Monday, February 16, 2009

Just Because They're Old Doesn't Mean They're Senile

Word of advice for those of us with aged parents. Just because they're old and have begun to act a little dotty, doesn't mean they're just going senile or losing their minds.

One of my many jobs was working part time in the geriatrics department of a large and well-known teaching hospital. My job was assistant web editor. I was to read through and post various presentations written by doctors onto a website where other doctors would come to do research. There were all kinds of presentations about all kinds of medical issues relating to the elderly. Most of it went over my head. But a couple of very important things stuck...

- The elderly very often don't run temperatures. So you cannot use fever or sweats or clamminess as a sign that something is wrong or that your elder has an infection.

- An infection in an elderly person... even if it's something as simple as a urinary tract infection, can cause symptoms like "dottiness", confusion, lethargy.

So if your normally sharp-as-a-tack parent or grandparent begins to be confused over simple things like writing checks, losing wallets or they're glasses, don't just chalk it up to "old age" or being senile.

Also, back pain can be an indication of a severe infection. Twice my father has had severe, debilitating backpain, and twice he's had a severe infection. The first time it was a staph infection; this time the results aren't back yet, but trust me... he's got an infection. The likes of which haven't been seen in a while because the docs dismissed the symptoms and it's been festering awhile.

Which brings me to something else... "specialists" are apt to miss something important if it doesn't fit into their specialty. Meaning, don't expect the hernia surgeon to pay attention to elevated white blood cells especially if there is no infection AT THE SITE of the surgery. He might refer you to the oncologist. Who, if he doesn't find a cancer, isn't going to give you a clear answer or dismiss it as a random infection. The renal doc is going to suggest a CAT scan or fill your mind with a fear of cancer. Find a geriatrician for your elder. And that's hard to do, because there aren't many, apparently, but there needs to be someone who can look at the overall picture and connect the dots, realizing that 2+2=4. Too often the "specialist" doesn't see the overall big picture and will chalk up pain or confusion as just something that happens when you're old.

Be aware that your elder may not tell you EVERYTHING that's going on. For a variety of reasons. They may be embarrassed. They may not see the significance. They may not see themselves as being "elderly". A geriatrician will be more aware of things that will affect the elderly and so is more likely to ask the right questions to get the right information. For instance... a regular GYN is not going to be aware of all the issues an elderly woman may face. But a geriatric GYN will. A geriatrician will also be able to spot signs of depression. And depression in the elderly can mask itself as something else entirely.

Here's a few links (some are more technical than others):
http://www.eldercareadvocates.com/pages/art14.htm
http://www.kcom.edu/faculty/chamberlain/website/lectures/noll/sld001.htm
http://medinfo.ufl.edu/~gec/hmoa3/pt3tk3/pt3tk3.html
http://www.lifebridgehealth.org/sinaibody.cfm?id=1973

Generally my parents are pretty healthy, and I'm only now beginning to navigate the hell that is elder care. And truthfully, the Professor does most of the navigating because she's got an MSW and is sufficiently bossy enough to get hospital staff to listen to her. What I do is listen to the terms she picks up, and then Google everything, feeding her things to ask.

Meaning... it practically takes an army paying attention full time to get adequate care for your elder. And you will still find that the doctors don't listen, don't look at the big picture. So don't rely on the doctor to fix your elder. They really don't like it when folk come in armed with research done on the Internet, but honestly, you have to, if only because your questions may spark them to take a closer look. And if your parent is NOT normally forgetful, be sure to say so. Even if you have to say it 1,000 times.

2 comments:

Nina said...

This is some of the most valuable information I have seen in awhile. I will be checking out the links a little later.

Thank you, m'dear.

Nina said...

This is some of the most valuable information I have seen in awhile. I will be checking out the links a little later.

Thank you, m'dear.