Diabetes and the Elderly – Small Adjustments Bring Big Results
Published October 17, 2007One thing that I have learned in life is that it’s full of surprises. Life has a way of keeping us on our toes. Surprises can come in the form of illnesses; one of the most common illnesses in today’s world is “Diabetes.” People think that if you have it you suddenly have limitations. It’s not that you can’t do certain things; it is just that you may have to better prepare yourself.
When going out for extended periods of time, you need to take your meter, your testing supplies, your medicine and maybe a snack bag with different foods should they be needed. Taking such measures can give you a sense of security. Imagine going into a convenience store while you are experiencing a low blood sugar level, and you have a need to consume sugar in order to bring your level up. You might be looked at like you are a shoplifter for eating the food while you are standing in the aisle. Or, on the other hand, if you have a high blood sugar, you might pass out or be confused. This could all justify the need for a medical alert bracelet to provide your vital information to anyone attempting to help you.
Many famous people with diabetes, including actors, politicians, and athletes, have lived “normal” lives with the disease. Diabetes, like many other medical conditions, may have other problems associated with it. You need regular checkups for your eyes and feet. Diabetics seem to heal slower when their glucose level is raised. By eating right, getting proper rest, exercising, drinking plenty of liquids, monitoring your sugar levels often and taking your medicine as prescribed, you can help yourself lead a more normal and free life. Sometimes this is a more difficult task for the elderly who have diabetes. They may need to count on assistance from family, friends or various other services to do the necessary things to keep them healthy.
Living with a person who is a diabetic can be challenging. When your emotions run from anger, sadness, depression, all the way to happiness, you may turn to food. The one thing that you might have turned to for comfort is now the very thing you need to control. Eating habits need to change. It becomes necessary to eat small meals all day long and to watch what you eat. To confuse matters, your doctor, family and friends may have suggestions for what you should be eating. You can get some control over your food if you make the right choices and there are many sources including books and websites to help you with those choices.
Anger and denial are common emotions encountered when one is diagnosed with diabetes. You are forced to become an expert on a disease that you previously knew little about. Personally, I have struggled to come to terms with this disease. It is almost like being in a club since both of my parents as well as some other family members have diabetes. At least we support each other in trying to cope with the disease. One of my uncles recently told me to take cinnamon pills to help lower my A1C average. (Your A1C is a blood test that reflects a three month average of your glucose levels). In six months, by following his suggestion, I have effectively lowered my level. The result is that I feel so much better.
Just remember this–in life many of us may have health problems. Thus, we might have to do things a little differently than planned. Having the freedom to live in this amazing world is worth all the effort.
Marcy Cox, BS Gerontology
Medicare—Does It Meet Long Term Care Challenges of the 21st Century?
Published September 10, 2007With an aging “Boomer” population and with many of the “Boomers” themselves facing the responsibility of caring for their parents, several challenges are presented. Meeting long term care challenges is complicated and often expensive. Two possible forms of help include assisted living and home health care. Assisted living is a long term care alternative housing arrangement for older adults who need help dressing, eating, bathing and toileting, but don’t need intense medical or nursing care. In-home companion care is a long term care concept that can encompass many social and personalized services. These services are provided at home to recovering, disabled, chronically or terminally ill persons who need help with various essential activities of daily living. The problem is that neither of these long term care options qualifies for any financial assistance from Medicare. They have to be paid for with the personal finances of the family involved. Some health or long-term insurance policies may cover some of the costs connected to assisted living.
Even though most of the elder population wants to live the remainder of their lives in the comfort and familiarity of their own homes, particularly when facing health issues, this may be an unfulfilled dream. Unless they have saved a considerable amount of money or get creative, like getting a reverse home mortgage, long term care services they most need or want like assisted living or in-home companion care may elude them. Medicare has not yet and probably never will be able to address the need for these kinds of services. Medicare is in as much or more financial turmoil as Social Security. It is plagued by rising health care costs and an aging population. The system is paying out more benefits than it is receiving in taxes. Failure seems certain if it doesn’t soon get a major overhaul. It is a not a government-run health insurance program but rather a government-funded health insurance program. As long as private insurers and providers are involved, the motivation will be to raise prices–not to evaluate, expand, and improve programs.
Medicare has not done well in explaining or managing the implementation of its new drug prescription system. In addition to that debacle, there are other flaws in its daily operation, one of which I can speak to personally. My father recently had back surgery. When he was released from the hospital, he had visiting nurses assigned to him for several weeks. He was also given a prescription for physical therapy. Months later, the physical therapy center told him that he owed them several hundred dollars because Medicare would not pay for both a visiting nurse and physical therapy at the same time. How would the average person know this? At this juncture, theoretically, he does not have to pay as the transgression was determined not to be his. He spent a lot of time, however, worrying about the outcome of this. It seems that Medicare is facing perilous times ahead, both financially and logistically. Will it be up to the challenge?
Gerri Tyber, Operations Manager
Barton Home Care
In Home Doctor Visits – Past Meets Present
Published July 28, 2007Do in home doctor visits still exist? Are any doctors making house calls like they did years ago? Believe it or not, a few are and it is becoming more and more popular among physicians. There is even an association called the American Academy of Home Care Physicians to support those who make in home doctor visits. Some have a practice dedicated to home visits while others offer it as a part of an office practice.
I have been making house calls to homebound elderly for about the past 25 years, initially in St. Louis where I had my practice and more recently in Denver where I opened a practice just last year. It provides joy beyond measure for me and hopefully provides a useful service to those I care for. One of my most memorable patients is a lady named Ruth, who had not been to see a doctor in over 10 years. She was developing memory loss, and was resistant to leaving her home. A concerned nephew called me to see if I could come to her. If you can’t move the mountain…, you know the rest. This lovely 81 year old lady was not functioning well at all. She had bottles upon bottles of old prescriptions and had those all mixed up. She was eating poorly, mostly TV dinners, but saving the aluminum tray they came in; she must have had over 100 of them stacked to the ceiling. Her clothes were soiled and her hygiene poor. She was very welcoming, however, and after some time she grew to trust me. We (my nurse and I) set up some home services; personal care aids, nurses, physical therapy, housekeeping, etc. and succeeded in allowing her to remain in her home. We helped her nephew set up guardianship and evaluated the cause of her memory loss, which turned out to be Alzheimer’s disease. She was able to stay in her home for about another year before she required more care and supervision, but that year was a safe and happy one. I can still picture the stacks of colorful hairnets she was wearing when I first met her because she hadn’t been able to dye her hair in a while.
Not all of my patients are as colorful as Ruth. Some need me because they are dying and I help facilitate hospice. Some need only temporary house calls while they recover from surgery or a fracture. Most, however, have numerous complicated medical problems that need the kind of diagnostic skill and oversight that only a professional can accomplish with home visits that allow enough time for listening and observing.
One of my older patients tells me the last time a doctor came to her house she was eight years old. My patient’s memories are not so different from what they experience now. I arrive with a large doctor’s bag (though mine is on wheels), visit for a while and do the same kind of examination and tests they would get in the office (for the most part). I am always amazed at the stamina and attitude of the people I visit. I learn a lesson from each and every one of them.
So if you think house calls are a thing of the past, think again. You just might be surprised to find how many physicians are (still) making in home doctor visits.
Nancy Wilcox Hooyman, MD
Phone: 303-757-0012
For more information, visit http://www.aahcp.org (American Academy of Home Care Physicians) or www.paradigmcare.com.
