Anonymous
Post 06/19/2024 21:39     Subject: Doctors just I’ll equipped for elderly!
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.
Anonymous
Post 06/19/2024 21:35     Subject: Doctors just I’ll equipped for elderly!
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.
Anonymous
Post 06/19/2024 20:11     Subject: Doctors just I’ll equipped for elderly!
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.
Anonymous
Post 06/18/2024 20:16     Subject: Doctors just I’ll equipped for elderlyi
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.


Unfortunately, EM physicians and nurse social media mock advocates who request interventions for the elderly.
Anonymous
Post 06/18/2024 19:52     Subject: Doctors just I’ll equipped for elderly!
Anonymous wrote:

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.


This. Each doctor also has so many patients now that the time they're able to spend with each is limited. It makes sense to focus on the young instead of the old, in case those old have a new ailment every other day.
Anonymous
Post 06/18/2024 15:26     Subject: Doctors just I’ll equipped for elderly!
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.

Sure, but that decision should be made after a diagnosis, not at the bedside seconds after the patient complained about a new symptom. Some procedures are relatively cheap for the payoff in quality of life, cataract surgery, hip replacement. If they have cancer, they should be referred to hospice, not blown off until it is stage 4 and cant be ignored anymore
Anonymous
Post 06/18/2024 15:18     Subject: Doctors just I’ll equipped for elderly!
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.


PP with Parkinsons dad here. I do agree, but on the flip side-I also found that some providers did disregard symptoms. One rehab he was briefly at, totally disregarded his symptoms of a UTI, despite Mom and I saying, this is not his normal and not his parkinsons. I ended up leaving work and calling 911 to have him removed and hospitalized (it was a UTI).

I agree with PP that the elderly do need an advocate for them.

That's just so hard to believe. UTIs are such rare things, don't assume zebra when you hear hoofbeats

/end sarcasm
Anonymous
Post 06/18/2024 14:54     Subject: Doctors just I’ll equipped for elderly!
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.


This. I will never understand why people want to prolong sickly lives.


That is YOUR choice (and one I generally agree with) but it is also not for you or a medical provider to decide. As someone noted above, if the patient has the desire to live and able to make that decision then that's it. Just because someone is elderly doesn't mean their lives are any less worthy to continue living, regardless of the cost.


I agree if they want to pay for it, but to use medicare to run up hundreds of thousands in hospital bills for nothing is just not sustainable.
Anonymous
Post 06/18/2024 14:40     Subject: Doctors just I’ll equipped for elderly!
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.


This. I will never understand why people want to prolong sickly lives.


That is YOUR choice (and one I generally agree with) but it is also not for you or a medical provider to decide. As someone noted above, if the patient has the desire to live and able to make that decision then that's it. Just because someone is elderly doesn't mean their lives are any less worthy to continue living, regardless of the cost.


Cost, availability of treatment, quality of life, and pain/discomfort should absolutely be a factor when we are looking at elderly patients. So many doctors will try to aggressively treat elderly patients when the outcome is pain, discomfort and a lower quality of life after the procedure. It shouldn't be purely about the patient's desire when a doctor knows a patient is going to have a poor outcome at 85 or 90 years old.
Anonymous
Post 06/18/2024 14:06     Subject: Doctors just I’ll equipped for elderly!
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.


This. I will never understand why people want to prolong sickly lives.


That is YOUR choice (and one I generally agree with) but it is also not for you or a medical provider to decide. As someone noted above, if the patient has the desire to live and able to make that decision then that's it. Just because someone is elderly doesn't mean their lives are any less worthy to continue living, regardless of the cost.


+1
Anonymous
Post 06/18/2024 09:13     Subject: Doctors just I’ll equipped for elderly!
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.


This. I will never understand why people want to prolong sickly lives.


That is YOUR choice (and one I generally agree with) but it is also not for you or a medical provider to decide. As someone noted above, if the patient has the desire to live and able to make that decision then that's it. Just because someone is elderly doesn't mean their lives are any less worthy to continue living, regardless of the cost.
Anonymous
Post 06/18/2024 06:43     Subject: Doctors just I’ll equipped for elderly!
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.


This. I will never understand why people want to prolong sickly lives.
Anonymous
Post 06/18/2024 06:34     Subject: Doctors just I’ll equipped for elderly!
Absolutely true. There are some who excel,or specifically do geriatric, but most are terrible and demeaning to patients - even those who advocate for themselves
Anonymous
Post 06/18/2024 06:24     Subject: Doctors just I’ll equipped for elderly!
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.
Anonymous
Post 06/18/2024 05:50     Subject: Doctors just I’ll equipped for elderly!
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.


PP with Parkinsons dad here. I do agree, but on the flip side-I also found that some providers did disregard symptoms. One rehab he was briefly at, totally disregarded his symptoms of a UTI, despite Mom and I saying, this is not his normal and not his parkinsons. I ended up leaving work and calling 911 to have him removed and hospitalized (it was a UTI).

I agree with PP that the elderly do need an advocate for them.