CARE OF THE ELDERLY
I'm just about finishing my Care of the Elderly firm. I hear cheering ^_^
I started off really hating the firm. I've not known myself to be good with the extremes of age. Babies and children - yuck. Old people - eehhh. So even before starting the firm, I was dreading tiny veins, wriggly veins, demented and delirious, septic and dehydrated little old ladies and men who have fractured their osteoporotic bones.
Now, before you start judging me, I didn't know any better then.
Well, when I was in Colchester (the Florida of the UK), I managed to meet a few ladies in their 90's. The very first time I met a 99-year-old lady, I was honestly surprised. I know the medical system sucked back then, so what's been keeping her alive for so long? And I know the medical system now doesn't work so well anyway. Must be something else.
I didn't feel appropriate to ask.
The average patient on the ward is a confused patient secondary to a sepsis complicated by a fall. The average age is upper 70's (when they use the words 'young man' to describe a 60ish man, well... makes you feel like an embryo yourself). You don't clerk a confused patient, you get collateral history from GP and family, which I did on my first day (well, actually you can try and clerk them but you may end up banging your head against the wall repeatedly).
But you still need to speak to them on daily basis because as a doctor, you can't get away without talking to your patients. As the weeks went on, I began to love watching the doctors speak to confused patients. The stuffs they come up can be so random from cats to East Enders to nurses stealing their things during the nights.
Just to be clear, nobody steals on the ward. Except for me *roll eyes* although lately I've been unsuccessful in getting the new BNF.
On the other hand, the ones who are orientated and able to talk don't like to be quiet. They'll tell you their life story if you just sit and spare a few minutes. You can complete an MMSE or a GDS in 10-15 minutes in an ideal setting but never with these people. Some of them have led a wonderful life, most however have had to endure hardships.
It's heartbreaking listening to someone telling you how his wife cheated on him with his best friend 40 years ago and he had been afraid of loving another soul since; and how her mother used to throw pots and pans and verbally abuse her father; and how lonely he feels at home now his children have refused to talk to him.
I am no fan of growing old, even more now than ever. Either that, or I've got to go out and meet jolly and happy happy old people.
On the ward, they make full use of PT, OT, nursing and SW. Unlike other wards, Elderly Medicine looks into every aspect of a patient's life. I've never learnt so much about care packages and homes until this firm. They just don't teach that sort of thing in medical schools. Sending an elderly person back to the community can be a real challenge. You send them home and they fall because you don't ask OT to assess their home first, it's on your head.
It's really inspiring the work that they do. I've never appreciated the need to make the last few (umm) years of someone's life as good and as high QOL as possible until this firm.
Age matters.
I'm still glad to move to a different firm. I don't mind coming back but not in the near future.
I started off really hating the firm. I've not known myself to be good with the extremes of age. Babies and children - yuck. Old people - eehhh. So even before starting the firm, I was dreading tiny veins, wriggly veins, demented and delirious, septic and dehydrated little old ladies and men who have fractured their osteoporotic bones.
Now, before you start judging me, I didn't know any better then.
Well, when I was in Colchester (the Florida of the UK), I managed to meet a few ladies in their 90's. The very first time I met a 99-year-old lady, I was honestly surprised. I know the medical system sucked back then, so what's been keeping her alive for so long? And I know the medical system now doesn't work so well anyway. Must be something else.
I didn't feel appropriate to ask.
The average patient on the ward is a confused patient secondary to a sepsis complicated by a fall. The average age is upper 70's (when they use the words 'young man' to describe a 60ish man, well... makes you feel like an embryo yourself). You don't clerk a confused patient, you get collateral history from GP and family, which I did on my first day (well, actually you can try and clerk them but you may end up banging your head against the wall repeatedly).
But you still need to speak to them on daily basis because as a doctor, you can't get away without talking to your patients. As the weeks went on, I began to love watching the doctors speak to confused patients. The stuffs they come up can be so random from cats to East Enders to nurses stealing their things during the nights.
Just to be clear, nobody steals on the ward. Except for me *roll eyes* although lately I've been unsuccessful in getting the new BNF.
On the other hand, the ones who are orientated and able to talk don't like to be quiet. They'll tell you their life story if you just sit and spare a few minutes. You can complete an MMSE or a GDS in 10-15 minutes in an ideal setting but never with these people. Some of them have led a wonderful life, most however have had to endure hardships.
It's heartbreaking listening to someone telling you how his wife cheated on him with his best friend 40 years ago and he had been afraid of loving another soul since; and how her mother used to throw pots and pans and verbally abuse her father; and how lonely he feels at home now his children have refused to talk to him.
I am no fan of growing old, even more now than ever. Either that, or I've got to go out and meet jolly and happy happy old people.
On the ward, they make full use of PT, OT, nursing and SW. Unlike other wards, Elderly Medicine looks into every aspect of a patient's life. I've never learnt so much about care packages and homes until this firm. They just don't teach that sort of thing in medical schools. Sending an elderly person back to the community can be a real challenge. You send them home and they fall because you don't ask OT to assess their home first, it's on your head.
It's really inspiring the work that they do. I've never appreciated the need to make the last few (umm) years of someone's life as good and as high QOL as possible until this firm.
Age matters.
I'm still glad to move to a different firm. I don't mind coming back but not in the near future.
posted by ai at
11/19/2008 10:15:00 pm
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