Is Healthcare Forgetting the Elderly? – Dec 11, 2019
The Caring Generation® – Episode 19 December 11, 2019 On this radio program, Pamela D. Wilson, caregiving expert, answers the question Is Healthcare Forgetting the Elderly? Guest Dr. Mary Wyman from the University of Wisconsin shares research to answer the question Is the Healthcare System Biased Against Care for The Elderly?
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Is Healthcare Forgetting The Elderly Radio Show Transcript
00:04 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is, that it doesn’t have to be that way. The Caring Generation with host Pamela D. Wilson is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.
00:48 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation radio program coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. The Caring Generation focuses on conversations about health, well-being, caring for ourselves, loved ones, work-life balance and everything in between, all tied together with a little humor and laughter that are essential to being a caregiver. Take The Caring Generation with you wherever you go on Apple Podcasts, Google Podcasts Pandora, iHeart Radio, Spotify, Spreaker, Stitcher, SoundCloud, Castbox and more. You can share the program with your elderly parents and your family members. All you have to do is download a podcast app to their cell phones and show them how to listen. Sometimes our elderly parents don’t know how to do all these technology things, and we as the younger generation can help them. It’s the perfect way to help begin conversations about caregiving by letting me do the talking for you.
01:57 Pamela D. Wilson: This week we’ll be answering the question, is healthcare forgetting the elderly, and not only the elderly, but middle-aged adults and even women? How many of you noticed that you are fortunate to get 15 minutes at a doctor’s appointment? Sometimes you leave and you feel like your questions weren’t even answered. As we age, we have more chronic diseases like high blood pressure, arthritis, breathing concerns, diabetes and other health issues. Healthcare bias can make it more difficult to get the medical care that we want. On this show for caregivers and aging adults, we will talk about whether doctors neglect older patients. We will also talk about why getting attention and treatment can be difficult from the healthcare system. Not all doctors have the skill or the patience to serve the middle-aged and elderly population. In the second segment of this hour we’ll visit with special guest, Dr. Mary Wyman from the University of Wisconsin—hello Wisconsin—to answer the question, is the healthcare system biased against care for the elderly? Dr. Wyman has a PhD in Clinical Psychology and a minor in Neuroscience. Her focus is aging research that includes mental health in the elderly, depression, coping with chronic illness, and healthcare decision-making. She also works with the VA Medical Center in Wisconsin.
03:31 Pamela D. Wilson: Let’s start by talking about the frustrations of not feeling well and trying to manage health conditions. When we notice ongoing health concerns that don’t get better, rather than ignoring them or hoping that they are going to go away, we should see the doctor. The same is true for our elderly parents. When we don’t feel well or we have a nagging ache or pain, this really is the time to make a doctor appointment. By being proactive and diagnosing concerns early, we save ourselves years of poor health in the future. The gap between the healthcare system and potential healthcare bias does bring up the question, do doctors neglect middle-aged and older patients? It’s better to prevent situations from advancing and becoming more serious instead of reacting after an issue like a heart attack, a stroke, or a hip fracture. Let’s talk about the healthcare system and why being proactive can be difficult. If you are Medicare-eligible, it can be difficult to find a new doctor who is accepting Medicare patients. If you have an Advantage or Managed Health insurance plan, you still may find it difficult to find a practice that will accept you as a new patient, or there could be a really long waiting list.
04:53 Pamela D. Wilson: The healthcare system doesn’t have enough providers. There aren’t enough geriatricians to treat older adults. Why? It’s the time and expense of medical school. If you think about it, becoming a doctor takes a bachelor’s degree, that’s four years. Then tack on another three to five years of training. Education costs between $200,000 and $300,000, sometimes more. Specialty programs like geriatrics can add another year to medical school. Some students just can’t afford the cost of medical school and the loans that have to be repaid, and the time and cost of medical school can lead us to believe that healthcare is forgetting the elderly.
05:34 Pamela D. Wilson: Did any of you see the 60 Minutes program? It was a few weeks ago, featuring the NYU School of Medicine giving tuition-free education to medical students willing to work in rural or low-income communities. We need this for geriatrics so that there will be more geriatricians available. Primary care physicians want to be helpful, but they may be uncomfortable going beyond their expertise to provide medical treatment or make recommendations that are beyond their skills. If you were with me for The Caring Generation show called The Signs of Dementia Checklist, we talked with Dr. Jonathan Graff-Radford about the value of seeing specialists. This related to memory loss, but really there is value in seeing specialists. If you missed that show, you can catch the podcast replay on my website www/PamelaDWilson.com.
06:25 Pamela D. Wilson: Specialists are beneficial for advanced and complicated medical conditions. When I managed care for my clients, I always made the extra effort to request a referral to a specialist. All you have to do is ask. Specialists allowed my clients to get more thorough care. I attended the medical appointments. But what the healthcare system doesn’t want you to know is that some insurance plans reward the primary care doctors not to refer out to specialists. This, in my opinion, can be healthcare bias, because it can lead to situations where doctors neglect older patients. Ask for a referral to a specialist. If your doctor doesn’t agree, ask if they are paid not to refer you/ They might be surprised about you asking that question. Another area involved in the question of, “Is healthcare forgetting the elderly?” are chronic diseases. Chronic diseases benefit from seeing a specialist. So, for your heart a cardiologist, breathing a pulmonologist, diabetes an endocrinologist, kidney disease a nephrologist, arthritis a rheumatologist, and a neurologist for memory loss.
07:35 Pamela D. Wilson: Specialists may be viewed as one more medical appointment by an elderly parent and you, as the caregiver. Because you are the person who has to take that time off work. You have to drive, accompany your parent, it can be time-consuming. But, if you can see a specialist, you will be amazed by their knowledge. Their advice and their recommendations to treat conditions can lessen your worries. Specialists have the expertise and the insights about complicated diseases that primary care physicians don’t have. You have that opportunity to use their experience to ask questions. To ask about the consequences of a diagnosis. To find out about medications. To learn everything that you need to know, so that you or your elderly parent don’t end up in the hospital, or your health conditions worsen. In the second half of the show, we will continue answering the question, “Is healthcare forgetting the elderly?” I’ll share real life experiences about healthcare bias when doctors neglect older patients. You’ll realize how important it is to advocate for yourself and an aging parent, or a spouse. Coming up after the break, Dr. Mary Wyman, from the University of Wisconsin and the VA Medical Center, to answer the question, “Is the healthcare system biased against care for the elderly?” and why family caregivers have a similar bias. This is Pamela D. Wilson on The Caring Generation, live on the BBM Global Network channel 100 and TuneIn radio. Stay with me. We’ll be right back.
11:32 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. We’re back to answer the question, “Is the health care system biased against care for the elderly?” Dr. Mary Wyman, from the University of Wisconsin joins us. Dr. Wyman, good evening.
11:55 Dr. Mary Wyman: Good evening, glad to be here.
11:57 Pamela D. Wilson: Thank you. So, let’s talk by having you share the definition of ageism.
12:03 Dr. Mary Wyman: Sure. Well, ageism is an “ism,” just like racism or sexism. It means bias against someone because of one characteristic, and kind of generalizing that bias or that negative attitude to the entire group. So, in this case, it’s bias against someone because of their age, and that’s usually directed at people who are older, rather than younger. Although I think there can be bias both ways. Sometimes, people have negative thoughts about teenagers, for example. But, as we’re talking about bias against aging or older adults, you know it’s a very interesting type of “ism,” because it’s the one “ism” that could affect all of us, if we’re lucky enough to live to old age. It’s been said that ageism is a prejudice or a bias against our future selves, and I think that’s really important to keep in mind.
13:00 Pamela D. Wilson: Let’s talk about how that bias might exist in the healthcare system, and what does the research say about how negative attitudes towards aging might affect our healthcare experience?
13:11 Dr. Mary Wyman: Well, that’s a really good question. And there’s actually quite a bit of research looking at age-related bias in healthcare and we can think about that bias or discrimination, being expressed at different levels. So, we can start at that basic interpersonal level thinking about healthcare staff, doctors, nurses, other kinds of healthcare professionals and their attitudes toward older adults and their behavior toward older adults. And one thing I should say that’s really important, thinking about this bias in the healthcare system and really in our society at large, we know that most of the time, that bias or that ageism is unconscious. It’s not something that people are aware of, it’s something they’ve simply picked up growing up in our society hearing lots of messages and negative stereotypes about older adults. So that’s certainly true for our healthcare professionals as well. So, we’re thinking about that interpersonal level between the healthcare professional and their older patient, but we’re also thinking about all the way up to the highest level, institutional bias, or bias in terms of policies, payment plans or other things that would affect healthcare for older adults, what they have access to and what’s paid for.
14:35 Dr. Mary Wyman: So, we know that there’s research showing that there are negative attitudes toward older patients among healthcare staff. Not all healthcare staff see it that way, but probably about half, in a number of studies describe by answering questionnaires, sort of reveal some more negative attitudes toward older adults. There’s also evidence that there are negative attitudes toward specialties or healthcare settings where people are working primarily with older adults. Often those geriatric settings aren’t seen quite as prestigious as some other medical specialties, and sometimes aren’t paid as well working in that setting with older adults. For example, there’s some studies that showed a description of a patient, same symptom, same presentation, and some doctors got a description of a patient that was described as being an older adult. Some doctors got the same description, but the patient was described as being a younger adult.
15:42 Dr. Mary Wyman: And we know for about half of those doctors, they tended to make a different decision based on the fact that they thought the person was an older adult, often not referring them for certain diagnostic procedures, not referring them for certain types of treatment. So, we know that the attitudes are there. We suspect based on studies like that, that behavior diagnossis or treatment decisions can be affected. Sometimes in very subtle unconscious ways as I mentioned. And we also know that at that upper level that institutional level or society level, policies like what Medicare in this country, what Medicare will cover, what kinds of services. That Medicare is based on age. That’s how people are eligible for it. And it wasn’t that long ago that Medicare didn’t actually cover certain preventive diagnostic tests or screening tests with the belief that older people as a whole couldn’t benefit from those tests and that’s changed now. But that would be an example of a healthcare policy, that bias operating at that upper level.
16:58 Dr. Mary Wyman: And what about family caregivers who are helping, do they also have this unconscious bias?
17:04 Pamela D. Wilson: That’s a great question, and there really is not a lot of research looking at the attitudes and beliefs of family caregivers, and that’s something that we really need to understand a lot more about. There is some research that suggests that even very loving, committed family caregivers of older adults often buy into those negative unrealistic age stereotypes, just like the rest of society, even if they don’t realize it. And our own group has looked at attitudes towards aging among family caregivers of older adults. We found a couple of interesting things. One is we found differences in ageism by cultural group, and to us, that suggested that we’re probably learning these attitudes about older adults early on through our cultural upbringing. We’re absorbing the messages and watching things happen in the society that we grew up in, and that’s good news because we also can unlearn those attitudes later on. So, another finding that we had is that the relationship with the older adult themselves is a really important part of trying to combat that unconscious bias among family caregivers. So, focusing on that relationship, a positive nurturing relationship with the older adult in your life, you might be able to shift that bias to be more realistic and less based negative, false stereotypes.
18:49 Pamela D. Wilson: Okay, Mary, we are going to head out to a break. We will continue our conversation with Dr. Mary Wyman from the University of Wisconsin after this break. I’m Pamela D. Wilson, your host, you’re listening live on the BBM Global Network, Channel 100 and TuneIn Radio. Stay with me, we will be right back after this break.
21:31 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host, you’re listening to The Caring Generation radio program for caregivers and aging adults coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. Let’s continue our conversation with Dr. Mary Wyman from the University of Wisconsin about healthcare bias. Dr. Wyman, so let’s talk about areas like, memory loss, depression, and pain that might be under-treated because like you previously said, doctors will look at a person as being older and they think, “Well, maybe they don’t need treatment.”
22:08 Dr. Mary Wyman: Yes, well, that’s a really good question. I don’t think it typically happens in that obvious of a way. I think stereotypes about aging are absolutely part of the problem. I think in healthcare and identifying and diagnosing, sometimes older adults themselves, family members, sometimes even healthcare professionals, buy into that stereotype that normal aging means memory loss. Normal aging means being depressed. Normal aging means experiencing bodily pain. And we know that all of those—memory loss, depression, or mood problems, pain, once they’re beyond a certain point, they’re not normal aging and they really should be evaluated and there are treatments and things that older adults themselves can do to make those problems better. So, I think it’s a complicated thing sometimes to separate that out in the doctor’s office. But also before that for the older adult to decide, yeah, there’s something going on and I want to get evaluated and get on top of this. This isn’t how being old should be.
23:19 Pamela D. Wilson: And how often does that happen? So how often does an older adult say, “Well, I am old, I should be in pain, I should have all these issues?” Is that a super significant problem or is that kind of a smaller problem out there?
23:34 Dr. Mary Wyman: Well, that’s a really good question. Well, we know that negative beliefs about being old exist among older adults themselves. After all, they were raised in the same society with lots of negative messages about what aging is, and those negative stereotypes. They were raised in that same society just like the rest of us. And we also have a fair bit of really interesting research data showing that attitudes about one’s own aging predict health problems in old age. So, we know that, for example, people who have more positive attitudes about their own aging later on are going to have less heart problems, less cardiac problems, also less problems related to brain changes that can be a sign of Alzheimer’s disease. So, positive attitudes are not buying into those negative stereotypes seem to be protective in some ways, and that’s really important to keep in mind. So, we know that older adults will tell themselves, “I’m old. I buy the stereotype. This is how it is, I just have to suffer through it.” And that’s absolutely not true. How we perceive aging really does influence our health. It influences the choices that we make about our health, and the absolute most important thing is for older adults and their caregivers to be informed about what normal aging really is and what it isn’t, and to seek help when there’s a problem there that could be treated or managed to have better quality of life.
25:16 Pamela D. Wilson: You know, there’s a shortage of geriatricians out there. What are your recommendations for how elderly adults can get care if they live in rural areas?
25:27 Dr. Mary Wyman: Oh, that’s a great question, really, really important. There is a shortage of geriatric trained health providers, and that’s one of the challenges that the healthcare system has in serving older adults, especially in areas outside of those big cities. So, one thing I want to mention is the Veterans Affairs Healthcare System, that’s where I work. The VA serves eligible veterans across the country and has done an amazing job doing outreach to veterans who live in more remote areas. They use technology and other approaches to make sure that they get really high-quality geriatric care, even to those rural areas. The other thing I want your readers or your listeners, excuse me, to think about is, finding out from the county or state Area Agency on Aging about healthcare options, where there may be a geriatrician, or a geriatrics trained provider.
26:23 Dr. Mary Wyman: You can also ask at the senior center, what they know about healthcare options. And organizations like the Alzheimer’s Association. They’re all over the world. They have chapters in many, many cities and state-level organizations in every state in the United States. They are a great resource, if there are questions about memory loss and questions about, “where could I go to get some memory loss . . . to get an evaluation? How do I know if this might be memory loss that’s significant and needs to get looked at?” They’re a wonderful resource, they have a great website. And, as I said, typically telephone numbers and even in the most rural areas, there’s a way to reach them via telephone. So, I encourage your listeners to be advocates for themselves, gather lots of information and really be proactive in caring for their health.
27:17 Pamela D. Wilson: Mary, I thank you so much for joining us, this has been such helpful information. Could you just really quick give, if somebody was going to try to find a local VA, what do they Google? Do they Google “VA Medical Center,” or how do they get there?
27:30 Dr. Mary Wyman: Yes, the website would be Va.Gov. You can get on there. You’ll find out where your local medical center is. Also, if you’re a veteran and you don’t know if you’re eligible, there’s a button on the website that will allow you to apply for eligibility and find out if you can get your care at the VA. I encourage all veterans to do that. So, very, very simple, Va.Gov.
27:57 Pamela D. Wilson: Great, thank you so much for being with us. Listeners, coming up after this break, we will continue to answer the question, “Has the healthcare system forgotten the elderly?” and, “do doctors neglect older patients?” Helpful information for caregivers and aging adults is on my website, pameladwilson.com. I’m Pamela D. Wilson, your host. You’re listening to The Caring Generation, live on the BBM Global Network Channel 100 and TuneIn Radio. Stay with me, we’ll be right back.
30:44 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host, you’re listening to The Caring Generation radio program for caregivers and aging adults. Coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. We’re back to continue our discussion, “Has the healthcare system forgotten the elderly? Is the healthcare system biased? And do doctors neglect older patients?” Let’s talk about healthcare providers, so that I can help you learn how to advocate for yourself or a loved one. If you listened to The Caring Generation show a few weeks back, “Why is Caregiving So Exhausting?” We talked about the fact that caregivers will continue to do more. You’ll have to be more proactive about care for your elderly parents and yourself. Otherwise you might experience healthcare bias and not receive the treatment that you need. How many of you have ever gone to the doctor, you’ve received advice, instructions, maybe a prescription, a test recommendation, follow-up appointment. But, you ignored the doctor and didn’t follow through. The situation happens, it’s real. Refusals by patients in following medical advice frustrate doctors. The doctors think, “Well, why bother? I have patients who are ignoring me, and won’t follow through with my advice.” How do you think the doctor feels? So exasperated, like they’re talking to the wall. This is one of the reasons why doctors might neglect older patients who don’t listen.
32:18 Pamela D. Wilson: The experience that patients don’t care and won’t follow advice is a problem. It’s a bigger problem when the doctor lists you or an elderly parent as non-compliant in your medical chart. You don’t know it, but the doctor putting that non-compliant in your chart can make it more difficult for you to get care and treatment when you want it. Be very careful about not following through and if you don’t follow through, explain why to the doctor so that that information can also get in your record. Because refusing care without a good reason does carry a cost. If consumers and patients followed medical advice all the time, there might be fewer health problems, lower health costs. The problem is, we all think that good health lasts forever and we are surprised when it does not. Once you start experiencing some aches and pains, and I laugh, because I have a few aches and pains, you’ll realize this to be a fact. Another challenge is that doctors don’t explain to patients why they should follow their advice.
33:23 Pamela D. Wilson: If you’re told what you should do with no explanation? How likely are you to do it? Not very. Then you have a surprise. Your health changes, a diagnosis gets worse. You have multiple health concerns that are stacking up one on top of the other. That can make it difficult for physicians to treat middle-aged and elderly adults. Here’s a simple example. High blood pressure, it can cause future heart and circulatory issues, memory loss, dementia. But we don’t talk about that. So, if you have multiple health conditions, are you being proactive? Are you attending doctor appointments? Are you taking your medications as prescribed? Do you even prepare for your doctor appointments? It’s important, because time is so limited, that you have a list of things to discuss with your doctor. The more prepared you are, the more you can make sure that you receive the care that you need. When you go to the doctor, do you take a list of all your medications, all the over-the-counter items which are extremely important? Because those can work against your medications. Regular blood tests, every six months if you have diabetes, or every couple of years for cholesterol, for triglycerides, all of those can indicate potential health problems before they arise.
34:53 Pamela D. Wilson: And then we have older adults who don’t question doctors. Some doctors do have big egos. They are offended if you bring in some article from the Internet, or if you ask questions, or if you question their recommendations. It’s your right as a patient to ask. If you’re not satisfied with the recommendation or you don’t feel that your doctor is explaining information well enough, you can always get a second opinion. I’ve had many circumstances where the second opinion was actually better than the first opinion, and a better treatment option. There are situations where doctors have different opinions based on their experience, like Mary talked to us about. The goal is to be informed. It’s to understand your care and the recommendations for your care. Ask questions. Ask for a second opinion if you are in doubt so that you have peace of mind that you are making the right care decision for yourself or an aging parent or a spouse. Because some medical decisions, they can’t be reversed. Also, if you have a power of attorney appointed for your medical care, involve that person in your decision-making process. Surgery or extensive treatments can put you in a position of needing somebody to advocate for you.
36:17 Pamela D. Wilson: That person to advocate, it’s your medical power of attorney. And if you have multiple health conditions, and you haven’t appointed a medical and a financial power of attorney, or completed your living will, what are you waiting for? The time is now. What if something horrible happens and you’re in the hospital, and you can’t make decisions and you have no one to make those decisions for you? There are articles about power of attorney on my website, in my Caring for Aging Parents Blog. Replays of all of The Caring Generation radio shows and the show transcripts are on my website at PamelaDWilson.com. Please share the show with your family, your elderly parents. Everybody that you know so that we are all better informed and not surprised about health, well-being and all things caregiving related. The guests that I have on the show are here to educate you, to help you learn and to provide resources for you. You can also follow me on social media, on Facebook, I do daily live videos, you can follow me there. My page is PamelaDWilson.page. On Twitter, I am Caregiving Speak, on Instagram, I am Wilson Pamela D and on LinkedIn, I’m PamelaDWilsonCaregiver Expert.
37:38 Pamela D. Wilson: Please, do help your parents with some technology. Download a podcast app off the Internet, where they can listen to The Caring Generation. Sometimes it takes somebody else to start that conversation for you. Because sometimes our elderly parents, believe it or not, do not want to listen to us as their children giving them healthcare advice. But yet they will readily listen to someone else. This is Pamela D. Wilson, caregiving expert. I’m your host. You are listening to The Caring Generation live from the BBM Global Network Channel 100 and TuneIn Radio. Stay with me, we’ll be right back.
40:35 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. We’re back, continuing our conversation about healthcare bias and answering the question, “has the healthcare system forgotten the elderly?” How many of you take aging parents, spouses or other family members to doctor appointments? Do you notice when you’re in the room, is the doctor speaking to you or them? Many times, when a family member is present at a doctor appointment, the doctors will talk to the family member in the room instead of the elderly parent. This is just one of those things. The doctor thinks it’s easier, quicker, and they will get faster answers from a family member, because there’s only 15 minutes for that appointment. There’s really no time for chit-chat or personal conversations. And sometimes, our elderly parents want to make small talk, because they think it is polite. Unfortunately, small talk can take up most of the appointment. Your elderly parent is there for a purpose. You want to make the time effective and efficient. So, you should be in that room but make your loved one the star of the appointment. Let your mom or dad answer the questions and when a question can’t be answered or if they answer incorrectly, ask if you can help with the answer.
41:58 Pamela D. Wilson: It’s a dignified approach to medical care. Other complications that can happen is if your elderly parent has hearing loss or vision loss. Sometimes you will need to step in and help explain information or relay information. Also, if you are listening as an elderly adult and you have vision problems, don’t sign any paperwork that you can’t read. Years ago, I was power of attorney for a woman who had macular degeneration, she didn’t want to tell people that she couldn’t read. So when people gave her paperwork, she would sign it, but she would ask to keep it so that she could ask me or somebody else to read it to her at a later date. This happens all the time when older people are hospitalized and you have to sign all of these forms. Be careful though, because you might sign something that you normally wouldn’t agree to if you understood it. So, other situations are healthcare conditions and getting the right care. Pneumonia is a common concern among the elderly who have asthma, bronchitis, COPD, any type of breathing issues. Pneumonia is a condition, it’s like a urinary tract infection that can repeat in the elderly and it comes on overnight, very suddenly. Sometimes only noticeable by a little cough or a temperature, but it can result in a visit to the emergency room and not feeling well, that can last for a couple of weeks.
43:22 Pamela D. Wilson: One of my clients was sent to the emergency room and he was diagnosed with pneumonia. It was so advanced that he was placed in the intensive care unit and I was his medical power of attorney. Like we talked about with Mary, the doctor called and he questioned me about, “Well, do we really want to treat this person? He is 90 years old.” This is a warning to you when you have a family member. Doctors may question whether or not they should be treated. In this situation, the doctor was leaning toward not treating my client. But because I was the power of attorney, and I knew his health history, I knew that he would bounce back from treatment, I was very adamant saying, “My client will bounce back. He does want to be treated.” And fortunately, because I was that legal decision maker, the doctor had to listen to me. I knew he would bounce back and he did. He was treated, he lived another two years. This is a situation where you as the family member, you can’t be shy when you know what your loved one wants for care. Doctors in any setting can be intimidating, especially in hospital settings, and family members can be easily swayed. You know your elderly parent better than anybody else, you have to make sure that they receive care.
44:42 Pamela D. Wilson: And another issue very important for you to be aware of, it is the Patient Protection and Affordable Care Act, Provision 3025, it’s called the Hospital Re-admissions Reduction Program. You can Google that. There are penalties for hospitals who admit elderly patients who leave the hospital and come back within 30 days for certain conditions. The conditions are heart attacks, heart failure, pneumonia. So, if you think of pneumonia, do you now see why the doctor didn’t want to treat my client? He didn’t want my client coming back to the hospital and having the hospital face a financial penalty. He was more interested in the hospital’s finances, and not the care of my client. Continuing on that list of conditions, hip and knee replacements, heart bypass surgery. The goal of hospitals today, is to get elderly patients in and out as quickly as possible. If they can find a way to keep an elderly person only for a few hours and send you home, that is their goal.
45:46 Pamela D. Wilson: When an elderly person goes to the emergency room, there is being admitted and there is being on observation. It’s different by state. Here in Colorado, where I live, there are hospitals that have built entire observation wings, so the patients don’t know if they’re admitted or not. The goal is that if that hospital doesn’t admit you, but keeps you on observation and you do come back within 30 days, they can’t be financially fined. The downside though, for the consumer, is that some insurance companies require admission and minimum stays of one to two to three nights to be able to go for physical rehabilitation, which some individuals need to be able to regain their strength and their well-being, and be able to stay at home.
46:36 Pamela D. Wilson: If you have an elderly parent or a spouse who is hospitalized, make sure that you ask the question, “Is my parent admitted or are they on observation?” And then start asking questions. Make sure that you understand the differences and the consequences, because sometimes, being on observation, patients actually pay more. It’s important to know about how all of these situations work, so that you can make sure that your elderly parent is getting the best care that they possibly can. You can do this by sharing The Caring Generation with others. Podcast replays of all of The Caring Generation shows are available on my website, PamelaDWilson.com, along with all of the show transcripts there for you to read. And again, I suggest, if your parents have a cell phone, find a podcast app, whether it’s Apple, or Google, one of your favorite ones, add the show, so that they can listen. After this break, I’ll share another story about the importance of advocating for loved ones, to make sure that the healthcare system is not forgetting the elderly. Learning to advocate for yourself or loved ones is so important. I’m Pamela D. Wilson, your host. You’re listening to The Caring Generation, live from the BBM Global Network Channel 100 and TuneIn radio. Stay with me, we’ll be right back.
51:21 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host, you’re listening to The Caring Generation radio program for caregivers and aging adults, coming to you live from the BBM Global Network Channel 100 and TuneIn radio. Let’s finish our conversation about healthcare bias and the question, “Is the healthcare system forgetting the elderly?” Topics that we’ve covered. There is a physician shortage of geriatricians. The healthcare system is definitely rushed to provide care. You, as consumers, patients, caregivers, have to be more proactive than ever in researching health issues, asking questions and advocating for care. Especially as the healthcare system pushes more responsibility for care on family caregivers. If you have a loved one with dementia, be sure to attend all of their medical appointments. And if for any reason your elderly parent is sent to the hospital, do show up. Persons with dementia or memory loss who don’t have an advocate in medical systems, they’re fair game for medical providers to do whatever they want to do, without consulting anybody.
52:36 Pamela D. Wilson: If you are the medical power of attorney, make sure that the medical doctors and the healthcare team know that you must be contacted for all decisions. I’ve had physicians change or discontinue medications without asking me when I was a medical power of attorney, and this harmed my clients. I’ve also had physicians refuse treatments. These physicians lacked education about dementia, because not all physicians who treat older people know about dementia, or memory loss, or Alzheimer’s, and sometimes there’s a belief that since these people might be forgetful, because they can’t remember information, they may not deserve treatment. Dr. Mary Wyman and I talked about this, earlier in our interview. The idea that old people are useless, or they’re a burden to society, or that medical care for the elderly is expensive and a waste of time, is prevalent in some healthcare circles.
53:34 Pamela D. Wilson: Since when do our aging parents, our grandparents, ourselves and others not deserve care? Well, it may be true that younger patients recover better, have long lives. It is not true that the elderly parents cannot recover and stabilize. They can recover. They can stabilize, and they can do well. We have to remember that doctors are not God. That we have to be this squeaky wheel, that advocate, who ask questions. Who isn’t afraid to disagree with doctors. It’s our responsibility to care for our elderly parents, because they cared for us when we were children, and they worried about us as we grew up. We all become caregivers because we love our elderly parents. We take on responsibilities, all of the tasks that do make our lives more stressful, because we love. But it’s up to us to make sure that the healthcare system doesn’t forget the elderly, and that it’s not biased against care for us and our older parents. Because one day we will all be old, and we will want somebody to advocate for us.
54:47 Pamela D. Wilson: Listeners, if nobody has told you that you are amazing this week as caregivers, or hasn’t thanked you for everything that you do as a caregiver or in helping others, let me say thank you. Please do share this program, add your favorite podcast app to the cell phone of your elderly parent or your family member, and help them listen to The Caring Generation, so that we can make caregiving, health, well-being, aging, something that we talk about. I’m Pamela D. Wilson, caregiving expert. I’m your host, I thank you for joining me this week on The Caring Generation radio program for caregivers and aging adults. Remember that all of the podcasts of the shows are on my website at PamelaDWilson.com. You can visit the website for helpful information. I look forward to being with you again next Wednesday evening, we have a fabulous guest who is going to talk about smoking and digestive problems. Please invite your family and friends to join us. God bless you all, sleep well tonight, have a fabulous day tomorrow and a great week, until we’re together next Wednesday.
55:57 Announcer: Tune in each week for The Caring Generation, with host Pamela D. Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone. Here, on Pamela D. Wilson’s The Caring Generation.
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