As Our Parents Age So Do We

My husband walks with his mother after her stroke.

The Kevin MD blog features an interesting post about atrial fibrilliation (afib). The article, Improving Atrial Fibrillation Communication Between Doctors and Patients, provides suggestions that can help improve communication between physicians and patients with diagnosed or suspected afib. Written by Mellanie True Hills, a patient advocate from Texas, the post suggests physician/patient afib do’s and don’ts.

Over 18 months, my husband’s mother, at a time when she was 90-years-old and an active member of multiple book clubs, complained about heart palpitations. She knew something was happening, but it never happened when she was at the doctor’s office. Mother even went so far as to read about atrial fibrillation in her Harvard Women’s Health Watch newsletter. Her doctor asked her to wear a monitor for a few days, but the device did not record any palpitations.

More than once, however, while we sat with Mother in the dining room she’d comment, “It’s happening now.” We’d suggest calling the doctor (now), but no, she wanted to wait until office hours, and she abhorred the emergency room because of unfamiliar doctors and long waits.

A stroke occurred, followed by increased dependence, and eventually stroke-induced dementia. Atrial fibrilliation was diagnosed immediately after the stroke and appropriate medications prescribed.

After Mother’s death we discovered that she had recorded each “fluttering” event in her diary — right next to notes about book club and dinner engagements. We doubt, though, if she ever shared her afib diary with her physician.

My husband and I have wondered again and again about mother’s afib.

• Would it have been OK for her doctor to put Mother on medication, even though the heart symptoms were never heard or observed at an appointment?
• Should we have insisted that she go to the doctor and gone along with her even though she was totally independent at that time?
• Should the doctor have known to ask Mother if she was keeping track and ask to see her records?
• Was learned helplessness the reason mother did not share the diary?
• Given the number of office visits generated by mother’s heart complaints, could mother have worn the monitor for a longer period?

We’ll never have answers for my husband’s mother — in fact we’ve discovered that many physicians, when we ask them, answer these questions differently. However, we need to have clearer responses, if not conclusive answers, for the two living seniors still a part of our family life. Atril fibrilliation is condition that we adult children need to know about as we increasingly care and partner with our aging parents.