health care
Successful Aging Takes a Team!
Successful Aging Takes A Team!
Let’s talk about why it’s critical to their quality of life to have a strong support team around seniors who are growing older.
Why?
Because I see so many older people in my private practice who face, for example, situations where they are grappling with:
- family members or loved ones with very strong opinions about what is best for them – opinions danabol that may or may not be informed and wise
- *no* family members or close friends at all to advocate for them
- a primary care physician who is prescribing medications but not following them in after-care. What is known as the “diagnose and adios” routine.
- a specialist or two who is also prescribing – say for instance a cardiologist or endocrinologist – but who is not tracking the interaction of *all* of the medications involved
- a psychiatrist who may be also be treating and prescribing psychiatric medications
- possibly a nutritionist, alternative health practitioner or two prescribing supplements, vitamins and minerals which may all be fine but which also carry side effects that can contribute to mood problems.
Way more often than not, there is very little, if any, communication and coordination amongst the health professionals. This coordinator function may have been done in the past by the primary care doc who managed the broad perspective overview of how each of his patients were doing. But nowadays primary docs are under so much time pressure in their practices that they just do not have time take on this role.
In order to build that coordinated team which will support an individual’s successful aging, it takes someone stepping into the role of being a skilled ADVOCATE. A person who knows how to coordinate effective communication amongst team members and who is in charge of reaching out on behalf of the patient to represent their concerns. Someone who can help the patient communicate their concerns and questions to other team members, and who also helps the patient remember the answers and instructions of doctors. Team members need to work in concert with each other, supporting the various lens through which each patient is viewed.
All of this process needs to be done with the utmost RESPECT for each patient where the patient has TRUST in the advocate that he or she is representing the wishes of the patient towards the goal of the best possible quality of life at any stage.
Gerontologists and mental health professionals who understand the importance of building good communication and coordination amongst care teams can be invaluable to the patient and family. Sometimes, it is care managers who provide this role, sometimes it’s an adult child, and sometimes it’s gerontological counselor.
Whoever it is that takes the lead in this role, a support team that is identified, built, coordinated and in good communication, will result in a patient who is much more likely to thrive and much less likely to fall through the cracks.
This is the health care situation for older people in our country today. Just the facts. And totally doable to navigate through it successfully. With help. With a solid, caring team.
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?