Everybody has a different reaction to health problems, but one response I consistently hear is, “why me?” A fair question. Life isn’t fair.
Another person recently stated over and over, “I’ve fallen apart, mentally and physically”. When he learned that his assets were depleting, he told his friend and POA, “just take me out back and shoot me.” I told him we could do a LOT better than that for him while thanking him for his service and explaining the publicly funded long term care available to him.
Another visit comes to mind when I was talking with a woman in a nursing home who just had her leg amputated. I saw her staring at my feet, exposed due to the sandals I was wearing. I was suddenly aware that I was reminding her of the leg she will never have back. Why me, she seemed to be thinking.
Then there was the individual I called to remind of some needed paperwork he had not submitted. “You have no idea what it is like to be disabled”, he stated. There is no response to that statement.
There is no place to hide when discussing matters of such importance with people. It is a part of being human myself and acknowledging the humanness in others. Again and again, I am reminded of how fortunate I am and how I must come across to people, many of whom are isolated and have little contact with people other than care providers. It is at these times that I realize the significance of this type of work, even though it is not very glamorous.
Abuelita translates to mean “dear grandmother” in Spanish. I visited the adult day program for older Hispanics recently and found several abuelitas there. I was meeting with a woman who had three younger generations there with her for the meeting, including a newborn, the baby’s mother, grandmother and great grandmother, all taking care of each other.
Around the Center, some men were playing dominoes and some of the women were helping with chores-sweeping and wiping down tables, occasionally breaking into song, singing along to the Spanish crooner playing.
Having dementia is difficult, but when compounded with a language and culture barrier, its even more so. There is a commonly held belief that Hispanic families are tight knit and don’t institutionalize their elders. This may have been true in the past, but now, family members may or may not be available to care for Abuelita 24/7. Adult Day Care is a great resource for many, but is an absolute necessity if an older family member needs 24 hour care and the Caregivers are working or in school. It also helps to give caregivers a respite break.
NADSA link Adult Day Services Locator
The long term care programs that cover the cost of adult day programs are part of the Medicaid dollars that are proposed to be drastically cut. Please consider contacting your Senator and asking that the Medicaid funding cuts are taken off the table!
One of the most wonderful parts of seeing clients in their homes and connecting older adults with long term care programs is supporting individuals and families in home settings. Along with keeping families together, it allows older adults to have their pets around, improving quality of life for all involved.
One of the most memorable pets I’ve met is Terry the cat-a very large grey cat. His owner, Marie, lives alone and has a limited support system. She told me that he comes running when she calls him Baby.
On one occasion a few years back, I brought my puppy into my workplace, which was an adult day center. One frail woman fell to her knees when she saw the puppy and held the dog with tears in her eyes. “I used to have a dog just like that and I miss her so much”, she said.
In the book, “A Man Called Ove”, there is a heartwarming subplot about his relationship with a stray cat. When Ove peacefully passes away, the cat curls up on his chest.
Pets help us to live in the present moment. It’s important to remember even when someone may be older, possibly ill or have a dementia, animals will likely provide the joy and feeling of connectedness.
I hope you enjoy this slideshow that outlines specific reasons why animals are wonderful companions for older people.
In this article, Gawande describes a different way to look at treatment of chronic health issues. The approach is based on slow and steady progress and the realization that complete cure is unlikely and that progress can be slow and incremental. There is rarely an immediate remedy and expectations are lowered. Doctors partner with patients to measure the problem and work through plans of escalating remedies. It involves continual measuring and adjusting. Medical practice can at times convey an “aura of heroism”, like a surgeon operating just in time to save a life. Data, however, shows that Primary Care (opposite of a specialist) is the area of medicine that has the greatest impact, including lower medical costs.
This approach emphasizes the importance of prevention and maintenance of health, as well as coordination among specialists for problems that have already been diagnosed.
Perhaps this approach resonates because I grew up in a household with a dad who specialized in Internal Medicine, who I believe practiced this type of medicine. He seemed to know his patients as individuals, many who were fiercely loyal.
I have also seen this approach work well in my 20 years working in the PACE model. This model sets up long term relationships between interdisciplinary health care professionals and individuals with multiple chronic health issues.
An incremental approach also would address the rapidly rising costs of health care.
It is also related to wellness, defined asis an approach to health care that promotes the prevention of illness rather than treatment of disease, or health as an actively pursued deliberate effort.
It definitely is a challenge however, because it goes against the fast pace of rapidly developing technology. Perhaps that’s the point.