Geriatrics

The nursing home staffing crisis will not be fixed through transparency

Policy
March 17, 2022

Staffing shortages and turnover rates have recently become a pertinent topic for hospitals. However, these personnel challenges have haunted certified nursing facilities since the 1970s. Even before the COVID-19 pandemic, the turnover rate for total nursing staff in nursing homes was about 128 percent. While increasing transparency on these atrociously high turnover rates has been a commonly proposed solution, it has only recently been …

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Is home hospital care the way forward?

Conditions
January 22, 2022

“There is nothing like staying at home for real comfort,” says James Austen. So, instead of traveling and waiting for hours by standing in a queue, what if health care is provided to you at home? That’s why home hospital care (HHC) is a viable solution for physicians and patients. HHC is an innovative, technologically advanced, and effective care model in which certain patients receive hospital-level care at their homes …

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Health care guest workers could make “home, sweet home” a reality for America’s seniors

Policy
December 31, 2021

“If you want to be happy in a million ways, for the holidays, you can’t beat home, sweet home.” The late Perry Como’s observations reflect a bittersweet truth about an unattainable goal — not just during the holiday season, but each day of the year — for the 1.4 million Americans age 65 and over who reside in long-term care facilities. Older Americans who might prefer to age in place …

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My grandfather’s death: What I’ve learned about life

Education
December 30, 2021

My grandfather passed in the early hours of December 11 and was buried the next day. It all happened very quickly. The last time I saw him was eight years ago. And that was the final time because I couldn’t make it to his funeral. Hopefully, when I look back at this, I’ll always remember to cherish my time with family, no matter how busy medical school or residency gets.

My …

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During COVID, older patients stopped going to the doctor. Here’s how to change that.

Conditions
July 20, 2021

When the COVID-19 pandemic broke out last year, Helen (not her real name) took all the right steps to protect herself. The 74-year-old self-isolated, wore a face mask, and practiced social distancing.

Helen stayed safe from the virus during this time, but she put her health at risk in another way: for nearly two years, she didn’t see her primary care physician. Nor did she go to the eye doctor to …

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Nursing home workers at catastrophic levels of burnout and trauma

Conditions
February 9, 2021

It’s been almost a year since nursing home workers began fighting on the front lines of COVID-19. They’ve witnessed and experienced extreme trauma. They’ve seen seniors they care for suffer in fear and loneliness during prolonged and repeated lockdowns.  They’ve seen residents fall catastrophically ill and too many of them die.

More than 17,000 seniors are dead from COVID-19 in Canada; Read more…

The value of intergenerational relationships

Education
November 17, 2020

With the rapid growth of modern medicine and awareness in lifestyle and environmental influences, individuals can live longer and healthier lives. Approximately 15.2 percent of the U.S. population consists of individuals 65 years and older. To make the added years of life expectancy fulfilling, older adults need to stay socially connected and involved. One key method is through the development of meaningful …

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Our seniors deserve better. It’s time we all paid more attention.

Conditions
March 2, 2020

Most Canadians are familiar with nursing homes or long-term care facilities that provide 24-hour care to seniors who are no longer able to care for themselves independently – but we don’t spend a lot of time thinking about them. Given our rapidly aging population, and the likelihood that someone we love, or maybe even ourselves, will be living there one day, maybe we should.

What might surprise …

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Why I love caring for geriatric patients

Physician
February 22, 2020

As I enter the exam room, I hear, “Don’t get old honey!”

As a physician caring for a large population of geriatric patients in Florida, I hear this approximately five times a day. To this statement, I always reply, “There’s no alternative, though!”  I also try not to get offended by repeatedly being called “honey.” Although I am waiting to someday state; “it’s Doctor Honey.”  Usually, my level is offense is …

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A quick CT scan for the frail and elderly

Physician
January 22, 2020

First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The …

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Avoiding late-stage dementia with advance directives for stopping eating and drinking

Conditions
October 6, 2019

On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions.

Growing …

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The questions surgeons need to ask their seniors before surgery

Conditions
August 13, 2019

The decision seemed straightforward. Bob McHenry’s heart was failing, and doctors recommended two high-risk surgeries to restore blood flow. Without the procedures, McHenry, 82, would die.

The surgeon at a Boston teaching hospital ticked off the possible complications. Karen McHenry, the patient’s daughter, remembers feeling there was no choice but to say “go ahead.”

It’s a scene she’s replayed in her mind hundreds of times since, with regret.

On the operating table, Bob …

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The truth behind the care at a skilled nursing facility

Physician
July 7, 2019

Reuters recently published an article on skilled nursing facilities and post-hospital stays.  They discussed the often-lengthy time between hospital discharge and the patient being seen by a physician or “an advanced care practitioner.”

Older, more infirm and cognitively impaired patients tend to be seen later than other patients. The later you are seen, the more likely it is that you will be sent back to the acute care …

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A diagnosis of pneumonia in a rehab facility: We can do better

Physician
June 28, 2019

I’ve known Pat McCann (identifying information changed) for many years. He carries a diagnosis of COPD and has a preventative and a rescue inhaler, but he has never really had any serious flare-ups.

He fell and broke his hip. Then he went to skilled rehab, one of a half dozen near Cityside Hospital. His stay turned longer than expected because he fell, luckily didn’t break anything, but had to go back …

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How a patient saved this physician from losing her passion for medicine

Physician
June 16, 2019

I left a full-time academic position five years ago because I was literally, “check-all-the-boxes,” burned out. In looking back during that time prior to my decision to leave, I recall months of feeling overwhelmed, emotionally exhausted, depressed, and in a sense grieved for the loss of what I envisioned my career path to be until retirement. It was not until one of my favorite patients, Mr. Young, who knew me …

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Appreciative and respectful of my privilege in caring for elderly patients

Physician
April 1, 2019

I dedicate this to each of you who have cared for or are currently caring for an ill parent or family member. 

Recently, due to the stress that several of my dearest friends have been experiencing in caring for their elderly parents, I am even more appreciative and respectful of my privilege in caring for elderly patients who have attentive and loving adult children who accompany them to our ER.

Although this …

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Here’s what caregiving taught me

Conditions
January 9, 2019

Caregiving is often described as a sacrifice. One individual bears a burden to care for another. There’s a connotation of drainage, evocations of burned-out batteries and tired limbs.

I was a premedical student. I was aggressive in pursuing an MD. I wanted to be the best doctor I could be. I did not realize that required me to become a much a better person.

I left school to care for my grandmother. …

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