Journal Article

The Insiders as Outsiders: Professionals Caring for an Aging Parent

Robert M. Kaiser and Susan L. Kaiser

in The Gerontologist

Volume 57, issue 1, pages 46-53
Published in print February 2017 | ISSN: 0016-9013
Published online August 2016 | e-ISSN: 1758-5341 | DOI: https://dx.doi.org/10.1093/geront/gnw104
The Insiders as Outsiders: Professionals Caring for an Aging Parent

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  • Geriatric Medicine
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Abstract

As professionals in geriatric medicine and social work, we are caregivers for our widowed mother of 90 years, a woman with neurocognitive disorder and multiple medical conditions. She has had repeated, problematic encounters with the health care system over the past 4 years. Caring successfully for an aging parent requires a comprehensive understanding of her unique medical, psychological, and functional status; need for social support; and overall goals of care. Poor communication between and among clinical teams—and with patients and families—is ubiquitous. The patient and family are not consistently listened to, or integrated, into the clinical team. We recount our experiences of one hospitalization and how we addressed the recurring obstacles we faced. Our training and experience gave us a firm understanding of the hazards of hospitalizing an elderly person and the need to be present, engaged, attentive, active, and vigilant. We caught and corrected major mistakes: failure to follow-up abnormal test results, multiple medication errors, undertreatment of pain, poor fall prevention, and inappropriate assessment and placement for rehabilitation. In a dysfunctional health care system, the family is, and must be, the ultimate fail-safe mechanism. We identify potentially effective solutions for the problems we encountered: adoption of dementia-sensitive and patient- and family-centered care, improved communication, better management of information (including better systems for monitoring lab results and for dispensing and reconciling medications), expediting care, changing reimbursement and regulation, and improving discharge planning and placement.

Keywords: Parent/child relationships; Dementia; Care coordination; Caregiving—informal; Hospital/ ambulatory care

Journal Article.  6379 words. 

Subjects: Geriatric Medicine ; Biological Sciences ; Psychology ; Care of the Elderly ; Gerontology and Ageing

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