She is 71 years old, a diabetic patient of mine for last 3 years. She is on 3 types of tablets to control her blood sugar. She checks her blood sugar regularly and keeps all her appointments with me, but her blood sugar fluctuates wildly. One month it will be 185mg post meal and the next month it will be 360.
She always look depressed. She never smiles at me. All my efforts to bring a smile on her gloomy face are always wasted.
She always come with her son, but she is not living with him. She lives alone in a big house with a house maid. Her son lives in the same town a few kms away.
I was curious about her fluctuating sugars. Her diet seems to be same. Her sleep is always good as she is taking a sedative. Level of activity is also the same. Then why the fluctuation?
Slowly, I realised there is a pattern to the fluctuation. She has 2 daughters. They stay some distance away in a different town. Once every 2 months she go to one of her daughter's place and stay there for 2 weeks. If she was tested immediately after her return from such a trip the blood sugars were near normal. When she stays alone, her blood sugar rises up.
Actually, she had realised it before me. She never wanted me to advise her to stay with her children.
When I asked her, 'why don't you stay with your children' her reply was immediate. 'Why can't they stay with me? At least my son should stay with me.I was brought up in an aristocratic family. I believe in staying in my own house built by my late husband. I cant go and live in my son's house'.
The son sheepishly smile all the time [I thought he must be thinking the same thing.Why should I live in a house built by my Dad?].
What can I say to this adamant lady? After a few minutes, I told her 'your children may also be like you,fiercely independent. So, better not to complain'. I suggested a longer stay at her daughter's place and then bid her goodbye.
Independence at old age if not stressful to your mind is good, but if it affects your health adversely then you should rethink.
Showing posts with label Geriatrics. Show all posts
Showing posts with label Geriatrics. Show all posts
Friday, August 8, 2008
Sunday, July 13, 2008
Respecting the elderly
We are all taught to respect the elderly and we all do it, but are we respecting their wishes?
A 70-year-old lady sits sheepishly near me in my consulting room. Opposite to us on the other side of the table sits her son. He scolds her for her high blood sugar and cholesterol. He says that his mother does not like an old, sick woman. She eats everything disregard her condition. Son also complains that she does hard house hold work and goes out to the fields to supervise the agriculture work. All these were unnecessary as there are others to do it. The lady has a guilty smile, but denies most of the accusations of her son.
This happens very often in my clinic. The younger generation wants the elderly to live a schedurled life.They will be happy if they just sit and watch TV all the day and eat as bland and tasteless diet as possible avoiding everything. They believe that elderly should behave themselves [as old and sick]. By leading such a life, the children feel that their parents can live long and happy. As they are [most often] footing the bills for their health care, children expects obedience from their parents.
After hearing from both sides, I usually take a middle path. I advice the children that even though their parents are old and have some health problems, don't make them feel they are sick by your reprimands [like don't do this, don't do that ]. I will tell that some restrictions in food and activities are needed, but do not put them in 'house arrest'. Try to understand what they like to do and allow it in such a way that there is no harm to their health.
I tell the elderly patient not to indulge too much in unhealthy food. I tell them to be active but protect themselves from extremes of weather.
Usually as they go out of my room, the elderly have a broader smile.
A 70-year-old lady sits sheepishly near me in my consulting room. Opposite to us on the other side of the table sits her son. He scolds her for her high blood sugar and cholesterol. He says that his mother does not like an old, sick woman. She eats everything disregard her condition. Son also complains that she does hard house hold work and goes out to the fields to supervise the agriculture work. All these were unnecessary as there are others to do it. The lady has a guilty smile, but denies most of the accusations of her son.
This happens very often in my clinic. The younger generation wants the elderly to live a schedurled life.They will be happy if they just sit and watch TV all the day and eat as bland and tasteless diet as possible avoiding everything. They believe that elderly should behave themselves [as old and sick]. By leading such a life, the children feel that their parents can live long and happy. As they are [most often] footing the bills for their health care, children expects obedience from their parents.
After hearing from both sides, I usually take a middle path. I advice the children that even though their parents are old and have some health problems, don't make them feel they are sick by your reprimands [like don't do this, don't do that ]. I will tell that some restrictions in food and activities are needed, but do not put them in 'house arrest'. Try to understand what they like to do and allow it in such a way that there is no harm to their health.
I tell the elderly patient not to indulge too much in unhealthy food. I tell them to be active but protect themselves from extremes of weather.
Usually as they go out of my room, the elderly have a broader smile.
Monday, July 7, 2008
Relief in death
Many of the patients admitted to my hospital are old and of course they are sick. When you are both sick and old and if you are dependent on your children or some other relatives ,you may become a burden to them.
I have many patients in their 80s, very sick, living in and out of the hospital. Most of them are taken care of well by their children, but when I talk to the son or daughter who is taking care, I can feel the burden they feel.
"How many more days Sir?
Why so frequent admissions?
Will some thing happen all of a sudden?
Will these medicines really help?
Is ICU admission really needed?"
In those questions I can feel the financial burden. Also, the strain on the family due to disrupted schedule, lost working days, sleepless nights etc. etc.,.
The death when it finally come is a relief for all. Relief for the patient from misery and also from being a burden to their kids. Relief for the children from the expensive task of looking after their parent. Relief for me so that I need not see both the patient and children suffering.
I have many patients in their 80s, very sick, living in and out of the hospital. Most of them are taken care of well by their children, but when I talk to the son or daughter who is taking care, I can feel the burden they feel.
"How many more days Sir?
Why so frequent admissions?
Will some thing happen all of a sudden?
Will these medicines really help?
Is ICU admission really needed?"
In those questions I can feel the financial burden. Also, the strain on the family due to disrupted schedule, lost working days, sleepless nights etc. etc.,.
The death when it finally come is a relief for all. Relief for the patient from misery and also from being a burden to their kids. Relief for the children from the expensive task of looking after their parent. Relief for me so that I need not see both the patient and children suffering.
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