Mark Twain

"Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do ...
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Friday, April 19, 2019

Q - Quality of Senior Medical Care - an Opinion

🎵 Happy Birthday to me. 🎉
🎠 Happy Birthday to me. 🎡
🎼  Happy Birthday, dear me! 🎶
🎉  Happy Birthday, to me. 🎊

Finally, actually 72 years of age - today at 8:45 pm.  I remember my 30th birthday.  Mom called to wish me a Happy Birthday.  She said she was calling at the exact time I was born 30 years ago. 8:45 pm!  I laughed and said that ... no, mom, I was born at 8:45 am ... she had missed it by 12 hours.   Mom quickly corrected me saying, no, I was born at 8:45 pm.   She was there and aware of the time - AND this was before I could tell time!!!  8:45 PM

Crap!  Here I was commiserating ALL DAY LONG that I was 30 years old, when in fact I was only 29 until just that moment.  I had been cheated out of 12 hours of being 29!!!

Today is my 72nd birthday and I elect to take those 12 hours of being 29 TODAY!!
 And so ... as you read this post, just know
 I am the oldest looking 29 year old you will ever see!
(at least until 8:45 pm - and then I will be the youngest looking 72 year old you will see!!
haha!)

*****

#AtoZChallenge 2019 Tenth Anniversary blogging from A to Z challenge letter

Ok, back to the blog challenge!  A more serious topic!

Quality of Senior Medical Care

Quality of Senior Medical Care is a serious concern of mine.  Medical care is pretty good in my area - I have no problem with the quality of medical care generally.  But during the last 8 years with mom, I learned that the medical care system is designed to keep you alive - at all costs - without consideration for the quality of living - Period, The End.

It can sometimes forget that living is more than just a beating heart!

More times than I can count, I needed to intercept / interpret / evaluate the need for care for mom against what that care would do to her in the aftermath.  Let's take an example:

Mom was diagnosed with a rather large aneurysm on her descending aorta from her heart.  I agree, that is a very serious life threatening condition.  She was in the hospital, however, for one of her many UTIs (Urinary Track Infections), that are SO common in the elderly (and yes they do hospitalize the elderly at times for this condition.)  I can't remember how they discovered this aneurysm in her chest, when her complaint centered in her belly - but they did. When the doctor told us of the aneurysm, he said something like ... "Really, this is serious, typically we wouldn't discharge her with this aneurysm and would insist on surgery to fix this.  It is a big, big, big aneurysm.  What did you think?" ... I looked at him.  Was he kidding??  What do I think??  So I told him. "There would be no surgery.  My mother's health was not good (many many other issues).  If she didn't die on the operating table, she would most certainly be bed ridden for the rest of her life, because the enforced weeks of bed rest would totally sap any little strength she had now.  She would never recover to her current disabled status."  I remember his eyes got big.  I am sure he noted in the chart that patient's daughter refused treatment for a life threatening condition.  He was off the hook.

The important point here is that the elderly need an advocate with them to guide the decisions of a hospitalization - ideally 24/7 advocacy, - because care in a hospital is 24/7.  Mom was suffering mildly from her dementia at the time of this conversation.  She could converse normally to the unfamiliar ear.  If I wasn't there, I don't know how that conversation would have played out.  Would she say yes?  Would she say no?  The bottom line is that doctors want to 'fix' things - they don't want to release a patient with a life-threatening condition no matter what their age.  I get that.  But sometimes you have to balance quality of life over longevity of life.  High quality medical care can keep you going for a very long time - but it can also hurt you if not managed in a humane and reasonable way.

And just so you know the full story, mom died 4 years later from dementia - not from that aneurysm which did not show on her death certificate ... or from her kidney failure or her Cardiac Heart Failure (CHF) or the painful boils on her legs or from the arthritis throughout her body - it was her brain disease, dementia, that was first on her death certificate that killed her.  Surgery I believe would have certainly taken her from this earth earlier.

Was I right or was I wrong!  I guess it is a matter of opinion.  But all the decisions I made on my mom's behalf are decisions I can live with - to this very day.  I believe I gave her more life - not less - and the quality of her life was surely better than trapped in a bed.

Mom was in the hospital many many times.   I was with her always.  Sometimes I would walk down the hallway to the cafeteria and I would see other very very old folks in beds - many without anyone to speak for them.  I always felt badly for those folks.  Always.

I have a special soft spot in my heart for only 3 things in life:
children, animals and the elderly!
Everyone else can fend for themselves!

9 comments:

Wendy said...

Firstly, happy birthday! Hope you have a great day. Secondly I get your post. I had to advocate for my mum too and completing a DNR form when she was admitted to a care facility was not an easy thing to do but I knew it was the right thing to do.

Leigh said...

Happy Birthday! Enjoy it no matter how many hours you have, LOL.

In what seems like a lifetime ago I worked in the hospital as an RN. Yes, the elderly truly do need advocates. I found it especially troubling that there is an assumption that all elderly are fumble-minded and not capable of making their own decisions. This isn't just something I saw with medical staff, but with families as well.

My own mom story took place when mine was in her 60s. I knew she had gone into the hospital and called to see how she was doing. I happened to call in the middle of a medical emergency. The doctor got on the phone with me and was hoping for a verbal DNR from me, telling me the other alternative was life-threatening surgery. I told him to go ahead with the surgery. Turned out to be a very bad gall bladder and she lived for more than a decade afterward in very good health.

Susan said...

Happy Birthday to whatever age you are and feel! I hope it's a wonderful day. Spending time in hospitals with my dad (and my mother, who is incredibly accident-prone) has really been eye-opening. I'm afraid, in our case, most of the problem is a complete dismissal of the cares and concerns of anyone over 80. My sister, bless her heart and soul, is a wonderful advocate for both of our parents and she managed to get my father a new primary care doctor who is wonderful. I just hope I don't live that long. Unless I am 96 and feel 66!

lyndagrace said...

Happy Birthday! I will be 72 in a few months. I agree with you about advocacy for anyone who has to deal with medical procedures. I totally agree with you also about quality of life. You made a thoughtful decision about your mom. I not so sure the doctor gave it as much thought.
Visiting from A to Z.

Marie Smith said...

Happy birthday! You are indeed a young 72 if your ability to express yourself is any indication!

Any person in a hospital needs an advocate. I went to hospital with a gall bladder attack when I was in my late 30s. My mother was with me. She’d had a ruptured gall bladder and had been sent home from the same hospital and almost died. She wasn’t about to let the same happen to me. She taught me a lot that day about advocacy for a loved one.

She died of a aneurysm in my arms, at home, two and a half years after diagnosis. It is what she would have wanted!

Lael said...

I'm with you on that last bit there too <3 100% Children, Animals and the Elderly. <3

We talk about death a lot in this house and while I've made my wishes known and signed all the papers, I sure hope my daughter treats me as well as you treated your Mum. I should send her to your blog, so she can see exactly what I mean.

Happy HAPPY Birthday to YOU! You had me laughing away with your birthday thoughts :) I hope your day is as lovely and as fun as you are!

Michelle said...

Happy, happy! Loved your opening; you have such a great attitude and sense of humor!

On the more serious topic, I firmly believe that having an advocate – someone else or being your own best advocate – is the most important determining factor in getting quality medical care at ANY age.

happyone said...

A Very Happy Birthday to you. 🎈

Terra said...

Happy birthday. You make a good point, that the elderly need an advocate, and an informed advocate. From reading your post it seems some doctors have other agendas than what is best for their elderly patients.