Aging Parents

Posted on December 6, 2007. Filed under: Family Life |

My father is back in the hospital….again.

I am officially in the sandwich generation-caring for children, while caring for aging parents. This past year has been really hard for my father, and by extension, our family. At the age of 71, my father was vibrant and healthy except for some arthritis and slightly elevated blood pressure. He traveled frequently, was active at work, loved to fish, and enjoyed being a prankster– with his children and granchildren being his favorite victims. Then one day he received a call. One of the medicines he was taking for his arthritis caused a reaction that destroyed his kidneys. So, over night, he became a dialysis patient. Suddenly, he needed to be in the dialysis center three days per week, where he needs to stay for 4-5 hours.

Then like a house of cards, the dialysis caused his body to fall apart, and other things started to go wrong. In the past year, he has needed care from gastroenterologists, cardiologists, nutritionists, nephrologists, hematologists, urologists, vascular surgeons, and intensivists. As bad as the year has been, the worst part is the sense that no one is in charge of his care. I have a health background, and was often asked by the family to talk with all of the health professionals to figure out what’s going on. For some reason, my family thinks that the doctors would be more willing to talk to me because of our professional alliances–think again. Getting them to call me back with updates or information was very difficult. In the end, most of the updates came from my father who relayed discussions from his hospital bed.

There was a recent opinion piece in the Wall Street Journal titled “How Many Doctors Does it Take to Treat a Medicare Patient?” by Peter Bach, a physician at Memorial-Sloan Kettering Cancer Center in New York. It is based on an article he wrote in the New England Journal of Medicine, and he says:

“The typical Medicare patient in one year sees seven different doctors, including five different specialists, working in four different practices. For vulnerable patients with multiple chronic conditions, care is even more fragmented and involves more doctors. Forty percent of the patients in our study had seven or more chronic conditions and they saw on average 11 doctors in seven practices.”

He goes on to say that we need to change payment so that someone is responsible for the general care of pateints who see so many doctors. There needs to be a doctor who knows everything that is going on–not just with one organ system–and who is coordinating all of the care, and is basically in charge and responsible for what’s going on. We have been trying to build that sort of relationship with my father’s doctor.

One day, I received a call from her and she asked me to fill her in on what was going on with him. I was pleased that she wanted to know, and was making an effort to stay informed about his care. However, I realize that her call meant that none of his doctors are talking to her, and probably not to one another. Even though she is trying to stay on top of his care, her colleagues are not making it easy for her.

So when you have a family member who is ill, and gets care from several providers, be prepared. It is a trip into the chaotic world of health care, and no one seems to be driving the car.



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    Musings on how a disorganized woman with a full time job, three kids and a real need to relax is trying to make life simple.

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