16456475” Increase the Altace from 5mg to 10mg;  Hold the Digoxin times 2 days and then cut the dose in half; Add 1000 mcg vit B12 (you can get it over-the-counter); Continue the coumadin but on the 26th we’re going to stop the coumadin and give Lovanox injections for 6 days and then reintroduce the coumadin on the FOURTH day; On the 25th, but NOT before, go to the lab for labwork; Surgery will be on the 29th; Check-in time is at 1 p.m.”  WHOA!

THESE were the physicians directions to me at my father’s cardiology appointment yesterday.

His appointment was a combination check-up and femoral artery study to check the circulation in his legs.  Before the physician had a chance to read the femoral artery study, we were “discussing” WHY my father, at age 87 and with 2nd stage demensia really needed a $2500 sleep study.  As it turned out, the point was mute because once the femoral study was read and showed a 90% occlusion on both legs, surgery was immediately scheduled.  You might wonder….surgery on an 87 year old with the aforementioned problems?  Well, yes, because the surgery would be a quality of life issue and will hopefully restore the circulation to my father’s feet which have become almost completely numb.  If no surgery is done, then amputations might be a part of the future.

Anyway, I wasn’t intending to discuss ethics here.  My point is that I am a registered nurse and am used to “verbal orders read back” (meaning when a doctor gives an order, we state it back to him or her so that both of us are certain we understand each other).  But how….in heaven’s name……can a lay person deal with that many medication changes, lab tests, INJECTIONS, scheduled tests, etc.  And what about those elders who are being cared for by their EQUALLY eldered spouses?

Society is pushing for seniors to be cared for in their homes and I’m wondering if anyone has actually sat down and thought about how this is going to work.  Can individuals actually handle this type of caregiving without giving up their own lives entirely?  And can they do it SAFELY?  I have to admit that I went home and stared at my notes for at least half an hour before I was certain of my directions.

Certainly seniors want to stay in their homes (or caregiver’s homes) for as long as possible.  My own home seems to be becoming a portable hospital what with its oxygen machine, handicap accessible bathrooms, special whirlpool tub, miniature pharmacy in a closet, etc.  ( In a way, it’s funny, because as a former feminista, I almost completely rebelled against the toys and cribs of my children’s youth.  And now….a completely different generation  is underfoot).

Home Health agencies specializing in senior services are springing up all over, but I’m worried.  Will Medicare and/or Medicaid pay for enough services to enable individuals to care for their loved ones safely at home AND will they consider the caregiver’s health enough to pay for a sufficient amount of respite care for them.

What’s your opinion??


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