Doctro patient relationships, fending for yourself, Your Doctor and You - Fifth in a Series

Fending for Yourself with Help

Most seniors, even those with chronic disease, are independent. You prefer to fend for themselves. But if you’re 75 or older, chances are you will need help. According to the National Council on Aging, most communities have centers for the aging offering help to improve the quality life, involve seniors in the community, and offer resources to aid independent living.

Senior Center with Expanding Services

Most seniors, given their druthers, prefer to remain in their homes. In Old Saybrook, Connecticut, where I live, the Estuary Council of Seniors, Inc. serves nine communities along the Connecticut shoreline.

Among other things, the Estuary provides nutritional counseling and low cost meals at its headquarters, has nutritionists who visit homes, and sponsors active daily meals-on-wheels programs staffed by volunteers.

The Estuary also offers health and support services, including talks by visiting doctors and other health professionals and other program for patients and caregivers of victims of emphysema, diabetes, Alzheimer’s, and spousal loss.

Senior services support exercise classes, weight lifting programs, book clubs, income tax preparation, and computers. Most recently, the Estuary has expanded its transportation services to include ferrying patients to doctors, hospitals, radiation and chemotherapy sites, in the immediate community and throughout the state.

The Estuary prides itself as a center where you can meet, greet, socialize, and learn. If you’re ill, of course, you may need medical services in your home. This is often supplied by home care providers or by visiting nurses associations. There are also agencies that will supply caregivers to stay in homes during the day or 24 hours a day.

Best Care by Doctors Who Know You

Many doctors feel the best care is care provided by a doctor familiar with the patient’s history. This is the position of the American Board of Clinical Medicine and an organization called Bridges to Excellence, a bonus program for doctors supported by multiple businesses including GE.

Francois de Brantes, who oversees Bridges to Excellence and who manages GE health programs, says, “We pay disease managers to coordinate care because no one else is doing it, but all the evidence says care coordination is better if done by a doctor. “

Doctors Feeling Less Chained to Offices

This may be, for many doctors feel chained to their offices. That’s where they receive their income, keep their equipment, provide ancillary services, and maintain their staff. Those are among the many reasons; they don’t make house calls anymore. But that is changing. A survey by the American Association of Family Physicians indicate 19 percent of their active members make house calls.

Doctors are feeling a financial pinch. They’re now less reluctant to venture outside their offices into homes and workplaces for disease management. Reimbursement is low, and they’re losing money in their offices. They're beginning to welcome information systems linking them to home-bound patients and to employees in the workplace and to nurses. Additional compensation for coordinating care would also be appreciated.

Gray Panther Political Power

Seniors vote. They swing elections. Therein lies the power of the over 65 crowd. If you doubt this power, I invite you to look at the Medicare Prescription drug bill passed in December of 2004. Senior anger forced Republicans and Democrats to pass “some bill” – even though it meant an unprecedented increase in Medicare spending, from $300 billion to $400 billion in 2006. With 78 million baby boomers starting to turn 60 this year, gray panther power will intensify.

Summing Up

It isn’t a bowl of cherries to be elderly, sick, and alone. But there is help out there.

• Senior centers are expanding transportation, educational, food, and educational services.
• Caregivers are going to homes.
• Doctors are devoting their time exclusively to the elderly.
• Health plans, independent firms, and health systems are developing disease management services.
• Companies are creating and installing remote technologies, i.e., telemedicine devices your home to keep you constantly in touch with the outside world.

If you’re still unhappy with the system, you always have the option of exercising your political power. When AARP (The American Association of Retired People), 40 million strong, speaks, politicians listen.