‘Medical Advocacy for Seniors’ Posts

Identity and Dementia: Where Do I Go?

March 23rd, 2015 by Doris Bersing
Frankly I do not give a damn...

Frankly I do not give a damn…

Most of us spend a big part of our life searching for meaning, trying to find our identity, and although Thomas Szasz said in The Second Sin (1973) said “…the self is not something one finds, it is something one creates…” we set ourselves for the pursuit of that elusive identity and our meaning as human beings. What is life all about and overall what is our role in life? What do we really live for? Who are we?

We pass many of our prime years looking for our identity, fighting for one, trying to assert one if we are ever given a glimpse of it, wrestling to have our needs met and to have our dreams come true. That search for identity comes sometimes in a puzzle of circumstances, challenges and exploits, and like the overprotected Nemo, we need to swim the oceans of uncertainty and grow until finding ourselves

Through the journey in search of our identity, we attempt to unfold our potential, our desires, and to adjust at the best of our abilities to the challenges of daily life. We build our life upon joys, shadows, and sorrows and fill that life with the mementos and the facts we carve in our memory, those we gathered throughout our journey but one-day, zas! You are diagnosed with dementia. There you are, all of the sudden lost, confused and soon to be stripped, if not of your identity, at least, officially, of your mind.

I know, hopefully, we all have been lost in our minds out of excitement, passion, or love and yet, after the diagnoses you will not be lost in your mind, anymore, since now, your are losing yours. Of course, we could discuss what really mind is, there is so much more to the mind than the cognitive aspect of it and yet for any purpose is THAT mind the one holding your memories, mementos, treasures, pains, and joys that is ready to go with the wind. Well in reality, with the plaques and tangles created in your brain, in a certain time you will not even remember the time of diagnosis. Just as Clark Gable stated while playing Rhett Butler in Gone with the Wind, stated, you may well say: Frankly, my dear, I don’t give a damn….” But he clock is ticking.

Professionals will offer all what they have. They talk and teach how to calm you down, how to deal with your mood swings and your challenging behaviors but do they really know what we are going through, what you are going through? Do they know that you are going through the tunnel, in and out of the darkness, the uncertainty with the challenge of living an existential tale of the here and now, for which, you did not sign up and for which, effectively you have never practiced. Then come the drugs, the optimism, the clinical trials, the walking to fund more research, hopefully before it is too late for you. Looking now for a different meaning. There is so much that is done, said, so much still to do and yet nobody really knows what you are going through.

We try and theorize about the phenomenon, the neurological, psychological, emotional, and practical side of it, even the spiritual side of it. Needless to say, we appreciate all the nice legitimate attempts people make writing new books about breakthrough treatments and findings; they present lectures, write articles about you but what if you could really explain how it is to know that your life is slipping away, fading away? What if you had a voice? What if they found a cure?

I wish I could be more helpful, but I really do not know how it is, all is in my best efforts to explain a phenomenon, I can only observe and witness with powerlessness, compassion and horror. I do not have dementia and I wonder if I had it how I would feel? What would it be like? Again, I do not know but if I could, if I were you, I would not like to go there. That said, I hope I would react calmly and with patience for myself, although I doubt it but let the journey continue and keep on swimming.

For now, I find some solace and motivation to keep ‘on swimming in Thoreau’s wisdom:

“…I went to the woods because I wished to live deliberately… only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived. ~Henry David Thoreau, 1854

Temporary memory loss strikes hospitalized seniors

April 18th, 2011 by Doris Bersing

dependent-100345_640Battling an illness, lack of sleep and strange surroundings can make any hospital patient feel out of sorts. Medical advocacy is key when having a senior in this condition. Hospitalization not only jeopardizes the general wellness of a senior but his/her dignity and self-confidence. Besides getting sicker at some point, seniors are usually placed on diapers to avoid labor-intensive trips to the bathroom and usually when confused, they are misunderstood on their needs. This article about how confused they can be and how memory loss occurs is the icing on the cake.

As we said, for seniors, hospitalizations actually may cause temporary memory loss and difficulty in understanding discharge instructions, according to a new Northwestern Medicine study.

The cited study found that seniors go back to normal one month after the hospital stay. But immediately following a hospitalization, it is a critical time in which seniors may need extra support from   professionals and family, according to Lee Lindquist, the lead author of the study, published online in the Journal of General Internal Medicine, March 2011.

Read more

Six Questions to Protect Elderly Patients

July 5th, 2010 by Doris Bersing

On the Wellness section of the New York Times, Pam Belluck compile the advice of three experts  on the questions family members can ask to lower a patient’s risk for delirium during a hospital stay.

Pam says “…Many readers have asked me what family members can do to help lower an elderly patient’s risk. To find out, I turned to three experts –  Dr. Margaret Pisani at the Yale University School of Medicine, Dr. Wes Ely at Vanderbilt University School of Medicine and Dr. Sharon Inouye at Harvard Medical School. Based on their advice, here are six questions family members should ask to lower an elderly patient’s risk for hospital delirium…”

Read the article

Not All Assisted Living Facilities Are Safe. A Report Describes How Elders Are Dying in Nursing Homes.

July 5th, 2010 by Doris Bersing

America’s largest elderly people live in California. 3.7 million over age 65. Most of these seniors live in institutions and although some of these facilities provide an outstanding care for many seniors,  a staggering number of others are being abused and neglected and even are dying on these residential care facilities. Some of these facilities are so eager to retain the residents that they ignore the issues that will need real medical care and well trained medical staff and keep the residents away from the needed care until it is too late.

Tanya McRae  conducted an investigative report on abuse and neglect of the elderly at skilled nursing facilities and nursing homes. In the video, one daughter shares her story of her mother’s horrific death, and attorneys explain staggering number of other criminal cases.

Watch the video

Caring for The Elder at Home: The Need For a New Paradigm.

June 29th, 2010 by Doris Bersing

Family meetingThe increasing number of people turning 65, the high number of elders with health constraints, and the sky-rocketing price of health care posits the question of how are we going to care for all the elders who constitute, today the upcoming silver tsunami?

More than 40 percent of adult patients in acute care hospital beds are 65 or older. Seventy million Americans will have turned 65 by 2030. They include the 85-and-older cohort, the nation’s fastest-growing age group. Elderly people often have multiple chronic illnesses, expensive to treat, and they are apt to require costly hospital re-admissions, sometimes as often as 10 times in a single year. Living Well Assisted Living at Home has designed a new model of comprehensive care that will help care for elders at home, including those who are frail, recovering from surgery, accidents or any illness. The model also strives to care for those suffering from dementia, at home.

In an article written by Milt Freudenheim for the Health section of the New York Times, in June 28, 2010, we find how geriatricians and other professionals are lobbying for best practices in the field of aging.  In the article it is stressed the fact of how “..to stay independent, the elderly will need to stay healthy. Many of these people could be back on the golf course and enjoying their grandchildren if we did the right thing for them,” said Mary D. Naylor, a longtime geriatric care researcher and professor of gerontology in the School of Nursing at the University of Pennsilvania. Her research showed that even fragile older people could avoid a quick return to the hospital if they are managed by teams of nurses, social workers, physicians and therapists, together with their own family members. Hospital re-admissions, which cost $17 billion a year, could be reduced by 20 percent — $3.5 billion — or more, she said…” Obviously a new approach to care for the elder is imperative if we wnat to promote wellness in this sector of the population and reduce the increasing costs of caring for seniors.

Mr. Freudenheim continues by saying: “…Many internists, family physicians and other primary care doctors are lobbying for payments for a team approach based in the physician’s office. The concept, which they call a patient-centered medical home, will be tried out under the new health care law by Medicare, Medicaid and some private insurers. Secretary Sebelius has called the medical home idea “one of our most promising models for improving the quality of care and bringing down health care costs…”

Read the article.

The Importance of Medical Advocacy for Hospitalized Elders

June 27th, 2010 by Doris Bersing

There is evidence that even short episodes of hospitalization on elders can hinder recovery from patients’ initial conditions, extending hospitalizations, delaying scheduled procedures like surgery, requiring more time and attention from staff members and escalating health care costs. Afterward, patients are more often placed, whether temporarily or permanently, in nursing homes or rehabilitation centers.

Medical advocacy is a key component of Living Well’s approach to care that has been demonstrated to lead to improved quality of life and avoid further complications for seniors’ health. It is vital to avoid unnecessary visits to the ER and prolonged home stays.

Pam Belluck offers advice on how to prepare when an elderly patient is headed to surgery or a hospital stay in a recently post in The New York Times. She offers  Six Questions to Protect Elderly Patients.

Read the article.