http://pameladwilson.com Fri, 31 Oct 2014 22:51:08 +0000 en-US hourly 1 http://wordpress.org/?v=4.0 http://pameladwilson.com/older-adults-viewed-as-disposable-by-medical-providers/ http://pameladwilson.com/older-adults-viewed-as-disposable-by-medical-providers/#comments Sun, 26 Oct 2014 20:05:09 +0000 http://pameladwilson.com/?p=4767

A client of mine was recently admitted to the hospital for pneumonia and was in the intensive care ward receiving a course of strong antibiotics. A physician calling me to ask about my client said “well she’s 94?. My response to the physician was, “yes she is 94 and she deserves care and medical treatment.” How many medical providers see older adults as old and as disposable?

The “Re-Hospitalization” act in the Affordable Care Act penalizes hospitals for re-admissions due to pneumonia, heart conditions and a number of other categories. In my opinion this part of the Act makes it more difficult for older adults to receive care and easier for physicians to deny care from a self-serving point of view – avoiding financial penalties for the hospitals by whom they are employed.

This particular client had been healthy up until recently and I was confident that if she received treatment she would recover and be able to return to her assisted living community. The physician would just as soon as given a death sentence to my client. She even went to the point of arguing with me about my role as guardian and legal decision maker. Knowing more about my client than this physician, I was not about to bow, like many family members would, to a physician who saw herself as an authority on my 94 year old client.

How many older adults lose their lives daily because they are viewed as disposable by physicians in hospitals or other professional settings? My guess is that the numbers are mounting each day. Family caregivers, intimidated by physicians and other professionals, fail to speak up or to advocate for loved ones. Family caregivers are uncertain about the questions that should be asked and due to a lack of experience are unaware of options.

Healthcare advocacy is badly needed for our older adults and for all individuals with health conditions – whether simple or complicated. Admittedly we’ve become a society who would rather take a pill rather than exercise, lose weight or stop smoking. Physicians have become jaded and disappointed by individuals who will not make positive health changes. But this doesn’t mean that all patients fall into this classification and it doesn’t mean that just because someone is old and sick they can be written off as undeserving of healthcare.

Family caregivers must learn to advocate for themselves and family members who need care. The Caring Generation website offers a free subscription to valuable articles, videos and podcasts in over 30 categories.  Click here to visit the Advocacy Category and to become a subscriber to information that supports family caregivers.

Professional advocates, like myself, exist to support families in situations where healthcare professionals seem to discount or ignore the desires of family. Many times difficulties arise because healthcare professionals are unable to explain issues in simple language or they assume family members understand. In other situations healthcare professionals are limited to their “world” whether this be a hospital or a nursing home and do not have expertise or experience of the outside world of services to support caregivers and older adults living at home.

Information about services and assistance for families is available on my company website The Care Navigator.  Also on this website are videos about common experiences of family caregivers and information about my upcoming book in 2015 called The Caregiving Trap. The role of caregiving is often unexpected – both caregivers and care recipients feel trapped at times by situations out of their control. Constraints of the healthcare system often result in care recipients feeling trapped because options seem limited.

By becoming more educated about options and learning to advocate, caregivers and care recipients can reduce feelings of overwhelm and feeling trapped by situations that may feel out of control. It is important as a caregiver to realize that you know more about your loved one than anyone else (or hopefully you do). Do not allow others to sway your opinion when you doubt their recommendations. Be the squeaky wheel and ask questions. How many of you remember the old television series Columbo? Sometimes it takes a little investigative reporting to arrive at the right answers and solutions for a care situation. Be persistent.

William Shakespeare said, “There is nothing either good or bad but thinking makes it so.” What is it about the idea of caregiving that makes it good or bad, positive or negative?

How might the act of caregiving be compared to the act of volunteering? Those of us who volunteer do so for several reasons: we believe in a cause, we want to do something to benefit others and volunteering makes us feel good. Most of the time when we volunteer, the people or causes we support thank us. This appreciation makes us feel good about volunteering so we give even more of our time and more of our money. We are happy to give.

Caregiving often begins with the idea of implied consent. A parent asks an adult child to complete a task to pick up a prescription or wash a load of laundry. Without thinking the adult child completes the task by acting in the role of caregiver and leading the parent to presume that if the adult child agrees to complete two projects they will continue to provide more and more support.

By contrast, volunteering usually involves a discussion and an agreement about a time period, specific skills and a financial commitment. When a family member begins caregiving, they unintentionally volunteer for a position that may last for years with no definition of time, skill or financial commitment and no formal caregiving agreement.

Might caregiving be viewed as a trap because appreciation and thankfulness are frequently absent in caregiving relationships? Is the caregiving trap supported by the idea of feeling burdened by the expectations of family members? Does the role of caregiving involve continual requests for help with no definitive end in sight? Most of us are able to sustain through extremely difficult situations for a brief period of time. The reality is that caregiving may go on for years.

Does caregiving have to be a trap?  Not if families are willing to openly discuss the challenges, be flexible, accept opposing opinions and work together. Accepting the reality that it is always not possible to meet a parent’s expectations is also very important. Caregivers are allowed and encouraged to have personal boundaries about providing care. For example when a loved one becomes incontinent or is awake all night this may mean that it is time to consider in home care or assisted living. If a parent lives at a distance and requires care it is unlikely that children 2,000 miles away will be able to show up to manage unexpected emergencies.

As much as family members may want to be helpful, having conversations to avoid the caregiving trap is important to preserve family relationships. Ignoring or delaying decisions may result in extremely limited options and less than ideal solutions.

Caregiving Support Category