By: Jennifer Beach, LSW, MA, C-SWCM
Mr. Smith is 88 years old and has been living in a long-term care facility for the past 18 months. He has multiple comorbidities, fatigue and muscle weakness. In the past three months, he has lost over 10 pounds. He has several specialists who manage a couple of his chronic conditions. When Mr. Smith must make a trip to see a specialist or have a test done outside of the facility, it is something he dreads. He travels to appointments in an ambulette due to his challenges with mobility.
Mr. Smith is a quiet and kind gentleman and would never say a word about the uncomfortable ride, the long waits, and the sheer exhaustion from going out to a medical appointment can cause him. He simply goes when he is told. Often, Mr. Smith reports that not much goes on at these appointments. The doctor sees him briefly, makes a few notes and then he is wheeled to the lobby to wait for the ambulette driver and the bumpy, loud ride back to the facility. His back seems to take the biggest hit after one of these trips.
I have witnessed many older adults go through similar situations and encourage family members to advocate for their elderly loved ones. Most times, individuals are required to pay for the ambulette service (in facilities, this is typically not covered by insurance). Often, the individual may experience long waits for their rides, which often can be bumpy, loud and uncomfortable. Subsequently, this all can take a toll on an elderly person, both physically and mentally.
Questions and points to consider when determining if a medical appointment is necessary:
- Call and talk to the physician directly. Ask what the goal of the appointment is and if it is necessary to see the individual in person. Often, follow-up appointments are automatically made and now are “in the system.” An appointment may have been made months ago, but we should question the medical necessity for the appointment at the present time.
- Can a virtual or telephonic appointment be considered?
- Can lab work or needed information be sent to the physician for review ahead of time? If so, then determine if the individual still needs to be physically seen.
- Does the older individual want to go to the appointment? If they do not want to go, ask them about their concerns. It is crucial to hear what is important to the older individual and share the information with the physician. Together, decisions can be made that are in the best interest of the older individual.
Thanks to the advances in science and medicine, individuals are living longer than ever. We need to consider quality-of-life issues and choices for our older adults. We want to do our best, and often go to extreme medical measures and tests to “help” our elderly loved ones. But is this the best approach?
It may be time to slow down, using common sense and kindness as we care for our older adults’ changing needs. We need to work on understanding, caring for and helping older adults live well and comfortably during their final years. This may be more important than the next medical appointment.