October 26, 2013
Are Elderly Patients Obtaining Quality in Outpatient Care?
There is only one answer and no is it. Education in medicine is a key most doctors are prone to ignore. They do have a reason, although not always the best and that is third party insurance places limits on the amount of time they will reimburse doctors for their time. Therefore, doctors dictate routines for the elderly and expect them to be followed.
Sometimes the doctor's orders are right, but often they forget some small part that in turn confuses the patient and none of the routine is followed. The patient suffers and becomes further confused. That is an excellent reason we need doctors that are geriatricians and can work with the elderly to clarify what should be accomplished by the patient.
Yes, occasionally the geriatrician discovers something totally missed, over looked, or the patient did not say that puts a different perspective on what the patient needs. Dr. Leslie Kernisan is a geriatrician and works to translate the information for the elderly, the caregivers, or the family.
With the numbers of seniors growing rapidly now that the baby boom generation is beginning to enter the senior category, doctors in regular practices or working for hospitals will not be able to take the time necessary to work with the seniors, their families, or caregivers. I am aware of a few doctors that will not accept caregivers and exclude them if possible even when they have the proper legal credentials. A few are also excluding family members.
One of the people I know is having memory problems and wants her daughter present to confirm what the doctor says. After her last appointment, she nearly came completely undone, as the doctor would not allow her daughter in to the exam room. This caused the daughter to talk with her doctor and ask what he would not allow. Turns out he will appreciate having family or caregivers when necessary. The daughter scheduled her mother with her doctor and they both came away happier. The mother said she has never wanted to go to her daughter's doctor, but with the actions of her doctor, she needed an alternative and will not be returning to her doctor.
After a complete review of her medications, he found what may have triggered the mother's memory loss and after talking about this, her daughter remembered that this started happening shortly after she was put on the medication. He stated that removing this may not return all the loss, but should help. The daughter produced three prescriptions her mother had received about three weeks earlier and the doctor looked at them and said no, her mother did not need any of them and two of them were for something her mother did not have while the third medication was not advisable at her mother's age and could add to her memory problems.
The mother asked if there would be any time that her daughter could not be present. The doctor answered only if her daughter was in the hospital and then he asked if there was another family member that could attend. The daughter said that her husband could if her mother approved. The mother said if it was necessary.
Because I have not covered much of the material from Dr. Kernisan's blog, you may want to take time to read her blog especially if you may be concerned about a parent or if you are a caregiver.