Four Ways To Make Doctor's Visits More Efficient For Elderly Patients


This pertains to the elder patient who is not suffering from Alzheimer's or another form of dementia, but is just getting older.

The human body is an amazing thing, but for seniors the word "amazing" takes on a whole different meaning. There are noteworthy conversations to have with your physician. These conversations, at the least, need to cover recent incidents; i.e. medicines (refills and new) falls, bumps, breathing problems, swelling, pain, any increase of fatigue, and large decreases of weight. With that being said, how do patients cover topics in the 15-20 minute appointment time with a doctor?

Below are some tips for an efficient visit.

1.) Bring a list with concerns numbered in a priority. The physician will have questions as well, so the time flies by. You will want the most important issues to be discussed first because some topics may have to wait until the next visit.

2.) Many offices require all medications to be brought to the appointment. It is very handy to have a list as well that can be gone through in the event some medicines are gone. Patient memory can be thrown off with any conversation such as high blood pressure.

3.) All offices are busy and run behind, but making notes and being organized will help the physicians. It's important to have someone with the patient, especially if they might have a hard time remembering what the physician instructs. It is most helpful if the escort knows your history before you start the appointment. If the physician takes time to go over history, this takes time away from treatment. It's important to listen to the conversation while taking notes for use later. Clarification can be made at the end of the appointment.

4.) All seniors should know why they are taking medications and/or using oxygen. "Because my doctor said to" is not enough information. All patients should know the reasons behind why they are taking medications/oxygen/breathing treatment and should become their own healthcare advocates.

The time restraint that they are under is not reflective of how much doctors want to help their patients. The more efficient and organized the patient is going in, the more they will be able to provide.


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Communicating with a Person with Dementia

Older Americans (65 years and older) are one of the fastest growing populations, with the elderly population expected to double from 35 million today to over 70 million by 2030! One of the most common difficulties that accompanies aging is dementia: a decrease in memory and general cognitive function that often occurs in the elderly. A decline in language and general communication is one of the hallmarks of dementia. Take a look at these tips to help communicate with a person with dementia:

Short, Simple, Slow
A person with dementia isn’t able to process information in the way that they used to. Speak slowly and pause between each sentence to give extra time for processing and response. Provide information in the simplest way possible; avoid long convoluted sentences. Repeat Important Information: Hearing information more than one time can help a person with dementia maintain focus and better understand what is being said. Repeat key points of your message more than once in a conversation.

Simplify Questions
Open-ended questions can be difficult for a person with dementia. Whenever possible, provide choices, or ask questions that only require a yes/no response.

Use a Positive Tone of Voice
Even though a person with dementia may have trouble understanding your words, they can usually read the emotion in your voice. Speaking in a tone that is tense, rushed, or unhappy, can upset or frighten your loved one, and is likely to provoke a negative reaction. Put extra effort into speaking in a positive, calming tone whenever possible.

Get Outside Help
A communication specialist, such as a speech-language pathologist, can provide education for the caregiver on how best to communicate, and can provide external aids and strategies for the individual with dementia to communicate their needs and preferences to the best of their ability.

A Guide To Traveling With Dementia


There are still several weeks of summer and it's important to remember that if a person has Alzheimer's or other dementia, it doesn't mean he or she can no longer participate in meaningful activities such as travel; but it does require planning to ensure safety and enjoyment for everyone.

DECIDING TO TRAVEL 

Whether taking a short trip to see friends and family or traveling a far distance for vacation, it's important to consider the difficulties and benefits of travel for a person with dementia. In the early stages of dementia, a person may still enjoy traveling. As the disease progresses, travel may become too overwhelming.

When you take into account the needs, abilities, safety and preferences of the person with dementia, what's the best mode of travel? Consider the following:
  • Go with the option that provides the most comfort and the least anxiety. 
  • Stick with the familiar. Travel to known destinations that involve as few changes in daily routine as possible. Try to visit places that were familiar before the onset of dementia. 
  • Keep in mind that there may come a time when traveling is too disorienting or stressful for the person with dementia. 

TIPS FOR A SAFE TRIP
  • Changes in environment can trigger wandering. Even for a person in the early stages, new environments may be more difficult to navigate. Keep the person safe by taking precautions, such as enrolling in MedicAlert + Alzheimer's Association Safe Return, Comfort Zone or Comfort Zone Check-In. 
  •  Have a bag of essentials with you at all times that includes medications, your travel itinerary, a comfortable change of clothes, water, snacks and activities. 
  • Pack necessary medications, up-to-date medical information, a list of emergency contacts and photocopies of important legal documents. 
  • Create an itinerary that includes details about each destination. Give copies to emergency contacts at home. Keep a copy of your itinerary with you at all times. 
  • If you will be staying in a hotel, inform the staff ahead of time of your specific needs so they can be prepared to assist you. 
  •  Travel during the time of day that is best for the person with dementia

DOCUMENTS TO TAKE WHEN TRAVELING 
  • Doctors' names and contact information 
  • A list of current medications and dosages 
  • Phone numbers and addresses of the local police and fire departments, hospitals and poison control 
  • A list of food or drug allergies 
  • Copies of legal papers (living will, advanced directives, power of attorney, etc.) 
  • Names and contact information of friends and family members to call in case of an emergency 
  • Insurance information (policy number, member name) 

AIR TRAVEL 

Traveling in airports requires plenty of focus and attention. At times, the level of activity can be distracting, overwhelming or difficult to understand for someone with dementia. If you are traveling by plane, keep the following in mind:
  • Avoid scheduling flights that require tight connections. 
  • Ask about airport escort services that can help you get from place to place. 
  • Inform the airline and airport medical service department ahead of time of your needs to make sure they can help you. Most airlines will work with you to accommodate special needs. 
  • If appropriate, tell airport employees, screeners and in-flight crew members that you are traveling with someone who has dementia. 
  • Even if walking is not difficult, consider requesting a wheelchair so that an airport employee is assigned to help you get from place to place. 
  • Allow for extra time. 


Tips For Long Distance Care For Elderly Parents



Just a generation ago, aging family members typically had at least one relative living nearby. These days, many are being cared for by Baby Boomer children who live far away.

Balancing careers and kids of their own, these grown children may find it difficult to move closer to parents who have begun to need daily help.

Caregiving has become "an unexpected second career" for many people in their 50s and 60s, says Tamar Shovali, who studies gerontology and teaches at Eckerd College in St. Petersburg, Fla.

"And distance caregiving is really difficult," she says.

If moving nearer to each other isn't an option, how can you provide care and support for an aging parent from afar?

Maximize visits

Make the most of periodic visits to your parents' home, says Amy Goyer, AARP's family and caregiving expert.

Look around to see what sort of shape it is in, and consider modifications (handrails in a hallway?) that might make it safer and more convenient.

Meet briefly with any doctors your parents see regularly so you can develop a connection. Ask questions. Make sure that a prescription written by one doctor isn't conflicting with a prescription from another. This will make it easier to continue managing a parent's medical care by phone.

Also, choose a point person who lives nearby and is willing to visit your parents regularly to note any changes in their health, behavior or daily abilities.

"You can talk to them on the phone, you can even Skype and still not get a full picture," Goyer says. You need someone on-site to tell you what they're seeing.

This person could be a cousin, neighbor, good friend or someone from their faith community. If no one is available, Goyer suggests hiring a "geriatric care manager," a growing profession because so many elderly people don't have relatives nearby.

The website caremanager.org is one place to start searching for someone to hire.

Even if your parents live in a facility, rather than at home, see that someone visits them regularly.

Small problems can get out of control quickly, says Goyer. Even at good assisted-living facilities, "there are a lot of services you expect," she says, and you have to make sure they are being delivered.

Seek new technology

Baby Boomers are increasingly using tools like video chat and e-mail circles (Google Hangouts is one example) to stay connected with elderly parents, says Duane Matcha, professor of sociology at Siena College in Loudonville, N.Y.

By creating a Google Plus group that includes parents, adult children and even grandchildren, Matcha says, distance caregivers can create a virtual support system. There is strength in numbers: The more relatives and friends who are aware of an older person's daily habits and experiences, the more likely someone will notice changes that need attention.

New technology for distance caregivers has been emerging rapidly. Shovali recommends an app called Reunion Care that keeps all of a person's medical records in one spot, plus contact information for doctors. "Friends and family can log in and put the information in," she says, "and that can be done in person or at a distance."

Cameras and motion sensors can help you make sure a parent is moving around the house normally, and monitor any visitors as well.

Wireless blood-pressure cuffs send data to a remote user, and electronic pillboxes can let you know whether elderly parents have taken their medication.

You can even buy a door lock that can be coded to let in certain people on certain days. "Let's say on Tuesday and Thursday you have a paid caregiver coming to help your mom take a shower," Goyer says. "You can give them a certain code that's only good on Tuesdays and Thursdays," and then use a motion-sensor camera to make sure that caregiver arrived on time and left as scheduled.

Difficult conversations

It's difficult, and often heartbreaking, to approach your own parents about changes in their mental and physical abilities. Asking them for access to their e-mail or voice-mail passwords to help protect them from online or telephone scams, for example, can be perceived as an affront to their independence. It may be even harder to discuss planning for end-of-life medical care or burial wishes.

But have these conversations early, before critical situations emerge.

Shovali says a document called the Five Wishes Living Will (available at www.agingwithdignity.org) can help start the conversation about end-of-life planning. It's written in clear language, "not in legal speak or doctor speak," she says.

As for discussing whether parents should stop driving, need help managing finances or should consider moving into assisted living, Goyer says it's valuable to "make very specific observations."

For example, take a ride with them in their car. "You can say afterward, 'I really noticed you seemed to be having trouble making left turns,' or 'I noticed a lot of dings on the right side of the car,' " she says. That can lead to a conversation about whether driving is still safe.

Driving is an especially sensitive subject, Shovali and Matcha say. If elderly parents live in a suburb, giving up driving can mean loss of independence and access to many things. So find a transportation service, friend or hired caregiver to drive to medical appointments, shopping trips and social outings.

In general, Goyer says, approach difficult subjects with an "I'm here to support you. I'm not here to take over your life" attitude.

Give thought to which relatives and friends should be involved in the tough conversations.

"You may be doing most of the caregiving," Goyer says, "but your brother might be the one your parents listen to."

You also might want to bring in a professional, perhaps a trusted doctor or lawyer, to offer advice.

Build a support system

Many communities offer transportation and meal delivery for elderly residents; call and find out what's available.

Even if your parents don't need much support, you might want to find clubs or organizations where they can socialize. You don't want your parents becoming isolated. Make sure they know where to reach old friends who may have moved, and tell friends and acquaintances if your parent is moving to a new home.

Finally, find a support group for yourself. Just because you aren't providing daily care in person "doesn't mean that at a distance you don't need support," Shovali says. Along with encouragement, you might find good practical advice from people with more experience caring for parents.


If you are a caregiver and need advice regarding care options don't hesitate to contact Elder At Home at 401-475-7705