House Calls: Assessing an Elder’s Health, Needs

By Guest Contributor September 15, 2008 16:46

By Dr. Matthew Personius, Family Physician

There is something about the memory of my grandmother that transcends almost all other childhood recollections. “Nana,” as we called her, had always been there it seemed; timeless and ageless, her kind and smiling face one my earliest and most vivid memories. Even though she lived two hours or more away from my boyhood home, we were together often and spent many of our holidays at her small house near San Diego.

It never seemed strange to me that Nana lived by herself; it was the way it had always been, and in my childish view of the world it was accepted as “normal.” I heard stories of Grandpa Al, and had seen grainy photos of my father and his dad back in North Dakota, but he was no more relevant to me than George Washington and I certainly couldn’t have imagined him intruding on Nana’s peaceful existence. It seemed to me at the time just as right for her to be alone as it was for me to live with my parents and siblings.

It wasn’t until much later that I was able to reflect in an objective fashion on my grandmother’s life as a widow. Recently I have thought of her often as I make calls on my many elderly patients who reside alone. As I observe these situations, two things have impressed me greatly.

First, just as I assumed that all was well for my grandmother, it is often assumed that elderly residents in our communities are “doing fine” because they are only seen in the context of a controlled and safe environment – an obvious example being a visit to the physician’s office. In this situation, the elderly patient is often accompanied by a family member of friend, has groomed especially for the occasion, and discussion is limited to the pertinent medical issues.

One could easily spend an appropriate amount of time and attention to this hypothetical patient, and yet be ignorant of the most pressing, urgent, or stress-inducing aspects of their life, be they emotional, financial, medical, or other. I know this to be true from personal experience, and am sorry to admit that I have been unaware of or unable to help with the most significant needs of my patients on numerous occasions.  But I think that family members, neighbors, and friends are just as susceptible to this naiveté as those in the medical field, unfortunately.

Secondly, I have learned that the old cliché is all too true: nothing stays the same. Many elderly in our communities walk what I would describe as a razor’s edge, which when viewed from the side has the illusion of stability, hiding the true, precarious nature of their existence. I can’t count the number of times I have stood at the bedside of one of my elderly patients and heard a family member say, “But they were doing so well.” For many it takes the equivalent of a small gust of wind to undo what seemed so stable and so secure.

The good news is this: by frequent evaluations of the elderly, careful attention to detail, willingness to listen, and engaging with some of the many support networks in our community, we can better care for our elderly patients, family members and acquaintances, and help ensure a better quality of life. We cannot avoid every eventuality, and preparing for the inevitable decline we all someday face is important, too. But we can go a long way toward making the road a little less difficult. And that’s a good thing.

Dr. Personius can be contacted at Sierra Housecalls Medical Group, (209) 532-4287.

© 2008, Friends and Neighbors Magazine

By Guest Contributor September 15, 2008 16:46
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