Medical treatment is generally given in relative isolation. A patient is seen by a doctor in the office or hospital and various interventions are done or prescribed. The physician often has to rely on the patient for history and reporting, along with the use of diagnostic tools and techniques.
For geriatric care, in particular, this presents a number of challenges. Patients of all ages (and for a variety of reasons) can be poor reporters; elderly patients with memory problems or cognitive impairment may be especially inaccurate in their reporting as well as compliance. Additionally, elders may have many aspects of their lives influencing their ability to be compliant or negatively effecting their healing.
Here are a few example stories of how geriatric care carried out in this traditional manner can be problematic:
Mrs. Smith takes several medications. Her doctor starts her on new eye drops at her most recent visit. She fills the prescription right away and takes the eye drops home, but a couple days later she confuses the new drops with her old drops and discards them. She continues taking the drops on the schedule the doctor wrote down for her (after discovering last time that she seemed confused by when and how she was supposed to take them), but unfortunately she is taking the old drops. For this reason, her lab tests do not appear to be improving on the next visit and the doctor is puzzled. She is also having trouble remembering to take one medication, which is the only one she takes as mid-day. When she realizes she hasn’t taken it she usually just takes it along with the evening dose. She has gotten sick to her stomach several times from this, but has reported to her daughter that she had a “stomach bug”.
Mr. Jones is a cardiac patient. He is on a good regimen for his heart issues as well as blood pressure medication. His doctor advises a low sodium diet and gave him some literature on it. Mr. Jones’ wife died about 6 months ago and she did all the cooking. Since she died, he appears to be coping well but he has stopped going to church activities (their main activity outside the house) and is sleeping a lot. He usually has a pot of coffee for breakfast, a can of soup and some saltines for lunch and either a frozen meal or Chinese delivery for dinner.
Mr. and Mrs. Yates have been married for over 50 years and live alone in a home on the beach. Mr. Yates has early Alzheimer’s, which Mrs. Yates is having a hard time accepting. She gets irritated with him for repeating things and has started to yell at him a lot. Their daughter convinced them to visit a memory clinic, where he was given a diagnosis and started on medication which can slow the progress and improve functioning. They also recommended a driving assessment be scheduled. Mrs. Yates lets Mr. Yates handle his own medicines and his daughter doesn’t think he’s taking the new medication. He does not take anything else right now, but he also seems to be having difficulty managing his hygiene. Mrs. Yates has also refused the driving assessment, as she states they mainly go places together or he goes to familiar places (though he has already gotten lost two times, fortunately only for a short time). Mrs. Yates has diabetes and blood pressure problems and her health seems to be worsening under the stress. She has also passed out two times, but has not said anything to anyone (her daughter is noting more bruises and that Mom appears to be losing weight).
Medicare home healthcare offers some in-home services to support medical treatment for elders, with short-term interventions. Because many of the lifestyle factors involved in the stories above are ongoing/non-medical issues, a private duty home care company like EasyLiving can help elders improve their outcomes. Some of the primary services that support an effective treatment plan include:
- Nutrition support (shopping, meal prep, meal planning for special diets and likes/dislikes)
- Medication management (R.N. supervision and set-up, reminders from trained home health aides, monitoring and reporting)
- Help with daily care (hygiene, gentle reminders, safety support, stress relief for caregivers)
- Companionship/helping clients stay active and engaged
- Assistance with errands, appointments and senior transportation
- Home safety and aging-in-place support (monitoring any concerns, helping with transfers and fall prevention, serving as an extra set of “eyes and ears”)
- Care management through our Aging Wisely advocacy team: assessments to gain a better understanding of the underlying issues, tailored recommendations and care coordination
If you see similar issues in your aging parent or work with patients who you know could use lifestyle interventions to support their well-being, give us a call today at 727-448-0900. We’re here to help!