Ask Ethel

Dear Ethel,

I have been with my primary care provider for years, but I’ve been hearing more and more that they should have more geriatric training. I am not sure at this stage in my life I want the hassle of switching. Do you think I should?

~ Questioning Switching in Bloomfield

———————————————————————

Dear Questioning Switching,

First, good for you for being so proactive about your own health.

The idea that primary care should be experts in geriatrics (or as we say ‘senior savvy’) is right in line with what many people are thinking. In fact, 94% of older adults agree that health care providers should be trained in the unique needs of older adults. It’s something to think about, especially if you take more than five medications and see more than two specialists for chronic conditions. Someone who specializes in seniors specifically can help you manage all of that and align on what’s important to your health and goals.

As the body ages, a lot changes that many primary care providers aren’t in tune with. For example, a medication dosage for you at 65 may be very different than when you are 80 because of how the body metabolizes medications as you age. A provider who has geriatric expertise would know this. You’d be surprised at how often this is overlooked.

I also like to think about this question in this way – who did you bring your children to when they were younger? Probably a pediatrician who understands children at each of the developmental stages; the same goes for those in elderhood. We just need different things, resources, and perspectives as we age.

For those primary care providers who are geriatric experts or are geriatricians with a certification in this specialty (by the way Lifespark has several who are) they focus their visits a little differently, often starting with what’s important to you. Conversations are geared towards your goals, medication reviews that cover not so much what you are taking but why, a focus on chronic and acute illness and simplifying the complexities that goes with it, and advance care planning so that no matter what life has in store, your wishes are met.

Now to the question you asked – should I switch? That is a personal decision that I can’t advise you on. What I can (and hopefully did) is share a few things to consider. If the above things matter to you, then yes, you should look into it. It all comes down to what you want out of your health and life. Does your current provider listen to you, direct your health around what you want, or are they giving you just the bare minimum in time and focused on medications, medications, and medications?

The easy part, if you’re a Lifespark COMPLETE member, you already have access to geriatric-trained medical experts and the key would be to call them now and get your annual wellness visit scheduled if you haven’t already. It’s a great way to test if their approach meets your needs better and it becomes an easy transition (you can keep both).

Stay in touch – would love to hear what you decide and how it’s going.

In health,
Ethel

Dear Ethel,

When I see my doctor, the visits last just a few minutes. I have questions that we often don’t have time to get to. What should I do?

— Medically Misaligned

———————————————————————

Answer: There are a few things that might help to make that time the most it can be…

1. Try making an appointment that’s just for your questions. And let your doc know that’s why you’re coming in.
2. Make a list of all the questions you want to ask and take time to write down or record the doctor’s answers.
3. Consider looking into an in-home-based provider. Appointments at home can offer you more time with the doctor.
4. You might want to think about adding the care of a provider with expertise in senior health to your team. They are trained in the changes that bodies experience with aging as well as medication reviews, advance care planning, goals of care and more. Appointments with these providers are scheduled for a longer duration too – often an hour, to give clients ample time to ask questions and talk about their health.

Dear Ethel,

I’m fine on my own but my daughter is worried that I’m not able to care for myself at home. She thinks I need more help, but I don’t want to lose my independence. Should I listen to her?

~ Mom Feeling Frustrated

———————————————————————

Dear Mom Feeling Frustrated,

This is a normal response from a daughter who is responding from a place of love. She’s worried because more than likely, she only wants the best for you. Imagine the other way around – I’m sure you too would want the best for her. My question would be to you – what do you want? My recommendation would be to sit down and have a courageous conversation with her and simply listen. There is a happy medium here where you can understand where she is coming from but also explain to her how you want to live your life including what your wishes and goals are. Many families would benefit from this kind of transparency.

Hearing her side of the story also sheds light on her perspective. It is possible that she is seeing things that you aren’t or perhaps seeing things that you know are there but you’re not ready to acknowledge. That is completely normal and understandable. There is a balance to living independently and sometimes even a little bit of support goes a long way to maintaining your independence and keeping you in control. But the first step is understanding why she feels this way and ensuring your voice is heard.

Starting now to explore options before a health crisis hits is a smart move. It’s always harder to have these conversations in the midst of a crisis, especially if you are unable to make your wishes known. Even if getting additional help is needed, it is not the end of independence.

Finding the right level of support not only can help you maintain your control and independence longer, but it can also ease her mind and support her being able to balance her life, too. As your health needs change, whenever that may be, you are already ahead of the game and can adapt or take away support as needed. And that’s nothing to feel frustrated or worried about – by talking this through you are establishing control and autonomy. To that I say well done, Mom – your daughter can learn a lot by watching you set the example for how to age magnificently.