My father-in-law had a collapsed lung and emphasema The VA doctor took a look at him and had him wheeled into the hallway. "Take him home and make him as comfortable as you can," he said.
Fortunately, my brother-in-law, the police detective was there. "Y'all better take him in there and do something for him," he demanded.
The doctors not only saved his life that day, he lived about four more years. They had been supplying him with oxygen. One day, he was told, "We are going to take away the oxygen. Do you know how much that costs?"
They put him on a treadmill, despite the fact his lungs had both collapsed more than once, and he needed the oxygen.
This knocked the stuffing out of him. He immediately developed pneumonia and shortly died. A younger, richer man would have been treated better and would have lived much longer.
Linkat,
I believe that what happened to your grandmother is not a common practice but a very unfortunate turn of events that should not have happened. We treat our patients with quality care, from the drug addict to the convicted prisoner to the habitual smoker to the sweet 90 year old man with a GI bleed to the poor kid with the ruptured appendix.
BTW, from what I hear the VA is a whole different world. Don't know why.
In all honesty I believe that having family pictures around the bedside help the health care personell to remember to personalize care. Just a nice reminder to take just a moment to think of who this person is in their healthy state rather than a sickly patient needing their 4pm pill. As a part of my BS I was required to take Sociology of Aging. And as mentioned previously I've heard that medical students are focusing more on bedside manner than in years past
I've worked on the floors as a lab tech, though not recently, and not then for a long time.
I think there is dismissal of the elderly at some levels, some times. I've noticed that as a lab tech, a human, a close relative of the very ill, and as someone with many friends and associates in medicine.
This thread coincides with film I saw with Diane today called Il Bacio Tosca, kiss of Tosca. It's all about a bunch of older opera singers at the Casa di Verdi in Milano, people in down circumstances, helped ...
damn thing made me weep.
My sense of all this is that change comes from above. Staff above needs to be educated to remaining resiliant potential that can be fostered in the older - or there and not presently listened to.
But whether or not anyone of primo brilliance is in these circumstances, it is all very strange to me. The younger don't usually get how fast all this life stuff goes. Simple attention can bring back incandescence from some seemingly somnulent folks.
But.... people at legislative level should be having a clue. Life can be rich, even among the poor elderly, brilliant or not, sentient..
I spent too much time with my mother with Alzheimer's; I don't want to do that again as either me then or me, probably near going into the state. But why older people in hospital gowns should be dismissed fairly categorically speaks to bias, and a bias of fear.
Once I was on an odd first date, a double date with myself and a VA intern, and someone higher up, a resident there and his girlfriend. We passed on the freeway, a US National VA cemetary, where my father was buried. The higher up pointed and said, that's where all the GOMERS are buried. Gomer means, Get Out Of My Emergency Room. (My dad had a tough time at the end of his life via that same VA.)
I said from the back seat, my father is buried there. Silence for a mile or so, when the talk turned to traffic..
I'll have to re-find the link for this on google -
Gomer -
Medical slang for a patient who "has lost--often through age--what goes into being a human being" (quote from Samuel Shem's "The House Of God"). Typically an old demented noncommunicative patient. Stands for "Get Out Of My Emergency Room".
I wish that gomer in room 3820 would stop moaning.
Osso- I remember reading an article once, whose message really stayed with me. The point that it made was that medical providers have a double standard in providing medical care to older people, as opposed to their younger patients The general attitude was, that once a person is past the age of 78, they are "on their way out", and it is pointless and a waste of resources to spend too much time and effort on them.
If that really is true, I think it has a lot to do with society and less with how medical personal/hospitals with it.
Phoenix, selection criteria for clinical studies must mirror the intended population that will benefit from the procedure/product once approved. Manufacturers target a specific age range in their preliminary approval studies (Phase II-III) because they want to reduce the amount of study differences due to confounding effects, while at the same time getting approval for their product for the target population as quickly as possible (which isn't very quick).
In that regard, you are correct, they are looking for positive outcomes from a finite target group for approval. Advanced age is considered a confounding effect unless they are the target group. Additional Phase IV studies can be implemented once the procedure/product is approved to expand the target population while the product is being used by a larger group than can be observed under Phase III clinical protocols. If the original population (those assumed to have the fewest complications from confounding effects) shows high tolerance and success then the manufacturer will usually look to expand the target population. Otherwise, if the the product doesn't meet expectations or demonstrates additional, unexpected side effects then it can be withdrawn or left on-market with expanded risk statements and/or contraindications.
Darn, I just had a long post vanish into the abyss. Oh well...
Phoenix, I hear you and I'm glad you were able to find a provider to offer you the procedure. There's no doubt about it, all is not equal or sometimes fair in the world of medicine.
Linkat, I too have worked in a hospital although not as an RN. I learned long ago to never assume I knew what someone else's job entailed if I'd never walked in their shoes, but I agree with your premise that the elderly can sometimes receive lesser care than younger people.
Miller mentions the idea of a patient advocate (either a family member or close friend) and I agree that those with advocates are at an advantage while in the hospital. This is true for any patient, but particularly for an elderly patient who might not be as able or willing to advocate for themselves as much as someone who is younger can.
I know you and your family would have advocated on your grandmom's behalf had you known she was in the hospital. Communication is a two-way street. You could have seen to your grandmother's care had the hospital informed you of her admission, as requested on her file.
I think your statement of lesser care for the elderly is true, but I don't know that I agree with the idea that it's because the nursing staff cares less about the elderly. I think it is probably more due to the squeakiest wheel getting the grease as in most environments today. Younger patients can squeak for themselves or tend to have a loved one close by to squeak for them.
JPB wrote:
Miller mentions the idea of a patient advocate (either a family member or close friend) and I agree that those with advocates are at an advantage while in the hospital. This is true for any patient, but particularly for an elderly patient who might not be as able or willing to advocate for themselves as much as someone who is younger can.
Some hospitals here have patient representatives. (Although such a system works best in clinics where you stay for a longer period.)
They don't act like the above mentioned
advocates (at least how I understand
that) but look more at the daily business re patient <> hospital relations.
martybarker wrote:Is there any way you can file a complaint with the quality assurance dept at this hospital? This sounds like a very unfortunate situation for your dear grandmother. I'm sure if the hospital wants to keep a certain reputation for providing quality care they'd be willing to change protocol or put in place some educational opportunities for the staff to prevent this from occurring again.
I certainly would hope that the personell doesn't discriminate against their elderly patients but if my parents were hospitalized I'd make sure they have pictures of family posted on their beds and nightstands. This way, if my parent were unresponsive, the staff could realize that this is not just a patient but someones loved one.
I don't understand why family weren't notified unless your grandmother signed her own permits and consented to the surgery herself. Does she have a power of attourney?
I am pretty sure my mom has power of attorney if my grandmom can not fend for herself, however, my grandmom was hurt, but would have been able to talk and sign for herself.
Miller wrote:Linkat wrote:Miller wrote:Linkat wrote:Phoenix32890 wrote:I can only guess that she had been given a P.R.N. (as needed)prescription for the medication. When there was no one around to make a noise, the nurses didn't bother. What a shame!
If the patient didn't say she was in pain, were the RNs supposed to read her mind?
Unless you were a complete idiot, it was quite apparent she was in pain. She was crying for God's sake.
No, it's never apparent that an elderly person is in pain. Some act as if they are in pain, because they're senile. Is your gandmother senile? There is a pain scale, and normally with someone not senile it is applicable.
You seem to think that the RNs are the problem, I on the other hand think you were the problem. You have no idea what medical practice in any hospital is really like, until you've worked in that specific environment. You moreover, know nothing about geriatrics.
See you do have some lingering anger at me. Jeepers keep it check. As I stated before my grandmother is far from senile and anyone that would speak with her would know this is true.
You keep saying I blame the nurses where if you read anything you would realize I stated they seem very helpful and nice, but overworked. And yes it is their fault. They are responsible for checking on patients every so many hours.
Again you assume I have no knowledge of geriatrics. I worked in a nursing home for four years. I have seen senile patients and I have seen 100 year old patients that were completely together. Also, my brother is a floor head of nurses with over 20 years experience. He felt there were issues too.
Phoenix32890 wrote:Miller- I hope that you are never old, in a hospital, and ignored by the nurses when you are in pain.
Actually it may be a learning experience.
Dorothy Parker wrote:Linkat, I'm sorry to hear about your Nana's recent bad experience in hospital. I'm assuming you're in America and I don't know much about hospitals over there but I did do nursing for a while here in the Uk and I am still traumatised by some of the things I saw.
Yes I do think old people are treated differently and it genuinely scares me to think that one day I might be at the mercy of people like some of those I used to work with. I have a lot of respect for nurses as it's backbreaking work but the lack of compassion I came across in some staff was astonishing.
Thank you - yes I am in the US. And especially knowing many nurses, I realize how hard they work. I also have met many kind and caring nurses. Fortunately she is in rehab now and doing very nicely. We are hoping she will be over next week for Thanksgiving.
are the elderly treated differently in hospital?
in theory no
in practice yes.
In this country where we have a wonderful National Health Service, care is free "from cradle to the grave"..except that its not.
Develop the wrong sort of illness, especially something that requires long term care, and you have to pay yourself. If you cant they take your house. If you have no house to sell they make sure the elderly person isnt a burden on the state for too long.
Yikes, that sounds quite grim, Steve.
Miller wrote:When an elderly person is admitted to the hospital, he/she should have with them ( at all times, if possible ) a good friend or a family member, who can speak up for them. This would help the Staff as well benefit the patient.
I think this should work for any patient. Having some one there to help speak with you when you are in pain, etc. An elderly person can have all their mental facilities as much as anyone else.
However, there are situations, especially for some one who has all their mental facilities and are physically active and are completely independent that they are out and about without a family member, get injured and an ambulance brings them to a hospital. No one is with them and no one needs to be as they are fully capable to take care of themself. Do you always go shopping with a family member in case you get hurt? You also have to be realistic.
