Tuesday, October 04, 2005

Nursing home? I don't think so, Doctor!

On this first day of Rosh Hashanah, Abe and I pay a visit to his doctor, a geriatrician, trained to deal with the illnesses that develop as a result of growing old. Even though Alzheimer's/visits/the homes/of young adults, it is generally found in the brains of the old and the old old; so one would expect that medical personnel treating people with this disease would have information in their knowledge banks that includes resources and advice broader than time for a nursing home.

The words didn't come out exactly in that form, but for the third time in a row, nursing home emerged from this doctor's mouth within two minutes of my talk with him. (This time, after Abe was out of the room and a volunteer had come to take him for an EKG). Never mind, the geriatrician didn't ask me what I thought of such a suggestion, much less Abe.

After all, this is an HMO and 15 minutes, maybe it's ten, isn't enough time for discussing the hospital's approach to Alzheimer's, as the good doctor informed me. He had to see other patients and we were late anyway. Never mind, I've waited in that hospital 30 to 40 minutes to see health care workers.

There seems to be a policy, written or not, that once a person is diagnosed with Alzheimer's the attitude that follows is: be gone, be gone. If Abe is treated this way - he was a physician for 43 years, 20 at this particular hospital - how are others treated? I'll be darn if I'll squirrel someone away, anyone, - and certainly not my husband - just because society, including the medical establishment, doesn't know how to confront a disease that is growing in leaps and bounds in our 21st century.

I do not want my husband to go to a nursing home. If we got to the point where I absolutely couldn't take care of him, that would be one thing, but we have help and I'm doing a good job. We have a lovely home with a porch that sits in the sun (or rain) and he has a favorite chair and loves to watch the trees.

We had an elevator put in the house and are in the midst of enstalling grab bars in just the right places. All I ask of the medical establishment is to treat Abe as a whole person rather than what can I do for you today, what seems to be the problem? I had spent half an hour on the phone trying to get through to the doctor's office, including explaining to the nurse what was happening. The doctor said he only got a sketchy report. So you start to tell Mr. Professional and he says, oh, we can only talk about one thing today. Is it chest pains or agitation? Well, the two are entwined.... Hello? Are you there?

I'd like to discuss the possibility of hospice or other resources helping out. From what I understand 6 months is no longer the bar... that's when nursing home popped up and I wonder what a hospital system gets out of pushing (or suggesting)nursing home care on patients who are not ready for it and on families who don't want it. What is behind not helping patients stay in their own homes? Who's getting paid off here? Tomorrow I'll call for an appointment with the chief-of-staff.

Another peeve: shouldn't a geriatrician be cognizant of the fact that an Alzheimer patient has greater needs than most people and that slowness is characteristic of the disease, along with a long list of other physical and social impairments that not only affect him but his primary caregiver? Isn't there a place in the system for something happening along the way, regardless of the time you start out for the appoinment, that could immobilize progress toward the practitioner's door?

I guess that's enough ranting for tonight... I'll either read or find some junk on tv. I wish I had some chocolate in the house. What possessed me to pass it by when picking things off the super market shelves? oy!

Did I mention that I have three major articles coming out and got this last one done in August while taking care of Abe? That doctor didn't ask us one question about what I thought was best for Abe and me. Maybe he just assumes it's too much for you. That's the standard comment. Well, let me be the judge of that, Sir. Of course it's a Sir.

And I'll tell you something else, if the situation were reversed, Abe would be holding my hand every step of the way. He wouldn't put me in a nursing home unless he absolutely couldn't take care of me, and that's what happened with my mother. I just couldn't take care of her anymore (in many ways). But I still can, Abe, and until then, I will. To the best of my ability.

1 comment:

Peter said...

Esther. Wow. You are totally right on here. Good on you for speaking your mind. I'm sorry it has been tough to be listened to at the doctor's office. I think Home Health and Hospice are usually much better at this kind of situation. Call me if you ever need anyone to talk with. Best wishes, P