Doctors just I’ll equipped for elderly!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Can you give some examples? There are things like say knee surgeries that are a reasonable suggestion up to a certain age, but once someone is very elderly the risk of death, dementia or worsened dementia from anesthesia, aspiration pneumonia from anesthesia and so many other things goes way up. So all they can suggest is PT.

There are great medicines out there, but if you are on a handful of medicines, the risks of interactions or falls can increase.

There's just a lot of issues with the over 85 folks where the risks with treatment may be greater than risks without.

The one concrete example in this thread is a UTI. The other was an elderly woman with sudden onset cognitive issues. Both of those things should be diagnosed before you write off treatment. And while I imagine a UTI in an elderly person could be harder to treat it still seems very treatable with a fairly low level of care.

Really? Most doctors we encountered seemed to know that UTI is a primary r/o for just about anything because they can cause so many issues in the elderly.

Parkinsons dad PP here. He had several UTI towards the end, and while usually they did recognize it-we had a few occasions where the symptoms weren't taken seriously enough, I felt, because 'oh it's parkinsons'. I had to advocate and say, no, this is not his normal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Can you give some examples? There are things like say knee surgeries that are a reasonable suggestion up to a certain age, but once someone is very elderly the risk of death, dementia or worsened dementia from anesthesia, aspiration pneumonia from anesthesia and so many other things goes way up. So all they can suggest is PT.

There are great medicines out there, but if you are on a handful of medicines, the risks of interactions or falls can increase.

There's just a lot of issues with the over 85 folks where the risks with treatment may be greater than risks without.

The one concrete example in this thread is a UTI. The other was an elderly woman with sudden onset cognitive issues. Both of those things should be diagnosed before you write off treatment. And while I imagine a UTI in an elderly person could be harder to treat it still seems very treatable with a fairly low level of care.

Really? Most doctors we encountered seemed to know that UTI is a primary r/o for just about anything because they can cause so many issues in the elderly.

Parkinsons dad PP here. He had several UTI towards the end, and while usually they did recognize it-we had a few occasions where the symptoms weren't taken seriously enough, I felt, because 'oh it's parkinsons'. I had to advocate and say, no, this is not his normal.

One of my kids as ongoing serious medical issues. This isn't ageism. I have the same issue. Doctors aren't magical. It's a collaborative process. If I think something isn't being taken seriously, I remain persistent and try to help the person understand. Sometimes it's time to switch doctors. I got my child to a much better place through many years of advocacy and also really trying to collaborative and assume the doctor wants to solve things. Sometimes an ailment is typical for that medical issue and you have to help them understand why it's a red flag for your own loved one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I noticed that as my father aged, medical staff was more often disregarding his symptoms or input. I was his advocate, but it depressed me to think of all the seniors who don't have someone looking out for them or speaking up for their needs.

Perhaps because there comes a point in a persons life that there isn’t really a benefit to treating something. Or doing the most aggressive treatment.

Family member was 80 and was told just that, no reason to treat the prostate cancer because dr said had “had a good life.” Family member rejected the do nothing approach and got treatment and lived another 20+ years in their own home- alert, healthy, mindful and self-sufficient until day died, over 100.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I noticed that as my father aged, medical staff was more often disregarding his symptoms or input. I was his advocate, but it depressed me to think of all the seniors who don't have someone looking out for them or speaking up for their needs.

Perhaps because there comes a point in a persons life that there isn’t really a benefit to treating something. Or doing the most aggressive treatment.

Family member was 80 and was told just that, no reason to treat the prostate cancer because dr said had “had a good life.” Family member rejected the do nothing approach and got treatment and lived another 20+ years in their own home- alert, healthy, mindful and self-sufficient until day died, over 100.

This happens in minuscule cases of elderly with health issues. Maybe 80 was too young to not treat but very very few people are living to over 100 alert, healthy, mindful and self-sufficient. Most likely there was a family member (most likely a female) who was sacrificing to make this happen. Factoring in how long a patients patents live is probably important. As well as their quality of life. If your parents lived to be 95 and relatively healthy you have a better chance as well.

[Anonymous]

Anonymous wrote:I had a hard time getting hospital staff to understand that Mom was suffering from something that came on suddenly. She had been doing the NYT crossword puzzle every morning and learning new knitting patterns. What they saw was not who she was. Ultimately, she recovered and was more herself.

I had something similar with my mom recently. Fortunately I was able to go to all her appts for several months. She seemed in bad shape and I think was getting written off as having one foot in the grave and I repeatedly emphasized that her situation had changed drastically and that she was just before driving, going out to lunch every day, to the theater etc…she’s made a significant recovery and is almost back to where she was previously but I had to fight tooth and nail to get her necessary help.

I’m sure a lot of older people are difficult but a lot of drs are just rushed with everyone, don’t listen well and clearly don’t want to deal with the elderly.

[Anonymous]

I've yet to meet a competent doctor, period. Most are mediocre at best AND have 0 motivation to help with most things.

[Anonymous]

Nurses and doctors see a lot of old people getting life-prolonging therapy that is not offering them quality of life. Families making decisions that they disagree with, etc, or people in under staffed nursing homes. So I think their default is to be conservative with an elderly patient, especially one with a progressive disease like Parkinson’s, Because they’ve seen a lot of older people living lives that don’t seem to them as worth living.

My mid-80’s dad has atypical Parkinson’s, and I really had to step in to get various issues treated seriously by doctors and nurses— Issues that I think they would’ve seen as urgent if he was a 45-year-old man.

The fact of the matter is, my father probably only has a few years of life left. But every single one of those days is very important to him. I think doctors and nurses look at him and see an old guy who’s very debilitated and doomed. But he loves his life and wants it to last long as possible. He can’t really advocate for himself, though. Certainly his primary care doctor was not equipped to take care of an extremely old person, and yet he has treated my dad for so many years that my dad is loyal to him, even though the doctor is not competent in geriatrics my view. The whole thing is very sad.

[Anonymous]

Anonymous wrote:Nurses and doctors see a lot of old people getting life-prolonging therapy that is not offering them quality of life. Families making decisions that they disagree with, etc, or people in under staffed nursing homes. So I think their default is to be conservative with an elderly patient, especially one with a progressive disease like Parkinson’s, Because they’ve seen a lot of older people living lives that don’t seem to them as worth living.

My mid-80’s dad has atypical Parkinson’s, and I really had to step in to get various issues treated seriously by doctors and nurses— Issues that I think they would’ve seen as urgent if he was a 45-year-old man.

The fact of the matter is, my father probably only has a few years of life left. But every single one of those days is very important to him. I think doctors and nurses look at him and see an old guy who’s very debilitated and doomed. But he loves his life and wants it to last long as possible. He can’t really advocate for himself, though. Certainly his primary care doctor was not equipped to take care of an extremely old person, and yet he has treated my dad for so many years that my dad is loyal to him, even though the doctor is not competent in geriatrics my view. The whole thing is very sad.

You say that now - every single one of his days is important to him. Does he fully understand chances are if he doesn’t die of something else first he will most likely lose the ability to walk, talk, and swallow, will become incontinent and bed ridden? I really don’t get why you would want to prolong his life so he can suffer. Mid-80’s is beyond a typical lifespan for when he was born.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Nurses and doctors see a lot of old people getting life-prolonging therapy that is not offering them quality of life. Families making decisions that they disagree with, etc, or people in under staffed nursing homes. So I think their default is to be conservative with an elderly patient, especially one with a progressive disease like Parkinson’s, Because they’ve seen a lot of older people living lives that don’t seem to them as worth living.

My mid-80’s dad has atypical Parkinson’s, and I really had to step in to get various issues treated seriously by doctors and nurses— Issues that I think they would’ve seen as urgent if he was a 45-year-old man.

The fact of the matter is, my father probably only has a few years of life left. But every single one of those days is very important to him. I think doctors and nurses look at him and see an old guy who’s very debilitated and doomed. But he loves his life and wants it to last long as possible. He can’t really advocate for himself, though. Certainly his primary care doctor was not equipped to take care of an extremely old person, and yet he has treated my dad for so many years that my dad is loyal to him, even though the doctor is not competent in geriatrics my view. The whole thing is very sad.

You say that now - every single one of his days is important to him. Does he fully understand chances are if he doesn’t die of something else first he will most likely lose the ability to walk, talk, and swallow, will become incontinent and bed ridden? I really don’t get why you would want to prolong his life so he can suffer. Mid-80’s is beyond a typical lifespan for when he was born.

+1

[Anonymous]

Anonymous wrote:

Anonymous wrote:Nurses and doctors see a lot of old people getting life-prolonging therapy that is not offering them quality of life. Families making decisions that they disagree with, etc, or people in under staffed nursing homes. So I think their default is to be conservative with an elderly patient, especially one with a progressive disease like Parkinson’s, Because they’ve seen a lot of older people living lives that don’t seem to them as worth living.

My mid-80’s dad has atypical Parkinson’s, and I really had to step in to get various issues treated seriously by doctors and nurses— Issues that I think they would’ve seen as urgent if he was a 45-year-old man.

The fact of the matter is, my father probably only has a few years of life left. But every single one of those days is very important to him. I think doctors and nurses look at him and see an old guy who’s very debilitated and doomed. But he loves his life and wants it to last long as possible. He can’t really advocate for himself, though. Certainly his primary care doctor was not equipped to take care of an extremely old person, and yet he has treated my dad for so many years that my dad is loyal to him, even though the doctor is not competent in geriatrics my view. The whole thing is very sad.

You say that now - every single one of his days is important to him. Does he fully understand chances are if he doesn’t die of something else first he will most likely lose the ability to walk, talk, and swallow, will become incontinent and bed ridden? I really don’t get why you would want to prolong his life so he can suffer. Mid-80’s is beyond a typical lifespan for when he was born.

Pp's description of her dad's view of his own life can be true. He can focus on being alive while also being aware of what medical problems might be ahead.

[Anonymous]

With Respect, it’s not *me* wanting to prolong his life. *he* Wants to prolong his life.

If he may suffer in the future, he is not suffering now, and he wants to have as many days as he can in his one life he will ever have. He wants aggressive treatment.

I think the attitude you express is why it has been so hard for him to get decent therapy. Last year it became hard for him to swallow. He wanted a feeding tube. I think doctors would say “what’s the point” And they see people on feeding tubes who they think should not be, people with dementia. But he has spent the last year living a very good life with my mother, on this feeding tube at home.

[Anonymous]

Anonymous wrote:With Respect, it’s not *me* wanting to prolong his life. *he* Wants to prolong his life.

If he may suffer in the future, he is not suffering now, and he wants to have as many days as he can in his one life he will ever have. He wants aggressive treatment.

I think the attitude you express is why it has been so hard for him to get decent therapy. Last year it became hard for him to swallow. He wanted a feeding tube. I think doctors would say “what’s the point” And they see people on feeding tubes who they think should not be, people with dementia. But he has spent the last year living a very good life with my mother, on this feeding tube at home.

He has dementia and is on a feeding tube. You say he is having a good life, but is your mother? How often are you over there giving your mother a break? Is it really fair for your mother to have his life extended when he has dementia and additional problems. Doctors often look at the whole dynamic and realize how many women suffer when they end up having to take care of someone who wants aggressive treatment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I noticed that as my father aged, medical staff was more often disregarding his symptoms or input. I was his advocate, but it depressed me to think of all the seniors who don't have someone looking out for them or speaking up for their needs.

Perhaps because there comes a point in a persons life that there isn’t really a benefit to treating something. Or doing the most aggressive treatment.

Family member was 80 and was told just that, no reason to treat the prostate cancer because dr said had “had a good life.” Family member rejected the do nothing approach and got treatment and lived another 20+ years in their own home- alert, healthy, mindful and self-sufficient until day died, over 100.

This happens in minuscule cases of elderly with health issues. Maybe 80 was too young to not treat but very very few people are living to over 100 alert, healthy, mindful and self-sufficient. Most likely there was a family member (most likely a female) who was sacrificing to make this happen. Factoring in how long a patients patents live is probably important. As well as their quality of life. If your parents lived to be 95 and relatively healthy you have a better chance as well.

My relative had a tumor removed at 100. The oncologist did not recommend chemo or radiation but said removing the tumor would be an easy surgery that would make them more comfortable and give them another good year. They actually lived 8 more years and was mobile and cogent until the end. OTOH, my mom’s orthopedist has told her not to fix her torn rotator cuff in her late 80s because it’s a difficult painful recovery particularly because she has had a lot of previous shoulder work. He told her just to not raise her arm above shoulder level.

I think there’s a lot of questions that go into it and you hopefully have a doctor that can consider all the pieces and not just “fix” the one problem in front of them. We find the hardest part is coordinating different conditions that overlap but are treated by different specialists. One may put them on a medication that makes the other problems worse. Luckily we have some medical professionals in our family that can check for these things, but most people don’t.

[Anonymous]

Anonymous wrote:With Respect, it’s not *me* wanting to prolong his life. *he* Wants to prolong his life.

If he may suffer in the future, he is not suffering now, and he wants to have as many days as he can in his one life he will ever have. He wants aggressive treatment.

I think the attitude you express is why it has been so hard for him to get decent therapy. Last year it became hard for him to swallow. He wanted a feeding tube. I think doctors would say “what’s the point” And they see people on feeding tubes who they think should not be, people with dementia. But he has spent the last year living a very good life with my mother, on this feeding tube at home.

DP. You father is lucky to have loving family members who are supporting him. I hope he continues to stay comfortable.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I noticed that as my father aged, medical staff was more often disregarding his symptoms or input. I was his advocate, but it depressed me to think of all the seniors who don't have someone looking out for them or speaking up for their needs.

Perhaps because there comes a point in a persons life that there isn’t really a benefit to treating something. Or doing the most aggressive treatment.

But it's not for the doctor to decide that. If the patient has a will to live and is participating in their care, they should be treated as any other patient.

Don't always agree here. A person with advanced age who develops cancer cannot always do aggressive chemo, for instance.