MANY older patients complain that the primary-care workers in health centers lack compassion and are harsh in dealing with them. These workers, meanwhile, complain that older persons are obnoxious and are difficult patients.
The perennial questions “Who would you like to kiss, a newborn baby or an old lady?” and “Whose diaper would you like to change, a newborn baby’s or that of an old man?” are still difficult to answer.
It is true that is very easy to take care of babies while it’s very hard to deal with older persons. Culture and society play an important role in this kind of it. Perhaps, a little change of perspective will help us take care of these two vulnerable members of society with the same love and affection.
Why is there a need to educate primary-care health workers on the proper care of the elderly?
An elderly presents differently in the clinics. The normal signs and symptoms of certain diseases are affected by the normal physiologic changes and diseases that the elderly have since adulthood.
A very worried patient called one day after lunch, asking me if he needs to bring his 65-year-old mother to the hospital. Her blood pressure (BP) was 160/100; she was nauseated and complained of headache. I told him to calm and asked him of the events that could have led to the elevated BP and if his mom has maintenance medications. He said yes—one in the morning and one in the evening. I told him to give his mom her evening dose, and “make her relax and don’t show her that you are in panic.”
If the BP does not go down after 30 minutes or an hour, we might consider bringing her to a hospital. Thirty minutes after, he called and said that his mom’s BP was 140/90 and she felt a lot better.
In my own experience of staying in the emergency room, the anxiety escalates, especially when you see patients who are intubated and suffering from heart attack. You start to panic and become anxious if you, too, will suffer the same fate. This anxiety will only elevate the BP more and, for an elderly, the fear of impending death becomes very real. This is why I am very careful in managing the elderly with high blood pressure. Of course, this is done with proper medical history and a query on what the patient really feels. If the symptoms are likely to be an acute coronary attack, I would have advised, otherwise.
The point is, the elderly has to deal with a lot of changes, which may be normal and common as we age. A little bit of empathy and understanding these physiologic changes might help the health-care workers look at the elderly in a different perspective.
Understanding that we, too, are going to become older persons someday and that we, too, will undergo the same changes might help us become caring providers. Aging is a gift and a privilege not given to many. We should be thankful that our dear ones are still with us when they are old.