Q: My brother and I are our dad's caretakers. He is 77 and still able to function in his own home with part-time help. Either my brother or I personally check on him every day. His doctor now recommends major surgery to extend his life for a few extra months.
Neither Dad nor we believe it is the right thing to do. How should we resolve our differences with his doctor?
A: You are wise to consider all possible options before explaining to his doctor your decision. Dr. Jerome Groopman in his book "How Doctors Think" makes the point doctors don't necessarily listen to patients, and many patients don't feel empowered to challenge the doctor's opinion. By necessity, doctors face daily pressures dealing with emergencies and overscheduling; many don't ask enough patient questions, are interrupted and stereotype their patients.
The failure of doctors to listen and patients' fears create major stresses. Goodman recommends doctors allow patients to first speak a couple of minutes about their problems, avoid phone calls and actually review patients' charts before greeting them. Strong communication skills create more concrete results.
Recently when my partner experienced a sudden loss of energy, we were encouraged to find a major medical school's "expert" to determine her problem. That academic doctor, who had several students in tow, ran her through a number of tests. He quickly reached the conclusion her problem was exactly what he specialized in. He offered no solutions, but recommended she make another appointment in three months if she didn't feel better. We left frustrated, and actually more concerned than before we had seen him.
She did not improve, and after two more opinions, we found the real problem, which was a fairly simple medication situation. She is now well on her way back to normal. That doctor simply did not ask the right questions and she was given little chance to explain her condition.
I have just learned of Kaiser Permanente's major investment in the rollout of its KP Health-Connect. This project is designed to strengthen patient safety and improve care by providing instant electronic access to accurate medical records and information. During each patient's visit, all of the medical information is keyboarded into a computer for use by both doctors and patients. Patients are handed a copy. Privacy protection is also set up.
Whatever decision you make with and for your father, future developments like these will be helpful in empowering us to know and understand how best to make the most appropriate decisions for ourselves and loved ones.
Q: Now I am receiving Social Security checks. As a widower, I find my health appears to be breaking down. During the years of employment I was always upbeat and enjoyed my work.
After retirement I find I am getting lazy and into a rut, slipping into bad habits such as not taking care of my personal appearance, not eating the proper foods and not making much effort to maintain personal relationships because I don't see why I need to do so. Do I need a wake-up call?
A: Yes. As we grow older health indeed does have more of an impact on our ability to function. We are all victims of our emotional health and beliefs. It's easy for most of us to rationalize our response to living, and what we think strongly influences our well-being, attitude and longevity. Because you know your friends may precede you in passing, make a serious effort to make new ones. Remind yourself daily of your good health. Accept your future with a positive outlook, keep a happy disposition, pursue a vocation and volunteering interests seriously, don't be judgmental, try not to complain, fake yourself out by telling yourself you are not tired (try a short nap) keep yourself presentable, and maintain a pleasant disposition. No one wants to spend a lot of time with a sourpuss - an unhappy individual who is always complaining and making sure everyone knows it. Doing so will simply magnify your unhappiness and you will find yourself unhealthier and lonelier!
Doug Mayberry lives in a retirement community in Southern California. Send your questions to him at firstname.lastname@example.org or write to him at P.O. Box 2649, Carlsbad, CA 92018.
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