Where do you go when you are traveling and something goes wrong with your old body. Is it serious? Does your insurance cover you? Can you let it go until you get home? What if you don’t get help?
We have used urgent care in Smithtown, NY and Tucson, AZ; places where we didn’t have physicians.
We were in urgent care for one hour and 15 minutes which included check-in, filling out forms, having vitals taken, seeing a nurse practitioner, and a board-certified Emergency Room Physician. He examined my wife who had a rash on her face and a severe sore throat, diagnosed the problems, tested for strep, and prescribed the necessary medications.
She has Medicare and a private medigap plan. She was charged nothing; not even a co-pay. She may be charged later, but…
Everyone was pleasant, seemed concerned about our problems, provided us with a lot of information and fixed two problems that had been troubling her for a while. The strep test was negative. The doctor prescribed three medications for the face rash, but said to hold off on one for two weeks, as it had a high co-pay.
We received a printout of the diagnosis and treatment for our information and for her primary care physician in Albuquerque.
The place was clean, neat and professional. They did the strep test there. We were never kept waiting and felt good about the place and the people. They all listened to us.
A few years ago, I hit my head on a cabinet door that I was painting in Tucson. There was a bleeding gash in my forehead. I went to CVS pharmacy Minute Clinic, saw a nurse, was examined, told it wasn’t a serious problem and provided with an over the counter antiseptic. I went home and had no problems. I had been worried, with all the blood, but got the reassurance and treatment quickly and professionally.
In both cases, we were examined and treated by professionals. The treatments were quick, inexpensive and effective. My head is still ok and my wife’s rash which she had had for several weeks has cleared up. No problems.
The point is that at a certain age, a lot more things go wrong with your body. You don’t know how serious they are. You know something is going to kill you in the near future, but you just want to head it off for today; and, you don’t want to catch something new at the hospital in the meantime. If it is serious, you go to the emergency room or dial 911; but, for most things, where you primarily need reassurance that today is not “the day,” you just need someone to check you out; fix you; call an ambulance; call a mortician; or, tell you to go home. That is what you get at urgent care.
I hate to sit in emergency rooms; have done it many times with parents, kids and spouses. It takes a long time, it is expensive even if medicare and/or insurance is paying for it; people feel rushed and they rightly take the life threatening cases first. They practice triage, and usually for old people it is just some part wearing out that you don’t think should wear out. Mostly, it is not life threatening. That puts you at the bottom of the list. What you really need is reassurance.
Did you ever try to get an appointment with your private care physician; not only might it take a week or two, but when you get there, you have to wait. Plus, many of them are shying away from medicare because of cost cutting.
You should try urgent care; they are everywhere. And worth it even if you have to pay out-of-pocket.
And, I wonder about where I fit in the triage scheme being over 70???
References that might interest you:
Atlantic $2168 is the average cost of an emergency room visit.
Business Insider The average wait-time can be over four hours.
Stat Health; where my wife went in Smithtown, NY
Minute Clinic; where I wend for the cut on my forehead.
Finances for seniors can be difficult. This is obvious both, from looking into my financial mirror and from the number of articles about seniors being taken advantage of. Who do you trust? Look in the mirror; that is not the person to trust after a certain age. How do you pick a financial planner? Do you need one? Who has your best interests at heart?
Today’s New York Times describes some of the problems. The author suggests a team, a trusted relative, etc.
The geezer thinks you need a mentor. Wikipedia defines a mentor as someone more experienced who advises someone less experienced. I suggest that you find a younger mentor; who, can advise you as you lose your experience and your ability to make “rational” decisions.
At some stage in life, you need a mentor. The best is a spouse or a child. After that, a professional that you can trust; a lawyer or an accountant; hopefully one that will outlive you and still be competent. This is someone who will monitor you and advise you, or your relatives, when you start to drift financially, medically, or mentally. Someone who can take action if necessary and who can shield you from yourself. You are your own worst enemy; like it or not. You still think you know everything; and, in reality you may be a joke.
This said, you should make it easier for the mentor. Your stocks should be in index funds; you should have one bank account; one credit card; and, all ordinary bills should be paid automatically. Your house should be paid off. There should be lists of information; financial and medical. The mentor should receive copies of accounts. You should have a credit freeze in place and your debit card should have a daily limit.
There should be a health care power of attorney; and, perhaps a regular power of attorney naming a spouse, child or trusted mentor.
Most importantly, you should reduce your life to basics. You should live simply without a lot of clutter. If you live alone, someone should check on you regularly and you should have some sort of alarm button that you wear to press in case of trouble. You should know how to use whatever you get.
Your home should be age-proofed. Nothing worse than falling when you get out of the bath and are not wearing your alarm button. Get some grab bars. Think of neighbors coming in and finding you naked on the bathroom floor.
The bottom line is that old age brings new worries. You need to minimize these. You need a mentor more than you did when you were young and starting out. Go for it.
On July 17th Presbyterian Health Services, which I had joined in January 2014, sent a nurse-practioner to visit my wife and me in our home. She explained that they were just trying to set up a data base for us and see if there was anything we needed. They come once a year if you want. It is an interview, not a physical. Naturally, when she searched our names, there was not much in our data-base.
I will have them come each year because:
1. She checked the medicines we were taking, called our druggist and called our primary care doctors. There were a few things that needed to be sorted out. Old people frequently take too much medicine and don’t know what it is for. There are also a lot of unexpected interactions and the amount you take makes a difference.
2. She suggested several programs for us including Silver Sneakers.
3. She took our blood pressure and listened to our heart beat. She asked questions about our life-style and general health. She spent several hours with us.
4. We will be able to access our records on our computer anywhere in the world. So, when we travel and get sick, we can pull up our records for the physician who treats us in some foreign country. I haven’t tried this, but will report when I get my access information.
5. Most importantly she told us about a program that Presbyterian has called “Hospital at Home.” If you meet the requirements, you can elect, hopefully in the emergency room, to either be admitted to the hospital or be sent home. If you are sent home, a doctor visits you once a day, a nurse up to 3 times a day, you are monitored, and they deliver the equipment and drugs you need. The hospital benefits because it is 32% cheaper; you benefit because you are not in the hospital. I haven’t tried it, but will if the need ever arises. It probably helps to have a spouse, significant other, or caring neighbor.
You can read more about this in USAToday.
The geezer is becoming more aware of his health and the role he has to play. My idea is to be comfortable and pain-free. I haven’t figured out any way to live forever, but am working on it.
At a few weeks shy of 74, based on my present condition, my genes, my family history, etc., I can expect ten “good” years; ten “so-so” years; and, 4 years in the “home.” So….
In last Sunday’s New York Times there was an article entitled “Fields of Study Creativity.” Dr. Cyndi Burnett had each student in her “Introduction to Creative Studies” Class at Buffalo State College write down 100 things that bothered them. She then had them come up with solutions.
I have attended three, week-long workshops put on by the Creative Problem Solving Institute at SUNY Buffalo State College, albeit, almost 30 years ago. Needless to say, I was much younger, but Dr. Burnett’s article got me to thinking about being old, creativity, and the difference 50 years might make.
I seem to be annoyed by a lot of things in the course of a day; and, the usual result it that I am annoyed, period. Perhaps if I came up with 100 things that annoyed me, Dr. Burnett’s class would take a look at them and come up with creative, or at least off-the-wall solutions. Imagine a 19-year-old thinking about what irritates a 73-year-old. Maybe I don’t want to hear the solutions. Then, again, maybe I should think outside this 73-year-old box myself.
To the students in Dr. Burnett’s class: This is not so off the wall as you might think; ten thousand of us turn 65 every day and we are going to live for a long time and be annoyed a lot. Think about it! Am I an opportunity lurking out there.
I looked in the mirror and checked the calendar: I need to think outside the box.
Have you ever gone to a lecture where the speaker takes questions from the audience? Usually the speaker has a mike; and, usually the questioner does not. So, if you are old and deaf, like me, you get the answer, but not the question. There you are floundering about in the netherworld of the hearing impaired.
Why aren’t public speakers aware of their audience? I can understand if they are speaking to a general audience, but if the audience is made up mostly of people my age, why can’t they repeat the question; or, at least summarize it?
I am 73. I track my “real age” on realage.com, which has now become sharecare.com. The factors considered are the same ones that my doctor looks at. Even if there are questions, I do not see how you can go wrong by not smoking, losing weight, and doing things in moderation. I am not interested in living longer; but am interested in living better. I want to minimize today’s pains and problems.
Today at 73, I went onto sharecare.com and based on my answers to the questionnaire have a real age of 66.2 years.
While I feel good about this, what is more important is that on sharecare.com I can change my answers to determine if there is a benefit to making life style changes. My actual weight is 207, which resulted in a “real age” of 66.2 years. I changed the weight to 180 pounds, and came up with a “real age” of 65.7. The difference may be small but I will feel better. And, my doctor told me yesterday that I needed to lose a “few” pounds.
You can change the input and see what you need to do for a better “real age.” Try it with eating habits, smoking, drinking, etc.
I may try to update this each month which may give me incentive to go from 207 to 180.
In today’s New York Times there is a very good article about DWO (driving while old) and the role of driving rehabilitation specialists. The article contains a number of references to web sites, including an informative one describing the resources available in each state. It also describes what a driving rehabilitation specialist does and provides a link to the national organization.
The article made me aware, once again, of the increasing number of old people, their driving habits, their accident rates and the steps being taken to “help” them. It was informative, but appeared to be written from the point of view of someone under 65; which is probably good, as people over 65 become very defensive about their age, their ability to drive, and what they see in the mirrors every day: both the car mirror and the bathroom mirror.
It takes one to know one. I have discovered since I turned 65, that maybe I think a bit differently about things. Intellectually, I understand that I am getting older; as a practical matter, I fight it; helped along but any number of businesses that know just what I need. I may be more of a rebel than when I was in my teens. I won’t give anyone the least excuse to curtail my driving “privileges.”
I have taken the AARP Senior Driver Safety Class twice. The certificate is good for three years and you get a discount on car insurance. It lasts for four hours, has some good suggestions, makes you think a bit, and is a good refresher. It is non-threatening and everyone passes. It is something positive to have in your records and you can use it as an argument as to why you should not be evaluated; and, why you should continue to drive.
The geezer worries:
- If the driving evaluation results are negative, and I still drive, can that be used against me in a lawsuit resulting from an accident.
- What happens to a negative evaluation? You can’t reason with me when I need to drive.
- I am very sensitive to finding out and having documented, just how infirm I am and actually knowing what I can and cannot do. Some choices I do not want to make.
- In a perfect world, this would be fine, but I think I have to drive and have no acceptable alternatives; so, I am not about to do anything that would give anyone any reason to take my keys.
- Would the driving rehabilitation specialist report to DMV; to my kids; or, to my insurance company?
- am deaf
- after 40 years of driving with glasses, passed the MVD vision test and am not required to wear glasses. I am a bit nervous, as I am not sure of my vision. In an abundance of caution, I wear prescription glasses when driving; can see the road and signs much better; but would hate to be required to wear glasses again.
- am unhappy that I can only get a five-year license, instead of the ten-year license that I used to get.
- avoid driving with my kids when they visit; I let them drive. I remember my father missing turns, stop signs and not seeing other cars. No need to alert my children, who were raised to be responsible and who would take my keys, not to mention my car, to my increasing deficiencies.
- am careful about driving on free-ways, especially during rush hour or after dark.
- know all the side streets to get where I want to go, so as to avoid traffic and cops.
- am carefull about drinking
- am very aware that people under 65 think of me as a dangerous, but slow, old man.
- get obnoxious when I hear anything that might affect me just because I am old.
In conclusion, how do you convince me that I should be evaluated?
Remember, even though you are young, you are dealing with the GEEZER!
Am I a candidate for dementia? Or, do I just need to stop reading the news? When you read this, keep in mind that The Geezer has no hearing in one ear, even with a hearing aid; and only 30% in the other. However, with one expensive hearing aid, I can usually get by, although noisy restaurants are a bit of a problem. I am 72 and have been deaf for at least 20 years or so; whether I am demented, or about to become so, is open to argument.
The New York Times on February 12, 2013 has an interesting and scary article entitled “First Hearing Loss, Then Dementia,” by Katherine Bouton, who has written “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You.” She cites Dr. Frank Lin who speculates on the correlation between hearing loss and Dementia. One risk factor was social isolation. Hearing aids apparently are not yet associated with lower risk for Dementia.
A couple of thoughts from the Geezer.
- Since my deafness was severe; resulting in a 17% disability to my body as a whole, hearing aids were not an option – I had to get them.
- Since I became deaf in my 50’s, I had no choice but to adapt and to use all sorts of compensating techniques in order to communicate; some worked and some didn’t. Maybe the ability to adapt will help me avoid Dementia; or, maybe not……
- I noticed, once I became deaf, that a lot of people around me were as deaf, or deafer than I was, but refused to wear hearing aids.
- The noisy rooms at hotels don’t bother me as I sleep without hearing aids.
- The most important thing is that if I hadn’t gone deaf, I would still be doing bankruptcies, and would not have spent seven of the last ten years volunteering in Eastern Europe, an experience probably worth the deafness; not totally sure, but I think so.
This said, I enjoyed the article, hope to read the book, and am not going to worry about Dementia too much, as I think Dementia is not so much a problem for the demented, as it is for those who have to care for them. However, as a backup, there is an article in the same Science Section of the New York Times entitled: “Fitness May Prevent Dementia.”
Time for The Geezer to take his daily walk , hit the fitness center, adjust my hearing aids, and review my long-term-care policy.
This blog may support the thesis that there is a correlation between deafness and Dementia, at least in The Geezer’s case; who knows?
OODA Loop: observe, orient, decide, act.
On Sunday, Thomas Friedman,* in the New York Times, described the airforce training principle for use in arial dogfights. Dogfight? Why does the Geezer immediately think of old age and fellow seniors?
Observe where you are, who you are and what your situation is. A mirror helps. List. Don’t judge at this point; just observe reality, not hopes or fears. Where are you in real time?
Orient yourself using a “senior compass.” Focus on health, economics, family, resources, life expectancy , dementia probabliity, insurance, and any factors unique to you; all the while looking in the mirror. Locate where you are in relation to these factors.
Decide what you are going to do: downsize, move, sell, get a roommate, hospice, long-term care facility. Your decision is based on your observations and orientation; not on what someone else does. The decision should be taken in consultation with your “WingMan.” Test your decision by asking: What happens if I do nothing? Where do I end up?
Act on your decision. You can make adjustments along the way, but you will have a plan thought out; hopefully prior to senility.
Now you are ready for battle; and, old age is a battle. Your goal is to increase the odds of a pleasant and reasonable old age. It will not be perfect, but will be better than “winging it.” Your “OODA Loop needs to be better than the OODA Loop of old age.
You need a wingman!
The Geezer is still young, but increasingly in denial. He will never fall like other old people, but….. Thinking ahead and noting that the towel racks in his bathroom were always loose (wonder why?), the Geezer while still “rational” has installed what he sees as “decorative” towel bars, but which can support 500 pounds.
When he experiences a “senior moment,” he has something to grab. More important, it was his choice; and, not a result of the “none too subtle” remarks from his kids. Besides, grab bars make great towel bars; they don’t come loose and clang to the floor when you are only reaching for a towel.
Good taste dictated not showing the Geezer using the grab bars.
geezerTest: The Geezer tests his balance everyday by putting on his underpants while standing and without support. Do this only if you have a soft place to land. Do not do near hard objects that have sharp corners.