October 25th, 2016
We are excited to welcome my mother-in-law back into our home for the Holiday Season. We speak to her every week and she updates us on her preparations. She has purchased thermals because, being from London, she has heard about our nasty winters. Last time she came, we had looked into her medication. In my opinion, she was on too many medications and, upon researching the specific pills she was taking throughout the day, I realized that one of the pills was NOT indicated for someone with diabetes. She is a diabetic. We spoke to her pharmacist, got her an appointment with her doctor and, much to our dismay, they just added one more pill to her regimen. We were really discouraged. It's difficult to do anything from this far away.
She came, she had a great time, she went back and stayed in high spirits for months. Lately, however, our conversations were cut short because she was out of breath. She would either avoid my husband's calls or speak very briefly because she was too tired and out of breath. We became concerned. My husband asked her to go see a doctor. She would agree to it but, when he checked in the next day, she hadn't gone. As her health declined, he finally gave her an ultimatum: go or I will call an ambulance. She went. They diagnosed her with a lung infection and sent her home with antibiotics. She had a bad reaction to the antibiotics, throwing up, diarrhea, feeling weak and, still out of breath.
My husband explained that in the UK, the class system is still very much alive When her mother goes to the clinic for help, they don't assess her medication, listen to her concerns or follow-through with tests, they simply write a prescription and send her on her way. That is how she ended up with so many pills in one day. I think it was somewhere between 9 and 11 pills, some taken multiple times per day.
A friend of my mother-in-law, Lisa, contacted my husband. They had been communicating regarding their shared concerned for her health. My husband urged her to get his mother to the hospital. She took her to the Royal Free, a reputable hospital minutes away from her home. This is a teaching hospital, the very same one that saved my husband's brother three years ago when we all thought he was dying. It didn't take long for them to notice that my mother-in-law was jaundiced, that her breathing was laboured and that she had been misdiagnosed. She did NOT have a lung infection and, she was actually having a negative reaction to the antibiotics. What she did have was a clogged artery. Tests revealed that she was also anemic. Her white cell count was so low she required a blood transfusion. She was experiencing heart failure.
The doctors are taking really good care of her. She was in good spirits when we spoke this morning, feeling stronger, knowing she had been close to death and that she shouldn't have been too stubborn to go to the hospital in the first place. The doctors have taken her off all of her medications. They will be assessing her over the next week. My husband suggested that she enjoy her stay at the hospital, treating it like a hotel. I knew she was feeling better because, while we were Face Timing, she kept looking at the state of her hair in the computer. She's a tough cookie. I am happy that she is in good hands and will probably be in excellent health by the time she comes for a visit in December. However, it disgusts me that so many elderly like her are being overly medicated. Doctors stop listening to their clients. They rush through appointments, add medications to address the latest complaint without going any further in their investigation. "Oh well, she's just getting old", they say. What if she didn't have a friend or son who care about her and push her to get assessed? She would be like one of the many elderly who end up dead through complications caused by their medications, heart attack, stroke or being misdiagnosed.
Baby boomers are aging now and, as more of them go through this flawed health system, I just know they will shake things up. This level of care is unacceptable and inhumane. We need to return to the old days where physicians visited people in their homes and looked for the cause of the symptoms rather than cover them up with chemicals. I have faith in the boomers. Demand the best, accept nothing less.
Anne Walsh
www.artnsoul.org
Showing posts with label elderly. Show all posts
Showing posts with label elderly. Show all posts
Tuesday, 25 October 2016
Monday, 8 February 2016
Med Mix Up
February 8th, 2016
My husband is British. I have never met any of his relatives because they all live in London. For years he was estranged from his relatives until his brother was very ill and my husband was forced to interact with his mother. They had a chance to say the words they each held in their heart but had never spoken. Since then, my husband has taken his mother on a trip to Paris and, they spoke on the phone, weekly, for over a year.
For the past six months or so, we have started communicating via Skype. It is cheaper than long distance calling and we can get to know each other. The children can see what their Gran looks like and show off their gymnastics tricks. I can talk to my mother-in-law, face to face and get to know her mannerisms. Since these weekly Skype sessions began, we have heard her sing, discovered her sense of humour and heard many personal stories. I am so thrilled we got a chance to connect before it was too late.
She plans to come over for a visit this summer and we couldn't be more excited. We have been discussing these plans with her for months now. However, lately, she hasn't been feeling too well. She said she was feeling tired, run down then sick. Her energy fluctuated as well. Last week, my husband asked her which meds she was on. As she listed her prescriptions, I jotted down the information. My husband and I looked at each other, worried that she was being over-medicated. Later that day, I searched the names of her medications and came to the conclusion that she is taking four doses of medications for hypertension, five doses of medications to treat her diabetes, something for stomach acid that she may have needed at one time but likely hasn't needed for quite some time and, another medication to lower the fat content in her blood. This medicine is NOT safe for people with diabetes and can lead to kidney failure.
I went to our local pharmacist to discuss our concerns but he suggested we have her meet with her doctor as she lives in the UK and this pharmacist is in Ontario. I suspected this process would not be a smooth one. You see, I've been here before, with my grandparents and, with the many residents I worked with in long term care. They visit many specialists, each one prescribing a new medication to address the issue the older adult is presenting at the time. Older adults are from a generation that worships doctors and never questions their judgement. If you look at their medication and you ask them, "What's this one for?", they don't know because they don't understand why they are taking their pills. The doctor prescribed them so it must be ok. It doesn't help that the same medication can have multiple names. My grandfather was on the same medication from three different sources because it had a different name. He was behaving very sluggish like he was having a stroke. It was a result of the multiple doses.
I have seen it so many times in long term care where residents are admitted and the nurse and doctor assess their medication. Often, they improve as soon as the amount of pills they take is reduced. Most medications have side effects so the more pills they take the harder it gets to determine whether they have a symptom that requires a new prescription (like heart palpitations or anxiety) or whether they just need a lower dosage of the medication they are already taking. When it's a loved one who is being over-medicated, things can get complicated. They may not go to the doctor's office or, they go and don't ask questions or, they do ask questions but feel intimidated or pressured for time and leave the office more confused than ever. If you phone the doctor on their behalf, they may not be able to answer your questions due to the parent's right to privacy and confidentiality. It gets so complicated.
If you are responsible for your aging parents, keep an eye on their medication. Look up each medication so you know what they are taking and why. Ask your parents if you can come to their medical appointments with them to take notes and ask questions. Use the same pharmacist for each prescription and ask about contraindications with other medication or food. I know, for example, that taking iron pills with orange juice helps my body absorb it but milk cancels it out. This is important information.
It's also a good idea to jot down any changes in them over time. These could be an indication that their medication needs to be changed, increased or decreased. When I worked on the dementia unit, I documented every time one of the residents was particularly aggressive. When I read over the nurse's and physician's notes, I realized there was often a correlation between the resident having a urinary tracy infection and the likelihood that s/he would be more aggressive. Information is key.
Be your own advocate, ask questions and remember that pharmacists are a great resource. Bring all your medication to your pharmacist and ask for help understanding how they all work to keep you healthy.
Anne Walsh
www.artnsoul.org
My husband is British. I have never met any of his relatives because they all live in London. For years he was estranged from his relatives until his brother was very ill and my husband was forced to interact with his mother. They had a chance to say the words they each held in their heart but had never spoken. Since then, my husband has taken his mother on a trip to Paris and, they spoke on the phone, weekly, for over a year.
For the past six months or so, we have started communicating via Skype. It is cheaper than long distance calling and we can get to know each other. The children can see what their Gran looks like and show off their gymnastics tricks. I can talk to my mother-in-law, face to face and get to know her mannerisms. Since these weekly Skype sessions began, we have heard her sing, discovered her sense of humour and heard many personal stories. I am so thrilled we got a chance to connect before it was too late.
She plans to come over for a visit this summer and we couldn't be more excited. We have been discussing these plans with her for months now. However, lately, she hasn't been feeling too well. She said she was feeling tired, run down then sick. Her energy fluctuated as well. Last week, my husband asked her which meds she was on. As she listed her prescriptions, I jotted down the information. My husband and I looked at each other, worried that she was being over-medicated. Later that day, I searched the names of her medications and came to the conclusion that she is taking four doses of medications for hypertension, five doses of medications to treat her diabetes, something for stomach acid that she may have needed at one time but likely hasn't needed for quite some time and, another medication to lower the fat content in her blood. This medicine is NOT safe for people with diabetes and can lead to kidney failure.
I went to our local pharmacist to discuss our concerns but he suggested we have her meet with her doctor as she lives in the UK and this pharmacist is in Ontario. I suspected this process would not be a smooth one. You see, I've been here before, with my grandparents and, with the many residents I worked with in long term care. They visit many specialists, each one prescribing a new medication to address the issue the older adult is presenting at the time. Older adults are from a generation that worships doctors and never questions their judgement. If you look at their medication and you ask them, "What's this one for?", they don't know because they don't understand why they are taking their pills. The doctor prescribed them so it must be ok. It doesn't help that the same medication can have multiple names. My grandfather was on the same medication from three different sources because it had a different name. He was behaving very sluggish like he was having a stroke. It was a result of the multiple doses.
I have seen it so many times in long term care where residents are admitted and the nurse and doctor assess their medication. Often, they improve as soon as the amount of pills they take is reduced. Most medications have side effects so the more pills they take the harder it gets to determine whether they have a symptom that requires a new prescription (like heart palpitations or anxiety) or whether they just need a lower dosage of the medication they are already taking. When it's a loved one who is being over-medicated, things can get complicated. They may not go to the doctor's office or, they go and don't ask questions or, they do ask questions but feel intimidated or pressured for time and leave the office more confused than ever. If you phone the doctor on their behalf, they may not be able to answer your questions due to the parent's right to privacy and confidentiality. It gets so complicated.
If you are responsible for your aging parents, keep an eye on their medication. Look up each medication so you know what they are taking and why. Ask your parents if you can come to their medical appointments with them to take notes and ask questions. Use the same pharmacist for each prescription and ask about contraindications with other medication or food. I know, for example, that taking iron pills with orange juice helps my body absorb it but milk cancels it out. This is important information.
It's also a good idea to jot down any changes in them over time. These could be an indication that their medication needs to be changed, increased or decreased. When I worked on the dementia unit, I documented every time one of the residents was particularly aggressive. When I read over the nurse's and physician's notes, I realized there was often a correlation between the resident having a urinary tracy infection and the likelihood that s/he would be more aggressive. Information is key.
Be your own advocate, ask questions and remember that pharmacists are a great resource. Bring all your medication to your pharmacist and ask for help understanding how they all work to keep you healthy.
Anne Walsh
www.artnsoul.org
Wednesday, 20 January 2016
Grief, at any Age
January 20th, 2016
Last Friday, I visited my youngest daughter's class to offer a "Have You Hugged Your Alien?" workshop. There were two classes combined into one which meant 38 grade 2 students having a blast! I love doing these workshops however, I have noticed a pattern. Every time I go to a school and offer a workshop, whether it be about creativity, self-care, stress management or healthy emotional expression, children start telling me about the pets, grand-parents and parents who have passed away. They share stories about their loved ones, how they died and what people said or did after the death.
At this last workshop, a little girl said her dad had passed away. In response to a comment about that being very sad, the little girl explained: "Well, it's been two years". Her tone was very dismissive. Does she think she should be "over it" by now? That is very sad. The thing about children is they don't always understand what has happened to their loved one. They may expect to see them again. Their family is grieving as well so they may not be able to take the time to explain everything to them. We also try to protect the children so we may keep them in the dark, exclude them from funeral services and conversations. When children express grief, we may try to make them feel better. Only time will do that. We can't take away their grief, only be present and honest. We may hide our own grief from them because we "don't want them to see us upset". This further confuses them because they feel all these emotions and the adults around them are going about their business as usual.
It's not just children who are not allowed to grieve. I witnessed this first-hand when a close relative had a miscarriage, just how awkward it can be to grieve while everyone encourages you to move on. She had just had a miscarriage. The baby was quite advanced. She was upset, obviously. It was another relative's birthday. We all went out for supper to celebrate. As we sat at the restaurant, everyone was happy, giddy etc. acting as if nothing had happened. I looked over at her, in shock. She had this empty look in her eyes. I asked her if she'd like to come outside with me. We sat on a curb and I gave her a tiny compass on a chain. I told her I think about her all the time and, if she felt lost and alone, all she had to do was look at this compass and know that I was out there, waiting for her to call. We sat together quietly and she was ready to go back inside. She seemed a bit lighter and she was excited to share her compass with the group. They were not receptive. She was dampening the mood. How dare she, on this person's birthday? Once again, I sat there in disbelief. We looked at each other and she put on her necklace.
Another example of our negation of people's right to grieve is the move to a long term care facility. I have seen it many times. A family arrives with their elder. They empty the boxes and set up photo frames and decorative comforters, maybe hang some art. They try to create a festive atmosphere but they are stressed and worried. The tension builds in them throughout the day as the moment to leave approaches. The older adult is also stressed and worried. They join the other residents for lunch or supper and, just like the first day of school, they try to find a friendly face. They are suddenly alone. They look around their room. This is their new home. There are a few tokens from their full life but the room feels bare. They have held their emotions in to save their children from their own feelings of sadness and guilt. They know this was a difficult decision for them. They no longer live in their home, in their neighbourhood with all their stuff, accumulated over the years. They generally move in without their spouse who died a few years ago.
The staff welcome this new resident, oblivious to who this person is, what they have been through in their long life and what fills them with joy. Everyone is getting acquainted. The resident learns to eat whatever is served, three times a day, at the time it is available, they are bathed weekly, sometimes by the same person and gender, other times it's someone new, they may not have a car to get out, run errands or catch a movie. They wonder what has happened to their stuff. Who got the fine china?
As an art therapist or activity professional, you do your best to read their social history, taken from the social worker, to find other residents who might enjoy being friends with them, to organize a welcome party, to plan activities that might be enjoyable to them and to spend some time with the new resident and help them adjust to their new surroundings. They have gone through so many losses and now they have all the time in the world to feel the impact of each loss. We try to keep them busy, make them laugh and, convince them that this facility is "the best of its kind". However, just like children who have lost a parent and women who have miscarried, all they need is someone to be present, be honest and acknowledge that this is very challenging.
Grief is natural, it's painful and it takes time. We don't need to stop it, fix it or say something particularly deep. We just need to accept it, breathe into it, give it time and space then, show compassion for ourselves as we ride the wave of grief.
Anne Walsh
www.artnsoul.org
Last Friday, I visited my youngest daughter's class to offer a "Have You Hugged Your Alien?" workshop. There were two classes combined into one which meant 38 grade 2 students having a blast! I love doing these workshops however, I have noticed a pattern. Every time I go to a school and offer a workshop, whether it be about creativity, self-care, stress management or healthy emotional expression, children start telling me about the pets, grand-parents and parents who have passed away. They share stories about their loved ones, how they died and what people said or did after the death.
At this last workshop, a little girl said her dad had passed away. In response to a comment about that being very sad, the little girl explained: "Well, it's been two years". Her tone was very dismissive. Does she think she should be "over it" by now? That is very sad. The thing about children is they don't always understand what has happened to their loved one. They may expect to see them again. Their family is grieving as well so they may not be able to take the time to explain everything to them. We also try to protect the children so we may keep them in the dark, exclude them from funeral services and conversations. When children express grief, we may try to make them feel better. Only time will do that. We can't take away their grief, only be present and honest. We may hide our own grief from them because we "don't want them to see us upset". This further confuses them because they feel all these emotions and the adults around them are going about their business as usual.
It's not just children who are not allowed to grieve. I witnessed this first-hand when a close relative had a miscarriage, just how awkward it can be to grieve while everyone encourages you to move on. She had just had a miscarriage. The baby was quite advanced. She was upset, obviously. It was another relative's birthday. We all went out for supper to celebrate. As we sat at the restaurant, everyone was happy, giddy etc. acting as if nothing had happened. I looked over at her, in shock. She had this empty look in her eyes. I asked her if she'd like to come outside with me. We sat on a curb and I gave her a tiny compass on a chain. I told her I think about her all the time and, if she felt lost and alone, all she had to do was look at this compass and know that I was out there, waiting for her to call. We sat together quietly and she was ready to go back inside. She seemed a bit lighter and she was excited to share her compass with the group. They were not receptive. She was dampening the mood. How dare she, on this person's birthday? Once again, I sat there in disbelief. We looked at each other and she put on her necklace.
Another example of our negation of people's right to grieve is the move to a long term care facility. I have seen it many times. A family arrives with their elder. They empty the boxes and set up photo frames and decorative comforters, maybe hang some art. They try to create a festive atmosphere but they are stressed and worried. The tension builds in them throughout the day as the moment to leave approaches. The older adult is also stressed and worried. They join the other residents for lunch or supper and, just like the first day of school, they try to find a friendly face. They are suddenly alone. They look around their room. This is their new home. There are a few tokens from their full life but the room feels bare. They have held their emotions in to save their children from their own feelings of sadness and guilt. They know this was a difficult decision for them. They no longer live in their home, in their neighbourhood with all their stuff, accumulated over the years. They generally move in without their spouse who died a few years ago.
The staff welcome this new resident, oblivious to who this person is, what they have been through in their long life and what fills them with joy. Everyone is getting acquainted. The resident learns to eat whatever is served, three times a day, at the time it is available, they are bathed weekly, sometimes by the same person and gender, other times it's someone new, they may not have a car to get out, run errands or catch a movie. They wonder what has happened to their stuff. Who got the fine china?
As an art therapist or activity professional, you do your best to read their social history, taken from the social worker, to find other residents who might enjoy being friends with them, to organize a welcome party, to plan activities that might be enjoyable to them and to spend some time with the new resident and help them adjust to their new surroundings. They have gone through so many losses and now they have all the time in the world to feel the impact of each loss. We try to keep them busy, make them laugh and, convince them that this facility is "the best of its kind". However, just like children who have lost a parent and women who have miscarried, all they need is someone to be present, be honest and acknowledge that this is very challenging.
Grief is natural, it's painful and it takes time. We don't need to stop it, fix it or say something particularly deep. We just need to accept it, breathe into it, give it time and space then, show compassion for ourselves as we ride the wave of grief.
Anne Walsh
www.artnsoul.org
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