Friday, August 21, 2009

Stereotypes getting in way of good care for seniors

This is a column about my mom, and the crazy things that can happen when you take ill at 83.
My mother is a retired nurse who has done everything right in terms of looking after her health all these years. Despite mobility challenges since being hit by a car in a crosswalk seven years ago, she’s still very much a “tough old broad,” as a friend once described her.
But as our family has now come to see, in the eyes of our depersonalized and harried health-care system, she’s just Old Person No. 347,050 on a very long list. And from what she’s been hearing from her friends, that’s just how it is once you cross some invisible line into old age.
She has no chronic health conditions. She isn’t on any long-term medication. Up until two months ago, she was travelling, cooking dinner for one friend or another virtually every night she was home, and was an active, engaged community volunteer.
Then we went on a family holiday to Tofino in June. She got too much sun one day and went to bed feeling sick. Perhaps she slept too heavily on her bad arm - the accident left her with a broken shoulder and severe limitations in the use of her right arm. At any rate, she awoke the next day with major pain in her arm.
It’s been one strange ride ever since, starting with the prescription drug she was given to reduce inflammation - which lived up to its potential to cause “a general feeling of illness” as one of its side-effects.
By the time she figured that out and quit the drug, she’d developed blood-sugar problems and was showing diabetes-like symptoms. (With any luck, that was a side-effect of the drug as well, because they’ve since stopped.)
And wouldn’t you know it, my mother’s trusted family doctor retired just as all of this got underway. That put her into the care of the doctor who’d just bought the practice.
They’d never met before my mother came in about the pain in her arm. The physician knew nothing of the vigorous, active woman my mother had been just a few days earlier, and didn’t bother to ask. I’m guessing the doctor just saw a tired, sick 83-year-old with a bum shoulder - one who had yet to come to grips with her pain and illness as the byproducts of aging.
OK, I get that. So does my mom. She recognizes that she’s in the countdown. She won’t be looking for medical heroics when her time comes.
But there’s a fine line between expecting people to accept the aging process and relegating them to assembly-line care that presumes they’ll soon be dead anyway. That’s how it has felt for my mother these past two months.
Her saga was complicated by a much-anticipated cruise to Alaska in early July, which she desperately wanted to go on. The x-ray of her shoulder found nothing untoward and the doctors didn’t seem too interested in exploring the issue further, so she mustered her strength to go on the cruise. She still didn’t know whether the diabetes-like problems she’d experienced were a reaction to the anti-inflammatory she’d taken, but figured results from the blood-sugar tests would be ready when she returned.
And they were. But by then she’d caught some terrible flu-like thing that had morphed into a secondary bronchial infection, as had her sister on the final days of the cruise. (Could it be swine flu? My mother is on Day 21 of what she describes as the worst illness of her life, and nobody has even suggested she be tested for it.)
So the bronchial infection was the more pressing issue by the time she got home. In B.C., you’re only allowed one health concern per visit these days when you go to the doctor, which meant her doctor listened to her chest but then refused to review her blood-sugar results until a later appointment.
Her active life has ground to a halt over the past two months. Depression crept in. Fortunately, all those friends she cooks for have come through for her. And the really good news is that so much time has passed since her arm first started to hurt that the original problem appears to have resolved itself. I think she’s going to be fine.
I wouldn’t say the system failed her; she got drugs, tests and an x-ray. But all of it came grudgingly, as if done just to silence a frail old lady who hadn’t come to grips with her own mortality. Come on, docs - look past those aging bodies to the people who are still very much alive inside them.

1 comment:

Sue said...

I just had to reply to this. I feel so deeply for your mother. My grandma went through a very similar experience in her final days after she fell and fractured vertebrae in her neck. The hospital doctor was so absolutely convinced that he knew how he needed to treat her neck problem, and completely ignored our requests that he speak to her psychiatrist or her GP. In the end, the surgery they said was "necessary" to install a halo brace, plus the medication the hospital doctor prescribed exacerbated an existing heart condition, caused a relapse of gallstones and pretty much finished her off. She'd just had one of the best Christmases of her life, and was thoroughly enjoying her two great-grandchildren.

This whole "one health concern per visit" is a total crock. It's inefficient and patently bad for the health of ALL citizens, not just our elders. Somewhere along the way our medical system has become totally screwed up. I wish I knew where to begin to fix it.

Thanks for speaking out about your mom.