient Advocate to help her find a new community for her dad to live where he would have people around to help him and watch out for him.  If he refused to move, she could hire a non-medical home care agency to help with bathing, running errands and to make sure the house was safe for him. A Patient Advocate could research options so she and her father could make informed decisions.  All crises are not avoidable but if you could do a little planning you might avoid a few of them and make life easier on your parent and yourself.

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Keep Yourself Safe from Hospital Acquired Infections

Learn more about the necessary steps, and the work by RID:  Reduce Hospital Deaths

My last column on hospital infections seems to have hit a nerve with you, my readers. Stories and photos, each appalling, have arrived through e-mail and postal mail.

Many of you wrote to wish my mother-in-law well. You may remember she contracted a hospital acquired infection after surgery here in Central New York. She is on the mend, I’m pleased to say, and getting stronger. She’s one of the lucky ones.

Too many of you wrote to tell me about loved ones who died. Each of them had acquired a staph infection, including MRSA, the superbug that resists any of the drugs developed to destroy it. In most cases, the cause of death listed was whatever had put that patient into the hospital to begin with. But each letter said that the patient was healing before the hospital acquired infection set in.

A husband sent me horrible photos of a flesh eating infection around his wife’s surgery incision. She has now had nine surgeries, and they still aren’t sure she will pull through. She’s been living in a burn center because it’s the only place that is sterile enough to help her heal.

So why do I share all this with you? Because it’s clear that hospitals are not being diligent enough to combat these infections. And if they won’t clean up their acts – we patients must!

You may remember Dr. Betsy McCaughey’s name. She is a former Lieutenant Governor of New York. Dr. McCaughey left politics to found a national, not-for-profit organization called RID: Reduce Infection Deaths. I contacted her to get some advice on what patients can do to protect themselves.

Dr. McCaughey was very candid when she told me patients can do very little while they are actually in the hospital. Hospital Acquired Infections spread in so many ways, it’s almost impossible to be fully protected unless everyone around the patient wears a paper gown and gloves.

She told me that RID’s work shows that few hospitals take the necessary hygiene steps, already proven successful in Denmark and Finland, unless they are legislated to do so. In 2004, New York enacted a “Hospital Infection Report Card Law” which went into effect in 2008. The new law requires public disclosure of infection rates, which patients will be able to use to determine which hospitals they want to choose for services.

In the meantime, RID has published a list of 15 steps patients can take to protect themselves on their website, www.hospitalinfection.org . Hospitalized patients and their loved ones will be smart to use them.

Consider hiring a patient advocate to help you with strategies to avoid a hospital acquired infection.

If you need help making sure a loved one is getting good care and avoiding hospital infections, ReAssured Advocacy can help.  Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate:  www.EveryPatientsAdvocate.com

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Ads for Prescription Drugs Are A Place to Start

Don’t let those drug companies manipulate you

Heartburn? Allergies? Atrial Fibrilation? Insomnia? These days there seems to be a drug to deal with any health challenge you face, and pharmaceutical companies are spending millions to entice you to buy their brands. TV, newspapers, magazines, web sites…. Prescription drug advertising is everywhere.

How simple it would be if we could just buy them without a prescription.

Be thankful that for most, we can’t.

Suppose your car tire goes flat on a bumpy road in a snowstorm. You exchange it with a temporary spare, but it needs to be replaced. At the store, you find a 12-inch, all-weather, all-terrain style tire, and it’s on sale! It seems perfect, so you purchase the tire and mount it on your car.

There’s one hitch. You didn’t realize your car requires a 15-inch tire. The moment you try driving on the new one, you will have to contend with a whole new host of problems you never anticipated.

And so it is with prescription drugs. Insisting your doctor give you exactly the brand you request may not be helpful. Reading an ad or watching a commercial doesn’t provide you with the information you need to make a good drug choice. You may be buying more problems than you’re fixing.

But there is a way to make that information work for you. Here’s how.

Advertising helps us with concepts. If you see an ad for a medication that addresses a health or medical problem you’ve experienced, regardless of whether it requires a prescription, then write down the name of the product and prepare to learn more about it.

Using the internet, the library, or in conversation with your trusted pharmacist, gather information about the drug’s indications (what it cures or what symptoms it relieves), its contraindications (conflicts with other medical problems you have, or food or other drugs that you may be taking that may conflict), and its possible side effects. Then do the same for similar and competing drugs.

Armed with your research results, visit your doctor. After exams and tests, explain what you’ve learned and ask his advice. He can help you understand your findings and ultimately the two of you can make the best choice for your body.

Don’t let those expensive advertisements manipulate you! But do use them to your best advantage, to learn about possibilities, improve your quality of life, and to foster a good relationship with your doctor.

If you or a family member needs help researching a new medication or understanding your options, ReAssured Advocacy can help.  Call us today at 303-756-8436

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate:  www.EveryPatientsAdvocate.com

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Resolutions for Sharp Patients

With 2014 just getting started it’s not too late for a few resolutions to start the year right.

Resolution #1: Develop partnerships with your providers

No matter what medical problems confront you, you’ll have a better chance of weathering them if you work in partnership with your doctors and other providers.  Good physician communication involves you taking an active role as well.

Ask plenty of questions. Review and research information provided to you. Ask for definitions of difficult words. Speak up when you need better explanations.

Medical decision making is your responsibility, and your physician should be your primary resource for options. Collaborate with providers to arrive at the best decisions for yourself.

Resolution #2: Be smart about drug prescriptions

According to the Institute of Medicine, more than 1.5 million Americans are harmed by a prescription drug each year. There are several causes. There may be a problem with the drug itself, the wrong drug or the wrong dosage may be prescribed, or the prescription may not be filled correctly. Some problems stem from non-compliance, meaning, the patient fails to follow instructions.

Take responsibility for your prescription drugs. Make sure your doctor prescribes the right drug, in the right dosage, with the right instructions for taking it. Be familiar with side effects, and which ones should flag a call for help. Ask questions of your doctor, then corroborate his orders with your pharmacist. Be sure to take the drug in the right dosage at precisely the right time, while avoiding foods, beverages or activities that may interfere with the drug’s ability to help you.

Resolution #3: Find a patient advocate before you need one

Rarely are any of us prepared for a difficult diagnosis. Finding a patient advocate in advance can make it easier to handle the news and activities which follow.

The best person to ask is someone who works in healthcare – a doctor, nurse, or professional patient advocate – someone with some medical training, even if they are retired. Family members aren’t your best choice – it’s difficult for someone who loves you to be objective. Find someone who is organized, understands physician communication, available, and who can command respect from those who will participate in your care including physicians, hospitals, testing sites and insurance companies.

Sharp patients will embrace all three resolutions in the New Year, and as a result, they’ll enjoy the best medical outcomes.

I wish you good health and a dose of patient empowerment for 2014 and years to come.

If you need a patient advocate to help you with a difficult diagnosis or physician communication issue ReAssured Advocacy can help.  Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate:  www.EveryPatientsAdvocate.com

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New Year’s Resolutions for Smart Patients

Mark Twain defined New Year’s resolutions as those that “go in one year and out the other.”

Unfortunately for most of us, his observation is quite accurate! We quickly give up resolutions aimed at improving our health, like weight loss, exercise, or smoking cessation. By mid-January we’re back to our old, bad, health-defying habits.

Here’s a new approach — choose resolutions aimed at prevention instead. They are less challenging to achieve than the old standards mentioned above, but may have very positive effects on your health. Here are a few to get you started:

1. Get vaccinated. Vaccines are the single best way to protect against contagious illnesses that could turn deadly. From seasonal or H1N1 swine flu shots, to shingles, tetanus or pneumonia, there are many vaccines that can help keep you healthy. Ask your doctor about them.

2. Develop a healthy skepticism. When you are diagnosed, or a treatment is recommended, listen to what your doctor tells you, then confirm what you’ve been told. Get a second opinion, or find additional information on the Internet or in the library. Make sure that your findings mesh with your doctor’s recommendations. If they don’t, then raise your questions before committing to treatment.

3. Adhere to your treatment regimen. Once you and your doctor have agreed on a course of treatment, then follow that regimen to the letter. What good can your blood pressure medicine do if you rarely remember to take it? Create a reminder system or invite your spouse to nag you – whatever it takes. If your adherence challenges are due to another problem such as the cost of the medication or side effects that you can’t tolerate, then discuss possible alternatives with your doctor to be sure your needs are addressed.

4. Don’t get sick! While that seems a bit simplistic, there are definite steps you can take. Avoid situations where you might be exposed to colds or other infections. Don’t shake hands, hug or kiss someone who is sick. Spare others illness too. Keep your hands washed, sneeze or cough into the crook of your elbow, and dispose of tissues right away.

You can probably think of additional ways to stay healthy that won’t require a gym membership or a ban on your favorite foods. Smart patients realize that not all resolutions have to be painful to be successful.

A toast to a healthy 2014!

If your or a loved one needs help navigating the health care system, ReAssured Advocacy can help.  Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate:  www.EveryPatientsAdvocate.com

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