Dr Liz Geriatrics
Earlier this week, Dr. Nancy Hoffman, neuropsychologist and I (Geriatrician in the Greater San Francisco Bay Area) presented a talk about undue influence and how to address financial elder abuse. Today, I read that Sumner Redstone, 92, is ousting long time CEO/directors of his $40 billion dollar empire (including CBS and Viacom) and his estranged daughter (and VP of Viacom) is taking control. There seems to be a lot of legal action and uncertainty about the next steps for these businesses.
With my elders with dementia, it is often not so straightforward. Sometimes the symptom is that the person more is more agitated, aggressive or more lethargic. The person with dementia may not feel well, but not be able to communicate their symptoms. This is serious.
Medications can be like the Wild, Wild West in dementia. Too many medications, too many side effects, too little focus on treating pain. What to do?
What is better for the end of life, being at home with family or in the hospital with all the life saving equipment and technology available?
“We should look for the ways in America that we can address the health and wellbeing in a cost effective manner.”
So it seems that music can make a difference for patients whether suffering from dementia, undergoing medical procedures or post-surgery.
Someone calls and says you must join their prescription plan or you’ll lose your Medicare coverage. Don’t believe it. Whenever someone asks for your bank account number or your Medicare number, stop. Only give personal or financial information when you have verified who you’re talking to. Call 1-800-MEDICARE to make sure you’re talking to a legitimate representative.
Here’s a recent horror story that may make the point: I had a patient with complicated medical issues who had a hip replacement operation. To my dismay, the hospital discharged this man to “assisted living.”
“I’m sorry this is just not the behavior of an experienced politician. It’s also not the behavior of a person whose brain is working normally.” When dementia is involved, sexuality can be very complicated.
Financial elder abuse is much more common than most of us wish to think. Some believe that it will be the greatest crime of the 21st Century. This abuse doesn’t always come from ‘scammers’ outside the house or on the phone. Often, sadly, it comes from relatives of the elder. When you add dementia to the mix, it’s a terrible problem.
What is the ‘stigma’ associated with the diagnosis of dementia? How can we work to change this and help families and society at large understand that this is a brain disease and how to support those affected?
Sometimes, the medications ARE the problem, not the disease
Even if you walk slowly, even if you walk uncertainly, even if your joints are a little sore, even if you’re a little afraid of falling, even if walking makes you tired, just walk!
If you have an elder who goes into the hospital, and you don’t think his or her problem has been solved yet, ask the medical team why it hasn’t been solved. Push to keep the patient in the hospital until the problem is solved. Don’t give up. Ask the hard questions.
When you have a frail, elderly person who is having lots of trouble getting around, it’s important to get him out of bed each day, just to move around and retain what strength he can. It’s most convenient to transfer the patient from bed to a wheelchair. But if the patient really can’t walk any more, then that patient should use a reclining wheelchair if at all possible
We don’t have to duplicate Britain’s National Health Service and their ‘Health and Well-Being Boards’, but elders would be so much better served in the U.S. if we could work toward earlier screening and coordinated care for dementia patients.
Fight the flu by washing your hands and get a flu shot!
Every time you feel at the end of your rope. Every time you feel hurt, or out of patience, whisper this to yourself: “It’s not intentional, it’s brain damage.”
Disasters. Natural and man-made. What happens to your loved one if the power goes out? What if they no longer can rely on transportation or find their medications? These issues are important to think about and plan for when caring for someone with dementia.
As I do geriatric house calls around the Bay Area, adult children and other relatives of my patients often say, “He’s just not the way he used to be. Why can’t he be the way he used to be?” Children...