Finding a frail older person on the floor is stressful and chaotic. In this post, I provide some guidelines about what to do after a fall. Manage falls carefully. There can be major injury even if pain is not severe. Falls can also be due to a new medical problem. The most important points are: Step by Step Care After a Fall Call 911immediately for emergencies. Even for non-emergencies, do a 5-minute assessment before moving the person. Move the person into a sitting position if she/he appears stable. Provide follow-up care. Prevent future falls. Be […]
In the last post, I described my Mom’s recent fall. She ended up in the Emergency Room but is fine now. I was alarmed but not surprised that she fell. It was not her first tumble. Her fall did raise a red flag for me. What can be done to prevent her from tripping again? And what can be done to avoid serious injury. In this post I’ll discuss two strategies. First, improving her ability to walk safely. Experts call these “intrinsic factors”. Second, creating a “fall-proof” environment. Experts call these “extrinsic factors”. There is […]
Yikes, my 93-year-old Mom fell. Fortunately, it wasn’t serious, and I only heard about it the next day. Help arrived promptly since it happened outside. She was taken to the Emergency Room for evaluation and triage. They made the initial determination that she was stable enough to wait. After 8 hours of waiting, she decided she felt just fine and left. She’s not looking forward to going to the ER again. I’m not at all surprised that my Mom fell. That’s because it’s not the first time. A previous fall is the highest single predictor […]
Kate is an 84-year-old widow with mild Alzheimer’s Disease. She lives alone and in the past year she has lost 10 pounds. She has also fallen multiple times. This is serious. The last time she fell she was on the floor for at least 8 hours. Her daughter called and then came by when Kate didn’t answer the phone. She was hospitalized for a condition called rhabdomyolysis. Afterwards, she was in a skilled nursing facility before returning home. She regained weight and received physical therapy. The daughter has “decluttered” the apartment to decrease the risk […]
The physician who hired me decades ago was a leader. It took his entire career but against a great deal of resistance, he built a premier healthcare system. Even so, he always had time for me. Whenever I stopped by, he would always pull up a chair. It was as if my activities and ideas were just as important as his. There’s something else I remember. I became his healthcare provider not long after he developed Parkinson’s Disease. He ended up being a frequent user of the healthcare system he built. He had many falls. […]
My Dad has lived with us for two years ever since Mom died. He’s 87 now and has become more and more disabled due to recurrent strokes. Is there a better way to control his hypertension? He’s on 3 medicines and his blood pressure is still over 160. His doctor is suggesting another medicine. I’m very worried because he needs help walking. His pressure drops below 95 when he stands up. He gets dizzy and he falls a lot. I think it’s because of his meds. What is the best blood pressure for this person? […]
My Mom is 86 years old and “frail”. She has been in and out of the hospital for heart problems. I’ve been checking her oxygen levels, her blood pressure, and her heart rate. Her heart rate is usually around 55. Sometimes it dips as low as 48 then goes back up. That seems slow to me. Her PCP says that her slow heart rate is due to her medicines. Is her heart rate too slow? Is it making her weaker? Is she getting enough oxygen to her brain? In the above scenario, the patient’s heart […]
As our population gets older, will we just build more hospitals? Our healthcare system is designed this way. Hospitals are the center of the healthcare universe. When patients become acutely ill they go to the hospital. The hospital takes over.
Dr. Warren Wong
The hospital is a hard place for older patients. In a previous post, I described three awful things that happen too often. I was frequently asked to help care for frail older patients in the hospital. Based on these experiences, I came up with 8D's.
When you have an older loved one in the hospital, think of these 8 Ds:
In a previous post, my friend Shannon talked about gracefully and thankfully accepting a caregiver at a certain stage in life. Today’s post is Part 2 of our discussion. Shannon talks about the relationship “rules” that both the caregiver and the client need to keep in mind to make the relationship a strong one.