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Old 06-02-2012, 06:53 PM
 
Location: Tucson for awhile longer
5,170 posts, read 4,823,413 times
Reputation: 13793
Default Elders who doctor "too much"?

I'd like to air a concern that I don't hear addressed much but in my opinion is a serious conundrum. I see this problem a lot in the 85-year-old who lives with me, in the 80-year-old my best friend takes care of, and the 97-year-old my SIL takes care of, not to mention all their contemporaries.

These women LOVE to go to the doctor. They have every test known to man that Medicare will pay for, every single ache or pain warrants a trip to the primary care physician, if the pain isn't addressed with meds or therapy to their satisfaction they demand a specialist. My mother has seen 11 different doctors in the past five years, and she is what her primary calls a "very healthy" 85-year-old.

One of the three I'm closest to, who shall remain nameless, has chest pain every time she isn't getting the attention she thinks she deserves. She's like Redd Foxx in Sanford & Son. She's so good at faking a heart attack she's had TWO heart procedures in less than ten years that proved to be unnecessary. You can't imagine how much time this caregiver spends in the ER.

Another brief but telling example: I am willing to cut my mother's toenails for her but she has declared she "doesn't like" how I do it (?) and insists on being taken to a podiatrist for that job. Medicare pays for this and she's not diabetic. They wouldn't pay for a $20 pedicure from a nail technician, but they pay a PHYSICIAN. The waiting room of the podiatrist (an attractive youngish man) is packed with middle-aged people escorting their elderly mothers. I know darned well my mother just likes to get fussed over by this guy. Just as she adores having all her other specialists listen to her litany of complaints and offer her hope for a pain free and long-lived future.

I understand that these "patients" feel isolated (none of them is allowed to drive and all have refused to move to an assisted living facility). They usually aren't getting the empathy they desire from us caregivers. And, honestly, these doctors, nurses, and physical therapists are perhaps among the few who are genuinely comfortable being hands-on with fragile elderly people. I can't possibly give my mother all the attention she wants (and I don't have any children!) I would be by her side entertaining her every waking hour if she had her wishes come true. I believe these health care professionals are often a substitute.

Please don't suggest I take my mother out more. I already do it every day and it entails hauling around her walker, attending to all her other "stuff," and bringing the trip to a halt when she decides she's tired. For example I take her with me grocery shopping because she likes to go, but it makes a simple task three times harder. At this point, due to my commitments to her, she has a MUCH more active social life than I do. She is chauffeured (by me) to a club, visits with her friends, trips to the library, an art class, and church. She is visited several times a year by out-of-town relatives.

I would end this rant by saying I don't begrudge her proper medical care, but what is proper? I think the medical profession colludes in this dependence on doctors because they're making a fortune. They're afraid the well is running dry and this system won't be in place forever ... so cut toenails while you can!

Not only do we caregivers manage these appointments, deal with Medicare paperwork, and drive the patients hither and yon, but my tax dollars, hers, and yours are paying for this. And some of these doctor-addicted elders complain that their taxes are too high and vote Republican. Meanwhile they wouldn't have this indulgence at all if Republicans had their way. And do you suppose there will be any Medicare left when I am 85?

I honestly don't have any answer to this issue but I'd be interested in hearing if anyone else does. I don't want to send elders out to sea on an ice floe, but neither do I think this current system is working for anyone except doctors raking in the cash and people who seem to feel guiltless about abusing a system ... because it's there and they like it.
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Old 06-02-2012, 07:10 PM
 
1,802 posts, read 1,755,443 times
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lol, My ninety year old mother almost never wants to go to the doctor. Whenever she has an appointment she says "Why cant the doctor come here to see me?" lol
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Old 06-02-2012, 07:50 PM
 
2,757 posts, read 1,887,714 times
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My mother is definitely 'doctor addicted', but in a slightly different way. She wants to go and has a different specialist appointment almost every week, but she doesn't want to listen to what they have to say. She's 'allergic' to every med out there because the first thing she does when she gets home is look up all of the possible side effects. She doesn't like or trust any of her doctors.

And she LOVES to get MRIs and such, which are very expensive with her insurance.

I don't think she gets social attention from it as much as she gets confirmation that she's 'ill' and not just making things up
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Old 06-02-2012, 08:21 PM
 
Location: Tucson for awhile longer
5,170 posts, read 4,823,413 times
Reputation: 13793
Quote:
Originally Posted by Mrs. Lindo View Post
lol, My ninety year old mother almost never wants to go to the doctor. Whenever she has an appointment she says "Why cant the doctor come here to see me?" lol
LOL, indeed. That's cute. Not unusual for man, but she's different than most women I know.

My father HATED to go to the doctor and most of the time didn't. But his end-of-life care (three months of perfectly dreadful in-hospital drama) cost Medicare more than a quarter of a MILLION dollars (in 2002 money), so he made up for it in the end. And he had a DNR order and a living will that his entire family agreed to and his primary care physician understood. So the money he saved the taxpayers for 15 years got spent at the end in spite of his desire not to linger.
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Old 06-02-2012, 08:24 PM
 
Location: Southern California
3,116 posts, read 3,796,788 times
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Your post made me laugh! I've definitely seen exactly what you describe with my own relatives.
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Old 06-02-2012, 08:28 PM
 
8,430 posts, read 6,830,259 times
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What I found when a 91 year relative was not doing well for the last few years of her life is that doctors/hospitals will do anything and everything they can that Medicare will pay for. Like the OP, I don't begrudge people medical care, but I definitely saw that they spared no expense. Of note, the relative had not only Medicare, but also supplemental insurance that paid absolutely EVERYTHING that Medicare didn't cover and they were eager to cash in on that coverage. The reason that she had a great supplemental policy is that she bought it in the 70s. No way you could get a policy like that now for any amount of money.

I noticed small community hospitals/doctors who were more hard up for patients/money milked the Medicare/supplemental insurance were the ones who really milked it. They would admit her to the hospital just about any time she showed up in the ER and keep her the maximum amount of time that Medicare would pay. When she went to a large teaching hospital, though, they admitted her, stabilized her, and discharged her (kept her a reasonable amount of time, instead of extending/prolonging it like the community hospital did).

Her husband, on the other hand, got his healthcare from the VA. He'd go to the ER and they'd tell him he was fine and send him right home. He died of metastatic prostate cancer and he'd been to the VA emergency room and to his doctors many, many times in the couple of months before his death because he had unbearable pain. Instead of investigating, they gave him pain medications and sent him home. If he had had Medicare plus her supplemental insurance, I have no doubt he'd have been admitted and every test possible done.

I don't think either of these extremes are good.
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Old 06-02-2012, 08:36 PM
 
7,246 posts, read 1,986,023 times
Reputation: 2658
I'm wondering if this person's mom has diabetes. If she does, putting her feet in the care of her daughter of some dirty nail salon, is about the biggest mistake she can make. Further, diabetics need their feet checked with frequency. If they don't, it can mean big trouble.

I don't think Medicare pays for podiatrists unless there's a foot issue involved.



Quote:
Originally Posted by Jukesgrrl View Post
I'd like to air a concern that I don't hear addressed much but in my opinion is a serious conundrum. I see this problem a lot in the 85-year-old who lives with me, in the 80-year-old my best friend takes care of, and the 97-year-old my SIL takes care of, not to mention all their contemporaries.

These women LOVE to go to the doctor. They have every test known to man that Medicare will pay for, every single ache or pain warrants a trip to the primary care physician, if the pain isn't addressed with meds or therapy to their satisfaction they demand a specialist. My mother has seen 11 different doctors in the past five years, and she is what her primary calls a "very healthy" 85-year-old.

One of the three I'm closest to, who shall remain nameless, has chest pain every time she isn't getting the attention she thinks she deserves. She's like Redd Foxx in Sanford & Son. She's so good at faking a heart attack she's had TWO heart procedures in less than ten years that proved to be unnecessary. You can't imagine how much time this caregiver spends in the ER.

Another brief but telling example: I am willing to cut my mother's toenails for her but she has declared she "doesn't like" how I do it (?) and insists on being taken to a podiatrist for that job. Medicare pays for this and she's not diabetic. They wouldn't pay for a $20 pedicure from a nail technician, but they pay a PHYSICIAN. The waiting room of the podiatrist (an attractive youngish man) is packed with middle-aged people escorting their elderly mothers. I know darned well my mother just likes to get fussed over by this guy. Just as she adores having all her other specialists listen to her litany of complaints and offer her hope for a pain free and long-lived future.

I understand that these "patients" feel isolated (none of them is allowed to drive and all have refused to move to an assisted living facility). They usually aren't getting the empathy they desire from us caregivers. And, honestly, these doctors, nurses, and physical therapists are perhaps among the few who are genuinely comfortable being hands-on with fragile elderly people. I can't possibly give my mother all the attention she wants (and I don't have any children!) I would be by her side entertaining her every waking hour if she had her wishes come true. I believe these health care professionals are often a substitute.

Please don't suggest I take my mother out more. I already do it every day and it entails hauling around her walker, attending to all her other "stuff," and bringing the trip to a halt when she decides she's tired. For example I take her with me grocery shopping because she likes to go, but it makes a simple task three times harder. At this point, due to my commitments to her, she has a MUCH more active social life than I do. She is chauffeured (by me) to a club, visits with her friends, trips to the library, an art class, and church. She is visited several times a year by out-of-town relatives.

I would end this rant by saying I don't begrudge her proper medical care, but what is proper? I think the medical profession colludes in this dependence on doctors because they're making a fortune. They're afraid the well is running dry and this system won't be in place forever ... so cut toenails while you can!

Not only do we caregivers manage these appointments, deal with Medicare paperwork, and drive the patients hither and yon, but my tax dollars, hers, and yours are paying for this. And some of these doctor-addicted elders complain that their taxes are too high and vote Republican. Meanwhile they wouldn't have this indulgence at all if Republicans had their way. And do you suppose there will be any Medicare left when I am 85?

I honestly don't have any answer to this issue but I'd be interested in hearing if anyone else does. I don't want to send elders out to sea on an ice floe, but neither do I think this current system is working for anyone except doctors raking in the cash and people who seem to feel guiltless about abusing a system ... because it's there and they like it.
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Old 06-02-2012, 09:25 PM
 
2,757 posts, read 1,887,714 times
Reputation: 3893
Quote:
Originally Posted by Saritaschihuahua View Post
I'm wondering if this person's mom has diabetes. If she does, putting her feet in the care of her daughter of some dirty nail salon, is about the biggest mistake she can make. Further, diabetics need their feet checked with frequency. If they don't, it can mean big trouble.

I don't think Medicare pays for podiatrists unless there's a foot issue involved.
It says in the first post that she's not diabetic.
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Old 06-03-2012, 02:06 AM
 
Location: Las Vegas
7,676 posts, read 13,511,055 times
Reputation: 9038
Well, it's something to do. It's an outing for people who no longer get out as much as they would like. It alleviates the boredom for a while. And it gives you something to talk about. Garners attention and concern from others.

Plus, I think when you get older you just know every ache or pain is the beginning of the end.

Social isolation due to age and declining physical abilities is hard on most older people. Older relatives will ask for help to get to the doctor. Most likely they won't ask for help to get to a movie theater or a bar. One is acceptable and the other isn't.
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Old 06-03-2012, 02:38 AM
 
Location: Texas
27,821 posts, read 22,332,962 times
Reputation: 32962
Dear Op,

No, it's not just people you know.
It's not even just the elderly, though they and the medicaid people seem to be the worst about this.

It's frustrating and annoying, not to mention a giant waste of money.

What can you do, though? One of those times, they will be sick!
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