WHO WILL CHOOSE YOUR NURSING HOME?
Do you remember the bumper sticker "Be kind to your children - they will be choosing your nursing home."?
Here is a cautionary tale about adult children and their parents. The couple have lived in the same house for 30 years. In their 80s, he became so frail that he moved to a long tern care (LTC) facility in Toronto. The children persuaded their mother that it would be sensible and safer if she moved too "to be with him." They said they were worried about her being alone in the house.
Before she was forced to move, he died, and as we assembled back at the House after the funeral, we heard that the real estate broker had sold the house and she would have to move in two months time. She doesn't want to move yet .. in any event if she had moved "to be with him", they would have been in separate wings.
As regards the dangers of living alone, 35% of over-65s in Canada live alone. So should one suspect the motives of the concerned children: the money from the house? Less guilt about fewer visits? The feeling that she's had a good life and shouldn't hang on? Or is it just muddled thinking that ignores the true welfare of their mother?
Now, her concern is about her car. Will they let her keep it?
RMcM
Opinion
200 GERIATRICIANS FOR ALL OF CANADA - IS THAT ENOUGH?
I have often confused geriatricians with gerontologists:
GERIATRICIANS Branch of medical or social science dealing with health and welfare of old people.
GERONTOLOGISTS Scientific study of old age and process of ageing, and of old peoples' special problems.
Dr Atul Gawande, an assistant professor of surgery at Harvard Medical School, has written a hard-hitting article in the New Yorker about the shortage of geriatricians in the United States, where despite the growing elderly population, the number of certified geriatricians fell by a third between 1998 and 2004. Fields like plastic surgery and radiology are growing. In his view, this is partly about the low income in geriatrics and adult primary care, and partly that most doctors don't like taking care of the elderly.
"Give us a disease and we'll fix it" they might say, but give them an elderly woman with colon cancer, high blood pressure, arthritic knees, and various other ailments besides - an elderly woman at risk of losing the life she enjoys - and they are not sure what to do about it.
Dr Gawande points out that the geriatrician's approach is not high-tech medicine - no back surgery, lung biopsies or PET scans. It attempts to control arthritis, see that toenails are cut, and meals square. They look for signs of isolation and will arrange a visiting social worker.
Dr Chad Boult, geriatrics professor at Johns Hopkins, was asked what can be done to insure that there will be enough geriatricians for the surging US elderly population and he replied: "Nothing" "It's too late". However, he suggests training all primary-care doctors in caring for the very old. But medical students take no course in geriatrics (they don't take courses in empathy either). Dr Boult also suggests "Guided Care" - recruit local nurses for a highly compressed three-week course in how to recognise specific problems such as drepression, malnutrician, isolation, and danger of falling.
Jonathan Swift wrote "A Modest Proposal" (1729) to cure Ireland's overpopulation - sell babies as delicacies for gentlemen's dinner tables. Recently, a Swiftian proposal has been made to euthanase the elderly. May I make some more outrageous suggestions:
* (Each year 350,000 Americans fall and break a hip. Of these, 40% end up in a nursing home, and 20% are never able to walk again). Suggestion: train geriatricians to perform hip operations (the pay is great).
* (The Psychologists fought the Psychiatrists for analysing rights and won.) Suggestion: Gerontologlsts could take on the functions of geriatric medicine.
At Abbeyfield Houses we do our best to help residents stay with us for as long as possible without having to go to a long term establishment. The small size and volunteer involvement makes us aware of malnutrician, depression, isolation and we have the ability to take prompt action in case of a fall.
