advocacy
It’s Vital to Recognize Depression in Aging Adults
This is a very good, short article on why it is so important to recognize the signs and symptoms of depression in older people. They may not recognize that they themselves are depressed so it is imperative for caregivers and loved ones to be on the lookout. Undiagnosed depression can lead to isolation and even suicidality. Most cases of depression can be cured. This article is written by an older gentleman who has over 30 years experience working in retirement community and health facility administration. He includes reminders and tips for fighting depression in this article. Recognize Depression in Older People – You May Save A Life
Questions to Ask Your Doctor – About Being Empowered As a Patient
Here is a list of questions you can draw from when you or your loved one goes to see the doctor. I hope they are of use to you. – Nancy
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This first section is written by Sagar Nigwekar, an internal medicine physician, and Jim Sutton a family practice physician assistant.
Top 5 Questions To Ask Your Doctor
1. How will I know that my treatment is working?
2. How will the medication or treatment you are prescribing treat my condition?
3. Is there more than one condition that could be causing my problem?
4. What exactly is my condition, and what caused it?
5. What symptoms should I look for that means I should contact you or seek immediate help?
Additional questions to consider asking:
Are there treatment choices that don’t involve medications?
How long will it take for me to feel better?
If my symptoms get worse, what can I do on my own before I see you?
Is my medical condition permanent or temporary?
Questions You Should Ask About Your Medications
Any time you are prescribed a medicine you should ask these questions:
Can I take a generic medicine or is this available over the counter?
Can you review my instructions with me?
At what time should I take this medication?
Should I take it with or without food?
Can I take it with other medications?
What are the possible risks and side effects of this medication?
What is the reason for taking this medication, and how does it work?
Will this medication interact with any other medication I am taking?
Additional questions to consider asking
Can my medication be stopped suddenly or does it need to be stopped slowly?
Do I need to follow any restrictions (alcohol, driving, and work)?
Do you think a pill box will help me?
How long will I need to take my medicine?
If I do not tolerate this medication then what are my alternatives?
What should I do if I miss a dose?
Where do I store this medication at home?
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This next part is based on an article by Ginny Dillon, a business development consultant for hospitals and health care in Dallas/Fort Worth:
Physicians are under pressure to see patients in a timely, effective, and efficient manner. Take a little time, organize your thoughts, come prepared and your visit could be much more productive.
What to bring with you to your doctor’s appointment:
Pad and pen… you will likely receive recommendations and many patients forget them as soon as they leave the office.
A list of your medical problems
A list of your medications
A list of your prior surgeries
A copy of pertinent studies (MRI, X-ray, etc)
A copy of pertinent medical records (valuable for second opinions).
Dress appropriately. The physician will need to see the area of concern.
Organize your thoughts. A new orthopedic history (questions your doctor will ask you) may include:
When did the problem start?
What were you doing?
Have you started taking any new medications?
Have you changed your exercise program?
What makes the pain worse?
What makes the pain better?
Do you have pain at night?
Does it awaken you?
Any numbness, tingling or weakness?
Any morning stiffness?
Pain getting up from a seated position?
Pain walking on hills?
Shoulder patients consider what motion causes your symptoms.
Do you have any mechanical symptoms (catching, locking, clicking, etc)?
Do you have any instability (does the joint feel loose)?
Do you have any swelling?
How does the pain affect your quality of life?
What have you tried so far to obtain relief (physical therapy, injections, medications, exercise, etc)?
After the exam and discussion of the findings, your doctor will likely present you with alternatives. Here are some questions you can consider asking at this point in your visit:
What are the possible diagnoses?
Is further testing necessary (If the test will not change the plan of care, then it is possible that you do not require further tests)?
Is an MRI or expensive imaging necessary (many times it is not)?
What are the non-surgical, surgical alternatives available to treat my condition?
What are the possible risks, side effects of the treatment?
What will happen if I choose not to have surgery?
What does the literature or research recommend (many physicians still practice based on anecdotal experience [which might be appropriate, depending on the situation])
Here are some specific considerations for surgical patients:
What are reasonably forseeable risks of the surgical procedure?
What are the realistic goals of the procedure (relief of pain, functional improvement, etc)?
What is my “expected recovery time” (recovery means different things to different people… be VERY CLEAR about your goals)
When can I use my arm/leg?
When can I l use my arm/leg for activities of daily living?
When can I use my arm/leg against resistance (lifting objects or putting weight on your leg)?
When can I drive?
Do you know what I do for a living? When can I return to work?
Older Adults in Mill Valley
As Mill Valley Commissioner on the Marin County Commission on Aging, in October 2009 I presented my annual report to the Mayor and City Council members on the status for baby boomers and older adults living in Mill Valley. Here is a link to my report presentation notes – I hope you will find it helpful to give you an idea of some of the opportunities and challenges for older people in Mill Valley as of autumn, 2009. Some things have changed – statistics, numbers, contact information perhaps, so do note that this report is from 2009. Older Adults in Mill Valley
Butler’s 3 Consequences of Ageism
From AgingWatch.com. Aging Watch is an independent think-tank committed to ending ageism and the social marginalization of older people.
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In 1969, Dr. Robert Butler coined the term “ageism” to describe this process of systematic stereotyping and discrimination against older persons. The three most devastating consequences of ageism include:
- The underutilization or exclusion of older peoples’ knowledge and insights in our civil discourse.
As a result of the negative stereotypes associated with growing old, elders are consistently responded to with sympathy and pity—often in the form of charity. While certainly well intentioned (and beneficial for many), this sympathy is a double-edged sword; the kindness it elicits is dripping with condescension and paternalism. Many elders are treated as vulnerable children in need of our protection and good will. And like children, the knowledge, voices, desires, concerns, choices, contributions, and opinions of elders are often devalued or dismissed altogether. “If older people are incompetent has-beens who lack self-sufficiency,” so the thinking goes, “then what could they possibly have to add to our society?” The result is that the vast knowledge and social contributions of older people are overlooked and squandered. - The poor and unfair treatment of older adults that stems from age biases.
Much like racism and sexism, ageism is a social disease that paints older adults as an “other” and fosters differential (and often unfair) treatment in many areas of life. In the workplace, for example, older job applicants are less likely to be hired, and are viewed as more difficult to train, harder to place into jobs, more resistant to change, less suitable for promotion, and expected to have lower job performances. Older workers typically suffer extended periods of joblessness after being laid off, and when they do find work, it is often at salary levels far lower than what they have earned in the past. According to the Equal Employment Opportunity Commission, age-based discrimination complaints in the workplace are currently at an all-time high. - The assault on older individuals’ identities and self-esteems.
In social interactions older people are assumed to be slow, weak, and forgetful. Researchers have documented the propensity of younger individuals to use “baby-talk” (i.e., exaggerated tone, simplified speech, and high pitch) when speaking to older adults. Elders are at risk of internalizing these low expectations, which can then lower self-esteem and foster bitterness and disillusionment. Instead of coming in contact with the harsh judgments of others, some elders become reclusive and completely withdraw from society; they become socially isolated and put themselves at increased risk for negative health outcomes (including depression, alcohol abuse, and suicide).
By addressing ageism and transforming the way our society sees older people we can appreciably enhance the lives of elders; and our social debates can benefit from an increased presence of elder wisdom.
Ageism and Mental Health Funding
Something I have run into in our society is a seemingly widespread belief that mental health services are primarily for younger people and not older individuals. I have heard people say that older people have had their chances and that mental dianabolos 10 health funding should go to young people where it can make a bigger difference. While I love young people, and think that kids need and deserve a lot of support, I also am saddened to think that there is a bias towards older people not getting mental health help.
This attitude seems to reflect our youth-oriented culture which emphasizes staying young in order to be important. Where is the care and compassion and respect due to our elders? The aging journey very often brings up old fears, old triggers of insecurity, old pains, old losses even from childhood. Why should older individuals – who have given to their communities all of their lives – not benefit from compassionate support as they continue their life journeys? Where is our culture’s realization that we need to hear the stories our older folks can tell us in order to gain from their wisdom and experience?
It seems to me as I grow older that I see our society having a shorter and shorter collective memory. After one year is over, we tend to go on and focus on immediate problems and immediate gains, forgetting the lessons we might have learned from what happened earlier.
While our country’s economy has been severely impacted in recent years, it has been enormously helpful to me to listen to elders’ tips about how they got through the trying years of the Great Depression and WWII. As Joan Erikson explained once, “wisdom” is not necessarily about knowing “why” but about knowing “how”.
I hope that a fair portion of mental health funding allocated by government at different levels will go to mental health services for older people. It behooves us to take care of our elders, to listen to their stories and to afford them the respect they deserve. They are survivors. We need them. We can learn things from them!
Patient Advocacy for Older Adults
Patient Advocacy for Older Adults
One lesson I learned years ago from my mother (a retired nurse) and have continued to see the importance of to this day is how critical it is for older adult patients to bring a family member, friend or companion with them when they visit their doctors.
It is important for everyone to do this when possible but especially vital for older people who can use the help of someone they trust to remind them of their questions for the doctor and to write down what the doctor’s answers are.
Prescribed medications tend to increase as we age and many medications have side effects which are compounded by the combinations, potential contraindications, various times they need to be taken, etc. All of this information can be both confusing to remember and necessary to review on a regular basis.
Doctors can tend to change dosages and prescriptions and sometimes generic medications are suddenly substituted rather than brand ones when the generic versions become available. It is important for patients to log the effects of any of these medication changes.
A written log/chart can be brought to the doctor with them. The patient advocate can remember to bring the chart, remember questions, and write down explanations. If the patient is feeling poorly, it is especially important to be accompanied. Patients who are symptomatic at the time of the visit can find even more challenge to communicate since they are dealing directly with their illnesses and associated pain, weakness, side effects of treating medications, etc.
My experience and that of many others is that, more often than not, doctors will pay better attention to you if you are accompanied by a friendly patient advocate.