Elder Interventions

ElderTouch Health Elder Interventions Series

I am sure you have heard the story. There is a man standing on a crowded corner in New York, whistling as loud as he could. For a few hours everyone was passing him by, ignoring him. Finally, a shopkeeper on the corner noticed the gentleman and left his shop to go out and ask him why he had been whistling on the corner all afternoon. The man said that he was whistling in order to keep away the wild elephants. The shopkeeper responded that he didn’t see any wild elephants. The whistling man said then that’s because what he was doing was working. We call this a faulty assumption.

Unfortunately, we have been programmed by society to see the elderly with faulty stereotypical assumptions. We expect all older people will become forgetful, confused, and fragile. There are still many people in our culture who believe that nothing can be done to help these people. While in some cases this might be true, we can delay and even prevent this pattern from happening in numerous others. Please, do not make the faulty assumption that old age is the cause of a problem. You need to make sure the elderly person receives the proper elder care assessment to determine if something can be done to help them.

Choosing the Right Doctor.

There are many good general practitioners and family doctors as well as internists. Because of managed-care and other third party restraints such as insurers and governmental programs like Medicare, these doctors are often limited in the time that they can spend with their patients. Yet a comprehensive evaluation requires time. How do you find out which of the doctors available to you will be able to provide such an evaluation? Ask family members and friends about the doctors they see. You can also ask neighbors, friends, and associates about their physicians.

The local city or state medical society will usually have listings of physicians who are specialists in geriatric care. Clergy and health care workers, such as nurses, are good sources of information when searching for the right physician. The local health department or Office on Aging will usually have directories that list doctors who specialize in treating the elderly. Even many local phone books are now organized by categories, and will have a special section for those physicians who work with the geriatric population.

Once you obtain a few names, these are some questions that you will need to consider. Does the doctor have good rapport with the elderly? Does the physician spend a reasonable amount of time during the initial evaluation? A five or 10-minute evaluation will not suffice. Will the physician obtain appropriate laboratory tests or other studies? Will the practitioner, with the permission of the patient, discuss the case with his family or other concerned individuals? Will the physician take time to follow up the patient’s condition on a consistent basis? How easy is it to schedule initial and follow-up appointments? Will the patient see the same physician on a consistent basis? Elderly people do far better when they have one doctor managing all of the care, which includes periodic communication with specialists who are also seeing the patient.

This is an excerpt from Dr. Thomas Krajewski’s, MD, recent book Elder Interventions. It offers elder care solutions to caregivers and families.