If you assist or provide support for an older elder in your family, check to see whether you need to help out with that individual’s electronic medical records (EMRs). You may have routinely set up your own EMRs without much thought, but many elder adults have not established or have had difficulty establishing their accounts.
EMRs are now a feature of every physician’s office and clinic. Frustratingly, doctors’ offices use different EMR programs, and most are not compatible with one another. Thus each person will often need to set up multiple EMRs, and add new ones when additional physicians enter the picture — something that can confuse a frail parent who sees several doctors.
EMRs offer lots of advantages for patients. for example, people to sign up for appointments and receive text reminders — much nicer than pesky phone calls. Patients and doctors can add information at almost any time and request renewals for their expiring prescriptions. Reviewing visit summaries, checking laboratory test results, and formulating questions before a new medical appointment is easier for patients, and EMRs offer physicians a clean copy of our medical history to read. Continue reading →
The moment a person needs health information, the inclination is to Google it, even though there are much better places to visit — places that offer high-quality and reliable health information. A Google search does not guarantee good quality information — especially when it comes to health information, and due to sponsored advertisements and what I call pseudo health websites, a search may actually send a searcher in a wrong direction. Moreover, these days television ads, infomercials, and online ads seek to grab and hold people’s attention, and it’s difficult to figure out what’s a good source and what’s bad.
The good health information issue becomes even more critical for aging parents and elders, who often have many health concerns. Each day pharmaceutical advertisements and self-improvement ads bombard older adults with sales info disguised as health support. When they do Google searches, they encounter carefully groomed advertisements that may swoop in and look trustworthy. It can be difficult for a person of any age to tell what information is really useful and what information is just trying to get attention … and money.
When we are sick, how much health care is good health care? These days when we call an ambulance, the medics rush in with all sorts of equipment and medications — called advanced life support, which replaces the basic life support that many of us learned in CPR classes.
Doing More for Patients Often Does No Good, a January 12, 2015 article appearing in the New York Times, makes the point that more advanced therapies and medical care do not guarantee higher quality or better outcomes. Written by Aaron E. Carroll, M.D., the piece shares a study in the journal JAMA Internal Medicine that compared the outcomes for patients who had received life support — basic or advanced — before being admitted to the hospital. He also writes about other studies that appear to show how the most advanced emergency care does not necessarily mean longer survival.
Dr. Carroll, a professor of pediatrics at Indiana University Medical School, further reinforces this “more may be less” point of view by describing studies that show how women with breast cancer receive complex and also more expensive breast surgical cancer treatments that are no more effective than outcomes with a more standard breast conservation therapy.
This article requires readers to process fairly complex explanations about medical care, and it may be necessary to read some paragraphs more than once. Yet, it’s worth taking the time to understand that doing more medical care in many cases will not give us extra quality or a better outcome.
Just when you think that you have settled the most significant adult child-aging parent issues — when you and your parents have spoken about medical care support, finances, and the range of their end-of-life wishes — along comes another concern to worry about, and it’s one that may be completely out of our control.
We now need to be concerned about the possibility of a parent entering a hospital and assigned to observation status for several days. Observation means that, rather than being officially admitted as a patient, the person is there to be watched, sort of like an out-patient, but not really an out-patient. The problem is, it’s difficult to discover what status a hospital assigns a patient — the two look almost alike with nurses, doctors, hospital rooms, blood pressure checks, etc. Admission and observation do not look that different to the patient and family, and apparently many hospitals are not especially forthcoming with the information.
Why is patient status significant? It’s simple, really. If your parent needs to enter a skilled nursing facility or nursing home after three days of observation status, Medicare will not pay and the family will be required to pay all of the bills, including the hospital costs. For Medicare to pay the bills, a family member must be admitted as a patient for at least three days and not assigned observation status.
Over the past year newspapers and medical or health journals have carried stories about elders and observation, and I share them here so that you can learn as much as you can.
I’ve just returned to the hospital for another surgery on my right eye. My retina condition has a name — proliferative vitreoretinopathy (PVR) — which basically means that, so far, my retina keeps detaching. When I last reported on my detached retina issues, I explained how oil was placed into my eye to hold the retina in place.
Click to read about epiretinal membranes @ the Mayo Clinic.
The oil went in four months ago, and since that surgery I’ve been reporting to my retina specialist on a regular basis, and he has been monitoring my condition. He is watching the development of epiretinal membranes (read about them at the Mayo Clinic site — 4th paragraph down), studying them through the oil at each visit. These membranes needed to be removed, because extra tissue puts pressure on my retina.
So today my surgeon performed a vitrectomy, going in through the oil and removing the scar tissue but leaving the oil in place. The plan is to watch the retina for another two or three months, let it continue to heal, and then remove the oil and see how my retina fares (yes, I’m crossing my fingers and toes, just in case it helps). Continue reading →
This post is not a substitute for talking with your physician.
Since oil was put into my right eye to hold my retina in place for several months, I’ve been humming an old Sunday School song, “Give Me Oil in My Lamp,” last sung, by me anyway, some time ago. The only difference is that I’ve changed the words. (Listen to the original song here.)
I’ve got oil in my eye, keep me healing. I’ve got oil in my eye, I pray. I’ve got oil in my eye, keep me healing. Keep me healing ’til the break of day.
In early August my surgeon put silicon oil in my right eye after the retina kept detaching due to a condition called proliferative vitreoretinopathy. The oil holds the retina in place for a longer period than any bubble can — right now it looks like the oil will remain for about four months — holding my retina firm and promoting the healing process. Continue reading →