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Dr K has a point about talking to the patient with out being interrupted. I will sit next to mom, we both face the MD and I let him talk to her. If she lies, my eyebrows go up. At the end, he will turn to me to see if I have questions. I always ask them with her present, taking him aside upsets their patient-doctor relationship. If I think she is losing it and he says she is fine, I send her in next time with a sibling who will tell him the same thing.
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Wish the doctors and nurses would not call me honey, hun, sweetheart, or, sweetie pie, or sweety. I have a name. Its Brandy or Mrs. X. Even ma'am or miss would be better. I wish they would say lie down on the table not lay down on the table. But mostly not honey.
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Just to set one point straight. An overseas physician can not just get off the boat - well the plane these days and hang up his shingle. It is necessary for him/her to meet very stringent standards and pass advanced examinations before he/she can obtain a US medical license not to mention becoming a permanent resident in order to remain here. Now that is not to say some practice in areas where they have no experience and some are unpleasant lazy individuals, but others come from very honorable halls of learning and have advanced credentials. I met one of the lazy type in the ER one day. I had gone with a dangerously high blood pressure which I caught by chance and had been monitoring every half hour. He prescribed a medication without even seeing me and discharged me (still with B/P too high) with the instructions to stop taking my blood pressure so often. I was glad to leave as I would not have trusted him to treat me anyway.
Brandywine I have noticed that I am always called out of the waiting room by my first name but this is because of the privacy laws. Since HIPPA patient's names are no longer on the doors of their hospital rooms. When I have been admitted to the hospital I have been asked how I wish to be addressed .
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One of my main concern with the medical profession is the use of hospitalists especially for those with dementia. What ever happened to a person's own doctor visiting patients in the hospital? It seem that particularly with older patients that it is important for the doctor to thoroughly know the medical history. The hospitalists do not know the patient or the family.
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Brandywine, I Agree. I lie on the table. I lay my bag on the chair. Now I lay me down to sleep means I am placing myself on the bed. Lie is intransitive. Lay is transitive, which means it needs a direct object.
That was fun.
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Wow .. some great conversation going on. Yay!!

I've been taking a bit of a respite .. long overdue, especially considering the stress of the last couple of months .. not to mention holidays. Now I have all kinds of stuff swirling around in my head in response to all the posts. So, if it comes off as a ramble .. eh .. it is. LOL Bear with me?

I have several pet peeves:

- Our scheduled appointment is at 1:15. We're expected to arrive 15 minutes early .. so that we can be seen 15 minutes AFTER the scheduled time. Really? Like our time isn't as valuable as the medPro? *grumbles*
- I'm not a fan of western medicine to begin with, but one of my greatest complaints is the seeming need to pigeon-hole the client (I will *not* call them a patient .. it implies we're just sitting there, patiently waiting for god's call .. pfft .. we are paying the medPro: they're working for US, dang it) into nice tidy categories. "Oh, it just comes with the aging process." or "That's what happens with dementia." (Well .. in this case, no, it was the meds, but I digress.) Why isn't there a more determined approach to *healing* the issues? It just seems like an 'easy out' to me.
- We seem to treat symptoms, rather than the patient, as a whole. When you have a client with multiple conditions, I really wish for a more holistic approach, rather than treating individual symptoms and NOT seeking a remedy - for the problem(s), as a whole. More often than not, one issue leads to the another.
- I'm tired of the assumption that just because Medicare won't cover a solution or treatment, alternatives are never considered or voiced.

Now .. for the hard topic swimming around in my head:

DrK .. you are, of course, welcome to this site, as is anyone involved with treating loved ones or the elderly. I met your arrival with some trepidation wondering if your reasons for being here were self-aggrandizing. Most of us are here to help ourselves, for sure, so I kind of stuffed that negative reaction and allowed a mental twist in my head to make room for whatever might come. Most of us come here to find help, one way or the other in dealing with the issues we face, daily. Most of us stay to offer each other support. Your mention of funding raises a flag for me, as if the only reason you'd remain and contribute would be in the role as the "professional" for which you'd be compensated. I truly hope I'm wrong about that.

We NEED the medPros to be on the team. The team. We need the entire medical field to hear and understand the daily, hourly, struggles we endure for the sake of our elderly. I wish every doctor and aide and nurse would spend a few hours a week reading the forums. I know there's supposed to be a measure of separation. I get that, to a degree, I really do. But we NEED some of you to care enough about the plight of the elderly and their caregivers, that financial compensation doesn't enter the picture.

I hope you find it in your heart to stay and learn and contribute, we need you, as much as we need everyone else, here.

LadeeC
(not to be confused with LadeeM)
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LadeeC. Like you my antennae shot bolt upright at the mention of funding. I have rubbed shoulders with this subject for many years. Both my husband and son have been at least to a certain extent involved in this through their work and I have dealt with it as a volunteer for a local arts organization. I hope this is not the case and we are not being "used"
What do you mean by "there is supposed to be a level of separation" There needs to be confidentiality between the patient and those in whom he/she confides but they should be told up front that if it is something the entire team needs to know they should be prepared to share for the good of their overall treatment.. The whole team can not work as a unit if they don't have the whole picture but of course there are exceptions. The person that delivers meals to a patient on infectious precautions only needs to know how to use those precautions not the nature of the disease. However that is another soapbox because I do not think ancillary staff should come in contact with patients under those circumstances All members of a patient's care team should be bound by the same level of confidentiality and share all relevant information.
It is interesting that you object to the use of patient, I object to the use of client. I feel a client is someone who uses the services of a professional other than a medical professional but while they are being cared for in any circumstances by anyone medical and dependent on that person for care they are a patient. if the caregiver is family or not being paid they can be loved one' friend or Mom etc
But that's another soap box and not really relevant to your comments.
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level of separation .. emotionally.
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OK LadeeC Now I understand. Sometimes it simply impossible not to have strong feelings for and about the patient, it is still very important to maintain professional standards
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I wish they wouldn't cancel apointments, especially if the elderly rely on their adult child to drive them to the appointments. The majority of these adult children have to schedule these appointments around their work schedule. Some take an unpaid day off. There is nothing more irritating than taking an unpaid time off in advance only to find out the appointment has been rescheduled.
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LadeeC and Veronica...... what are your concerns about DrK???? In what ways may we possibly be being 'used'.....
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LadeeM
We are freely sharing amongst ourselves information we have learned from training and experience. We are not picking each others brains so some day we can go off and write a book, text book or novel about the information gleaned here. As soon as some one mentions they can not visit very often because their time is not being paid for (funded) we wonder just why they are here. People come and go as we all will. Some just ask a question and move on others stay and become friends. Some have been through such a horrendous caregiving experience that once it is over they have PTSD and this site reminds them so much of what they went through it is healthier for them not to visit. Do you see what we were getting at.
That is why Agingcare has a policy of not allowing members to direct traffic to personal web sites where they may be conducting money making activities. There are ads on this site as there has to be income generated to pay the moderators and experts and maintain the site itself but I bet no one is getting rich.
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No matter what we do, over the next 20 years most geriatric care will have to be provided by non-geriatricians: general internists, family practice docs, NPs, and of course lots of family caregivers. So, I am all for encouraging people to go into geriatrics but really think we must focus on making geriatric care more doable for all involved.

This is rather wonky, but this RAND white paper by Joanne Lynn describes some practical reforms for the nation to consider.
"A reliable care system that helps the chronically ill elderly live well at the end of life would make seven promises: correct medical treatment, reliable symptom relief, no gaps in care, no surprises in the course of care, customized care, consideration for family situation, and help as needed to make the best of every day. "
http://www.medicaring.org/whitepaper/

Good stuff but of course it's always hard to make change in healthcare :(
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LadeeM .. what Veronica said, and .. if medPros (in general) come onto the forums hoping to strike up a profitable relationship, I guess that's just part of the game, but it strikes me wrong. It seems more like a distanced relationship, rather than becoming part of a community. Not sure my words are conveying my concern, but ..... there ya have it. It's sort of like this: I'm **really** good at what I do, it's my vocation and am paid for it .. if I came here, doled out advice and expected some kind of compensation, everyone on here would basically smack me over the head and tell me to get over my own dam*ed self, right?

Just because a medPro has more education and experience in the field (debatable considering my years, but, meh), doesn't exclude them from being a welcome part of the community .. but preferably on the same level as everyone else.
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LadeeC & Veronica91: Am only now realizing that I missed a few of your comments earlier; sorry about that.

Well, what can I say. As I mentioned when I first posted some comments here, I’m visiting and here to learn. Also as I mentioned, I wish I could participate indefinitely in such a forum, but probably can’t, and didn’t want to give you the impression that I could.

I’m a bit sad to realize that I’ve accidentally made some people uncomfortable. I do greatly admire the work all caregivers do, and appreciate having had this opportunity to learn from this community. Take care and thank you!
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Well Hell!!!! DrK, was looking forward to your input and insights..... hope you at least continue to read different threads on this site... sending you hugs and hope your endeavors are successful...
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I think Ms Lynne forgot the motherhood and apple pie in her white paper summary. The big question is HOW to achieve that reliable system. That help she promises - who's going to do it? And who's paying?
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