Caregiver’s Toolbox Ep. 36 “When Elders and Medical Culture Collide”
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Caregiver’s Toolbox Ep. 36 “When Elders and Medical Culture Collide”
Speaker 1:
Welcome to The Caregiver’s Toolbox. Tools for everyday caregiving, weer by education and information on senior care topics. Here’s your host, Ryan McEniff
Ryan McEniff:
What’s going on everybody. My name is Ryan McEniff. Janet, today we’re talking about when elders and medical culture collide. And they’re colliding right now.
Janet:
Like a supernova.
Ryan McEniff:
Like a supernova, creating a black hole which will suck us all in and we’ll all be destroyed.
Janet:
That’s right.
Ryan McEniff:
So Janet, give me an idea. What are we talking about today?
Janet:
Well, I think today we’re so comfortable with the whole concept of global society and you’ve got, especially in our Boston area, we have a melting pot. We have all different backgrounds and we also have some of the finest teaching hospitals in the world.
Janet:
So you’ve got all of this change, all of this wonderful things going forward, but a number of their patients, if, if any of our viewers are 50 year old or your parents or your grandparents, this is foreign territory to them. And they have developed a mindset of what medical services are and you need to keep that in mind. You’re not going to get them for the most part to just graciously go into the seven-minute visit, do the test, check out your notes on your laptop when the doctor sends it through the medical email. This is just not where they’re at.
Janet:
I think of my grandmother, I think of my own parents, and they thought the idea of a seven-minute visit was just absolutely horrible. And that had become the standard because the doctors, what do they need, got you in, got you out. And on the post acute side, meaning whether you need a nursing home or elder care or whatever, these are all things that did not exist a generation or more ago. You didn’t have elder daycare. Assisted living, that was grandma came to live with you. It was things like that. So to try and have your parent or your grandparent feel comfortable with this is really tough. I don’t know how your dad is navigating the system. He seems computer savvy so he’s probably doing great with it.
Ryan McEniff:
We’ll see.
Janet:
My dad is computer savvy so he loves looking up test results. My mother cannot for the life of her understand why things are the way they are. And that’s something that you, as the family caregiver, you have to be mindful of that mindset. My grandmother didn’t think that women could be doctors. So the doctor would come in and for all that she cared, it was the nurse. And the doctor had a God complex. You never questioned them. So as a caregiver or as an advocate for your family member, you need to be an unapologetic caregiver. If you need more time, if you need more information for them, you kind of need to fight for it, and that’s kind of unfortunate these days.
Ryan McEniff:
Yeah, absolutely. I mean, you have, generally well-known that the vast majority of dollars that are spent on your healthcare are later in life, right? 60 years old and after, because that’s when things start breaking down. Just like in a car, you’re not spending maintenance dollars for the first a hundred thousand miles, as much as you are spending it after the first hundred thousand miles, because that’s when things, wear and tear, takes on with vehicles, same with people. So you have younger people that were used to going to see the doctor regularly. Every single year, they went to the doctor. They had those experiences.
Ryan McEniff:
And then, for a lot of people, right around 25, 30 probably years old, doctors appointments aren’t as big of deal, right? Because I’m fine. Everything’s going, well. I spend this money or I see the doctor. I don’t need to see them. Same with dentists. My teeth are fine. I chew with them every day. They’re perfectly fine. Then, 20 years goes by with maybe a doctor’s visit here and there when the occasional flat tire occur and you just need to get it quickly fixed or whatever is going on, and then you get into a system of that it looks completely different than what you were used to when you were growing up and younger. And even every few years when you went there, maybe you don’t remember it as well, and how quickly that doctor was in there, did a bunch of things on his computer, talks to you for 30 seconds, gone. It’s a different world when you get into a hospital and they’re looking at you in a completely different mindset.
Janet:
Right. And there was no such thing as a walk-in. If anybody walked in, it was, in my grandmother’s generation, they walked into your home with their little black bag. You had this one doctor that knew you from womb to tomb in many cases.
Ryan McEniff:
Sure.
Janet:
Now, it’s this one does your physical, and this one looks at your eyes, and this one takes care of something else. And so, we’ve learned to adapt to that. But if you have … and it’s even more frightening in many cases, if the person has any form of a dementia or it’s just plain getting forgetful and it’s like, I have to keep this appointment and that appointment. I mean, I had to laugh myself. I was used to going to my doctor to get my physical and I have a new doctor this year, and it’s like, this one does this part of it and this one does that part of it. I’m like, it’s just a physical. I thought it was like getting oil changed on the car.
Janet:
And I mentioned, even to my parents and they’re like, “What? It was just a physical, but there’s three different people get this done?” We have to be sensitive to that, and understand that you are not going to change that mindset. That’s something that’s burned into their mind. You have to prepare to take them to an appointment, to answer questions for them, to let them know what’s going to happen before the visit. I think parents do a great job doing that with their kids, but I often say, elderly people are tall kids and that’s really the case.
Janet:
But we assume that just like us, we became adults. And as we go along, we know these things. We think our parents do too, or our grandparents do too. And they don’t. I find that it’s very helpful for us as a private home care to be upfront and ask questions about things that involve someone’s mindset. I will point blank, I will ask if someone is going to have an issue. If a caregiver is someone of color. It doesn’t mean they’re a bigot. It doesn’t mean they’re a racist. It’s just something they’re not familiar with. Or then there’s the association of, well, is English their second language. These are all things that you’re going to bring this into somebody’s home and they have to have a comfort level. You have to keep the mindset.
Ryan McEniff:
Absolutely, and it’s managing expectations as well. Somebody might be going in there and thinking that, using the example you used that you go in, you meet with one person, they handle everything, and things are good. And then you find out that generalist then refers out to a bunch of specialists and you just went from having one … or your parent has gone from thinking they just have one visit to do, that it’s just gone to three or four visits because you have to go see the difference, but you got to go do the blood work here, and then you got to do this, and then you got to do that, then we got to have you come back in and we’ll go over all the tests and we’ll explain to you what happened. When you’re used to, “I just went and saw one guy, not even a female, one guy, and he said everything and he knew everything. And if they said to put salt on it, then that would fix it,” when it might not necessarily be the case anymore.
Janet:
Absolutely. Some people, and some of the doctors to their credit, they’re coming up with the latest and greatest of techniques and medications and all these other things when someone’s thinking tea and honey and wearing socks to bed is going to solve what they need.
Janet:
Just recently, I was having a conversation with my parents about a friend of theirs that, I don’t know if it was a knee replacement, a hip replacement, whatever they needed, and these people are having a conversation about a particular Boston hospital which is world renowned for were doing knees and hips and that kind of thing. The person said, “That’s where I have to go.” Yet, a friend of theirs said, “Yeah, well, mine was fixed, but a couple months later I was in as much pain as I was before.” I’m trying to explain to my parents that, “Well, they are world renowned and take care of all these great athletes. But that athlete that has a hip problem is what, 21? And he’s got good muscles and he’s got got nothing but the best. If you’ve got someone who’s 90 and doesn’t get any exercise and now they need a knee replacement, they’re not going to have the same results at that world renowned hospital.
Janet:
So it’s the whole understanding of the mindset of what good care is that it needs to be taken seriously and respected as much as anything else.
Ryan McEniff:
Absolutely. I mean, and we can do a whole another show on the fact of that mindset with older adults when deciding on what care to get. Right? So we’ve had seen cases where people drag their feet a little bit, something catastrophic happens to mom or dad, and then the result is that they never get back to the baseline that they were at already. Their baseline has changed. Their basic ability to do certain things has gone down and they’re more than likely never going to get past that. Those are those types of things that you talk about with your parents of like, you need to, going off of what you said with the baseball player and that that expectation of you might not bounce back or your bounce back might be completely different. You might have pain in your knee for the rest of your life. It just won’t be as severe as it was before you got the knee replacement surgery, using an example which may or may not even be true.
Ryan McEniff:
Because we see it all the time where people take their time in finding care and think, and there’s that mindset because you’re 40, you’re 50 years old, you’re still young, or I’m 30. You’re still young enough that if you do fall, it’s not the end of the world. You generally get back up. Maybe you’re sore for a little bit longer than you would’ve been when you’re 20, but you’re thinking this mindset of, “Well, they’ll just go to the hospital. They’ll get better. And then they’ll be back to normal.” It doesn’t work out that way. What happens is that they fall, they injure themselves, and then their independence is shot for the rest of their life rather than getting back to where they can live on their own and they can walk up and down the stairs and still do their gardening that they love doing every single time. So, that’s a really great point that you make with that comparison of the age difference and the expectation level that will come when you’re dealing with somebody who’s younger versus somebody who’s older.
Janet:
Even to use that same example, we kind of ended the conversation just before the hockey game came on, and I was saying that, “Okay, how young did Bobby Orr stop playing because of his knees?” These athletes that can get the best care in the world, but they’re retired in their thirties. And then you find out they get to their sixties, the knees have been replaced, the hips have been replaced, and they still have trouble just getting around. So some of it is the kind of shape you were in when you got hurt, but there’s also just some things that as your body ages and certain things slow and certain things become brittle that you need to keep that in mind.
Ryan McEniff:
Absolutely. That’s another very good point. That wear and tear is an accumulated effect.
Janet:
Absolutely.
Ryan McEniff:
You see these people that do the same thing over and over and over again at a high level like an athlete, and it just wears their body down that much faster versus doing it sparingly over time. You can play basketball once or twice a week and probably do that till you’re 60 or 70 years old. But if you want to play at the highest level that you can, that’s going to take a toll on your body that’s completely different. It’s the same thing just on a different scale with everyday people.
Janet:
Exactly. There was a Red Sox game a few months back and up in the booth was Eckersley and Jerry Remy. It really was a funny conversation because you look at Eckersley and he looks like the picture of health. Even Jerry Remy was looking pretty good for someone who’s dealing with cancer and all kinds of things. But they were going on and on of just how broken their bodies are and how they could barely move. Eckersley, his shoulder is totally shredded. And there’s Remy saying, “Ugh, if I drop something, I can’t bend down to pick it up.” This guy was, was a great baseball player. It’s just they got old at 30 because of the toll in their body. So, you need to keep that in mind. You can’t think because you go to the best physician that he is going to make you younger. I think in some ways is what the hope is.
Ryan McEniff:
It’s going to magically fix everything. I mean, they can only bring you so far. And then additionally, there’s a lot of rehab involved. There’s a lot of, you hear about, and I’m guilty of this too so I’m not on my high horse, but you get injured and then you’re told you need to do these exercises every day or two times a day or three times a week or whatever it is. People don’t do it. And then, so they go, “Oh, well the surgery didn’t work.” Well, the surgery did work, but you didn’t strengthen the area with your rehabilitation to get to that next level, to get back to exactly where you were.
Janet:
Exactly.
Ryan McEniff:
That’s another problem that we see with this medical culture of, “Hey, you go to the doctor, it gets fixed and you go home.” Well, there’s a lot of rehab that’s needed in that and if you stay on that course with that rehab, you’re going to exceed far further than if you don’t. I’ve been guilty of that and I’ve made that mistake and I’m not going to make that mistake again.
Janet:
Guilty as charged. I think the athletes and all, they stick with that because they’re under contractual agreement to make sure-
Ryan McEniff:
There’s a lot money on the line. But when it comes with your parents, you need to be the one that’s hounding them and reminding them, “This is your independence on the line” or “You’re going to an assisted living” or “You’re moving in with me” or whatever case scenario occurs that you need to go there and get this done and explain to them what’s going to be happening.
Janet:
Yep, absolutely.
Ryan McEniff:
So anyways, that will wrap up our discussion on elders and medical culturing, excuse me, medical culture colliding. My name is Ryan McEniff. This is Janet. We are going to be … we didn’t do our little ad, but that’s okay. But one thing I would like to say is, please like us on Facebook, look up our page, The Caregiver’s Toolbox. There we can get your feedback on things. If you have certain topics you want to hear about, please let us know about it. We are also videotaping these podcasts so that we can put them onto Facebook video, onto YouTube. I think maybe in the future we’ll try to do some live videos, but we’ll see. We’re just testing this out. We really love the podcast, but I know that some people out there really like watching video as well. So that’s kind of why we went into this format. So, check it, so whether it’s on YouTube, whether it’s on Facebook, it’s going to be under The Caregiver’s Toolbox. We’ll see you next week. Thanks, goodbye.
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