Elderly father makes dramatic recovery

eskimobaby87December 8, 2007

I want to post my story on here in the hopes that it might be helpful to someone. About two years ago, my then 84 year old father began suffering from anemia. The doctors decided to perform a colonoscopy as well as a scope down the throat (cant remember the name of that one). They performed two of these tests within a two month period. As you might be aware, these tests require anesthesia. Following the first test, my father was quite loopy and had some minor difficulty regaining his mental capacities. After the second test he again experienced mental incapacities in his recovery; in the midst of this he fell and fractured his back. He was readmitted to the hospital, and he then began following a trajectory of decline that ultimately resulted in his becoming severely confused, and we were forced to admit him to the nursing home. The doctors diagnosed him with dementia, and they refused to listen to us when we insisted that he was fine (with the exception of the symptoms of anemia) two weeks earlier. My brother, a clinical psychologist who has done a great amount of study and has been published on the topic of delirium, insisted to the doctors that my father had a delirium. They said we were in denial. While my Dad was in the nursing home, his condition declined because his anemia was not being treated properly. I wonÂt go into that detail here, but suffice it to say that I was doing everything humanly possible to get the right medicine for my father. My fatherÂs decline was so striking that the neurologist even suggested to us that my father had Creutzfeld-Jacob disease, a rare disorder which is marked by sudden onset of dementia-type symptoms. My fatherÂs symptoms ultimately rendered him combative, incontinent, confused, he had no appetite, he had difficulty swallowing, he was unable to stand or walk without falling, etc. In October (he had been admitted to the nursing home in July) I was finally able to get the correct medicine for his anemia. He began a slow recovery. I brought him home in March. Today I am happy to report that he is out working in his shop shelling pecans for our upcoming Christmas. He turns 86 in a couple of weeks. His greatest complaint is that I wonÂt let him drive.

I mention all of this to you only because it seems that this is typical path a lot of elderly people follow, yet in certain situations there are things we CAN do to help them get better. I want to mention a few things I learned in our process:

1. Regarding anemia: there is a drug called Aranesp which is very effective in treating anemia. It is expensive; but it works. Procrit did not work for us. My fatherÂs anemia was quite severe. He received four units of blood when he was first admitted to the hospital. Then while he was in the nursing home his hemoglobin again dropped to transfusion grade, but they refused to transfuse him (another long story I wonÂt go into here). Once he began receiving the Aranesp, his blood count began improving; we check it regularly, but he has not had to have an injection since last December.

2. Reassess all medications for your elderly patient on a frequent basis. Confusion, falling, fatigue, etc., in the elderly is often caused by over-medication. If there is a drug you can do without; then do without it. For instance, my father urinates frequently at night. He was taking a medication which helped with his frequent urination, but caused his blood pressure to fall when he stood which, in turn, led him to faint and then fall. We decided to take him off the medication and gave him the option of wearing a diaper (he did this for a while) or getting up to go to the bathroom (we also positioned his bed about five steps from his bathroom). We weigh our options and donÂt always take a pill.

3. Dementia is insidious; delirium is notÂit occurs rapidly and is always associated with a physical problem (UTI, anemia, etc.). We believe my father suffered from a delirium which was caused by a combination of his anemia, the anesthesia from the medical tests, and finally the pain from the back fracture. Deliriums should be treated medically; an individual with a delirium SHOULD NOT be released to a nursing home until there has been some determination of what has caused their delirium, with an accompanying treatment.

4. You are the best advocate for your loved one; doctors may or may not help you. Good treatment for the elderly is difficult to find. Some physicians (sadly, IÂve not found ONE) do not want to spend the time to make a proper diagnosis for a patient who is old.

For those of you who are fighting for the finest quality of life possible for your loved ones, you have my deepest respectÂdonÂt give up.

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May I also add to this that we always check with our physician when tweaking any of my father's medication. But I'll also mention (once again, SADLY) that I've never had ONE doctor suggest that we reassess my father's medicines, although they've always been happy to prescribe more.

    Bookmark   December 8, 2007 at 3:11PM
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Even middle age people are being over medicated by many Dr's The pharmaceutical people who visit the Dr's will really push their products, free this free that etc even to the reception people. Very few Dr's will evaluate a persons condition why??because the insurance companies dictate how long they spend with each patient, in fact a Physician's Assistant will do most of the work, ask most of the questions, and Doc will glance at the chart, ask about 3 questions, and say get this filled and rarely follows up and gets annoyed if either the patient or family asks a question.
Just the way it is unless you yell, scream and threaten! Which I have been know to do.
Our Dr is so good with us and takes more time that he is prescribed to and does follow up and/or listens to us Very unusual!

    Bookmark   December 8, 2007 at 6:02PM
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What OP described is VERY common. Every case is different, of course, but many doctors (in my experience with my mother and father) are quite careless. Mis-diagnosis; inappropriate medication; over-medication; failure to monitor; etc. Pity the older person that doesn't have an interested advocate available. The "system" is soooo broken.

    Bookmark   December 8, 2007 at 10:47PM
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