It's often said that pediatricians and veterinarians have the hardest jobs in medicine because their patients can't tell them where it hurts. But the same is often true for the health care professionals treating older patients who can't communicate well or don't fully understand what's being explained to them. So, whose job is it to advocate for these patients? The answer is that everyone on the medical team must play a ...

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STAT_LogoDuring my training to become a primary care physician, the importance of preventive cancer screening was ingrained in me. The idea of catching cancer at an early stage so we can better treat it made intuitive sense. But as I’ve learned over the years, the simplicity of this concept can obscure its limitations and make it difficult ...

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Everyone knows someone today who's dealing with dementia. And as a geriatrician — that means a lot of questions come my way. Questions about parents who recently had cognitive testing, about the role of assisted living, about prevention — you name it. Dementia is out there in a way it never was before. People have questions, and they need answers. Dementia is not a normal part of aging This is where I ...

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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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Literature surrounding the effects of social isolation and loneliness for older adults is no longer lacking. Studies and articles outlining the dreadful consequences of these epidemics have even pierced large media outlets like Time magazine, where they emphasize how one in three older adults are lonely. While any attention brought to the fact that the age group containing people age of 85 and up is ...

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Cognitive decline in older adults has been accepted as a normal part of aging. Recall, episodic memories, processing speed, and divided attention are all expected to decrease with time, but the implications of this decay are rarely discussed. Elderly scholars, or individuals who have sought to learn about the world or facets of the world through books, articles or newspapers, often are devastated by this cognitive decay. But, what if ...

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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 call came about noon a few years ago that a patient I'll call Stella was being admitted once again. She had come into the ER from her nursing home to receive transfusions. These were now needed every two weeks to keep her alive. The problem was that every time Stella was moved she decompensated. Her Alzheimer's was severe. She no longer recognized her family. She was now 83 and slowly ...

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Our practice will no longer see nursing home patients in our office. If a nursing home patient is already established with us, then we will see him; but, we have decided not to accept new patients. Of course, we believe that these individuals -- like the rest of us -- deserve medical care. This demographic not only deserves care, but has the greatest need for medical services. Our practice will see ...

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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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