• April 21, 2014 /  Basics

    This is a continuing series using information from the booklet written by the National Institute on Aging working with the National Institutes of Health called: Talking With Your Doctor. (U.S. Department of Health and Human Services, NIH Publication No. 05-3452 August 2005 (Reprinted April 2010)

    What Can I Say – Giving Information

    This section gives ideas on what to talk about. I have found that few people are eager to share what is going on with their bodies for fear that something may be devastatingly wrong inside but many times early discovery of a disease will save the person or at least help prepare for the inevitable.

    It is important that you tell your doctor about your symptom(s). The booklet describes a symptom as “evidence of a disease or disorder in the body. Examples of symptoms include pain, fever, a lump or bump, unexplained weight loss or gain, or having a hard time sleeping.” While a doctor may perform exams and/or tests, it is your input that helps direct the doctor where to look.

    Before you start telling him/her your symptoms it is best to clarify what they are. The easy part is identifying them but when do that happen. Are they constant? If not, when do you experience them (frequency and duration)? When did they start? What are you doing or what have you done recently that may aggravate or ease the symptoms? Do they affect your daily activities? Which ones? How?

    The booklet makes the following recommendation:

    Take the time to make some notes about your symptoms before you call or visit the doctor. Worrying about your symptoms is not a sign of weakness. Being honest about what you are experiencing doesn’t mean that you are complaining. The doctor needs to know how you feel.

    It also states that it is very important to give information about your medications (especially if you are being seen by more than one doctor – example, did you go to the hospital recently and did that attending physician prescribe medication? If he/she did, your doctor would not know about it!) The booklet goes on to state:

    It is possible for medicines to interact causing unpleasant and sometimes dangerous side effects. Your doctor needs to know about ALL of the medicines you take, including over-the-counter (nonprescription) drugs and herbal remedies or supplements, so bring everything with you to your visit—don’t forget about eye drops, vitamins, and laxatives. Tell the doctor how often you take each. Describe any drug allergies or reactions you have had. Say which medications work best for you. Be sure your doctor has the phone number of the pharmacy you use.

    As you talk with your doctor you must be honest and let him/her determine what may or may not be important. Have your interests changed? For example, you used to be quite active but now you are tired all the time and so you no longer exercise. You may think that being tired is no big deal but your doctor can run a test that may determine if there is a chemical imbalance that is causing this. Did you know that changes like a loss of a loved one (including pets) is a big stress factor and it affects how you function? It has been shown that if there are several of these life changes in a short period of time that it can be debilitating. Your doctor should know things like if you have moved and why you moved. Did somebody move in with you or are you now living with somebody? Did you sell a home, have family move away (or nearby), drivers getting crazier and you are having more near misses?

    Look at this time with your doctor as being a detective partner. Instead of solving a crime you are solving the cause of your discomfort.talking with doctor on phone

    Next time: What Can I Ask?

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  • April 4, 2014 /  Basics

    In the following weeks I’ll be referring almost exclusively to a booklet written by the National Institute on Aging working with the National Institutes of Health called: Talking With Your Doctor. (U.S. Department of Health and Human Services, NIH Publication No. 05-3452 August 2005 (Reprinted April 2010)

    Getting Ready for the Appointment

    The hope with this section is that the better prepared you are the better results you will get. A list is important as we tend to forget what it was that we wanted to discuss or compare or…well, you get the idea. Here are some examples the booklet suggests:

    [D]o you have a new symptom you want to ask the doctor about? Do you want to get a flu shot? Are you concerned about how a treatment is affecting your daily life?

    I thought about other items:

    Did you check for interactions between medications? How do I stop smoking? Lose weight? I’m having bladder issues, what do I do?

    Of course, you have to remember to bring the list with you! Oh, and take your glasses and hearing aid with you. This is NOT a time for vanity!

    The booklet continues:

    Consider bringing a family member or friend —

    Sometimes it is helpful to bring a family member or close friend with you. Let your family member or friend know in advance what you want from your visit. Your companion can remind you what you planned to discuss with the doctor if you forget, she or he can take notes for you, and can help you remember what the doctor said. If you need an interpreter you can and should bring one.

    Next week: What Can I Say – Giving Information

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  • March 24, 2014 /  Basics

    I’ll be referring almost exclusively to a free booklet written by the National Institute on Aging working with the National Institutes of Health called: Talking With Your Doctor. (U.S. Department of Health and Human Services, NIH Publication No. 05-3452 August 2005 (Reprinted April 2010)

    http://www.nia.nih.gov/health/publication/talking-your-doctor-guide-older-people

    Consult reference sources

    “The Directory of Physicians in the United States and the Official American Board of Medical Specialties Directory of Board Certified Medical Specialists are available at many libraries. These books don’t recommend individual doctors but they do provide a list of doctors you may want to consider. MedlinePlus, a website from the National Library of Medicine, has a comprehensive list of directories (www.nlm.nih.gov/medlineplus/directories.html) which may also be helpful. There are plenty of other Internet resources too—for example, you can find doctors through the American Medical Association’s website at www.ama-assn.org (click on “Doctor Finder”). For a list of doctors who participate in Medicare, visit www.medicare.gov (click on “Search Tools” then “Find a Doctor”). WebMD also provides a list of doctors at www.webmd.com (click on “Doctors”). Don’t forget to call your local or State medical society to check if complaints have been filed against any of the doctors you are considering.” Pg. 4

    Learn more about the doctors you are considering

    Set up an appointment to meet and talk with the doctor you are considering and ask the following questions (you may think of more that are important to you).

    • Do you have many older patients?
    • How do you feel about involving my family in care decisions?
    • Can I call or email you or your staff when I have questions?
    • Do you charge for telephone or email time?
    • What are your thoughts about complementary or alternative treatments?

    When making a decision about which doctor to choose, you might want to ask yourself questions like:

    • Did the doctor give me a chance to ask questions?
    • Was the doctor really listening to me?
    • Could I understand what the doctor was saying? Was I comfortable asking him or her to say it again?

    Make the choice

    Once you choose your doctor remember to bring your medical records or make arrangements with your prior doctor to have them sent. You will need to sign a release of records form with them (make sure you bring your new doctor’s contact information).

    Next: How should I prepare?

    choosing your doctor 2

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  • March 17, 2014 /  Basics

    I will be referring almost exclusively to a free booklet written by the National Institute on Aging working with the National Institutes of Health called: Talking With Your Doctor. (U.S. Department of Health and Human Services, NIH Publication No. 05-3452 August 2005 (Reprinted April 2010)

    https://permanent.access.gpo.gov/lps66054/TWYD_Final.pdf

    You can choose your doctor! Yes, that may sound obvious but I have clients who are unhappy with their current physician and didn’t realize they could switch. It is important that you find a doctor you can talk to without reservation. He or she will be the one who will eventually know you and what constitutes a “baseline” for your health. They can help you with medical decisions and can serve as the hub for all the other medical specialists and providers (kind of like a matriarch of the family or quarterback of a football team). The booklet states, “People sometimes hesitate to change doctors because they worry about hurting their doctor’s feelings. But doctors understand that different people have different needs. They know it is important for everyone to have a doctor with whom they are comfortable.” You should understand that this may take time but it is time well spent.

    The following is straight from the booklet.

    Decide what you are looking for in a doctor.

    “Do you care if your doctor is a man or a woman? Is it important that your doctor has evening office hours, is associated with a specific hospital or medical center, or speaks your language? Do you prefer a doctor who has an individual practice or one who is part of a group so you can see one of your doctor’s partners if your doctor is not available? After you have made your list, go back over it and decide which qualities are most important and which are nice, but not essential.”

    Identify several possible doctors

    Once you have a general sense of what you are looking for, ask friends and relatives, medical specialists, and other health professionals for the names of doctors with whom they have had good experiences. Rather than just getting a name, ask about the person’s experiences. For example: say, “What do you like about Dr. Smith?” and “Does this doctor take time to answer questions?” A doctor whose name comes up often may be a strong possibility. If you belong to a managed care plan—a health maintenance organization (HMO) or preferred provider organization (PPO)—you may be required to choose a doctor in the plan or else you may have to pay extra to see a doctor outside the network. Most managed care plans will provide information on their doctors’ backgrounds and credentials. Some plans have websites with lists of participating doctors from which you can choose.

    To be continued…

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  • March 10, 2014 /  Basics

    In the following weeks I’ll be referring almost exclusively to a free booklet written by the National Institute on Aging working with the National Institutes of Health called: Talking With Your Doctor. (U.S. Department of Health and Human Services, NIH Publication No. 05-3452 August 2005 (Reprinted April 2010)

    https://permanent.access.gpo.gov/lps66054/TWYD_Final.pdf

    They emphasize the importance of talking with your doctor as you get older. Why? “Partly because you may have more health conditions and treatments to discuss. It’s also because your health has a big impact on other parts of your life, and that needs to be talked about too.”

    Many times we go to the doctor knowing something but we don’t tell her/him. We expect them to find out/discover what “ails us” and from the doctor’s perspective, they figure you will tell them so all they will do is perform a normal checkup. Your relationship with your doctor should truly be more like a partnership.

    In addition to your primary care doctor, you should also develop a partnership with your pharmacist. While your doctor prescribes medication for you it is your pharmacist that can tell you not only the side effects but also if there could be an interaction with other medication you are taking.

    Next: Choosing a Doctor

    talking with doctor

    I serve the counties of El Dorado, Placer, Sacramento, Solano, Sutter, Yolo, and Yuba, as well as cities like Auburn, Lincoln, Rocklin, Roseville, Sacramento, Placerville, and Woodland.

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  • January 29, 2014 /  Resources

    I have been in a couple of seminars with Stephen teaching and he has a lot to share. He cares about those with special needs (he grew up in that environment) and is a very strong advocate for the whole community. He is also a big supporter of the Professional Fiduciaries’ Association of California (a group that supports training, mentoring and high ethics for fiduciaries) and those who just found out that there are responsibilities of being a trustee of a special needs trust or conservatorship.

    You can either click on this link http://dalelawfirm.com/  or go to my Special Needs Resources tab and then look up the link to the office and then go to the educational videos tab and begin learning!

    I serve the counties of El Dorado, Placer, Sacramento, Solano, Sutter, Yolo, and Yuba, as well as cities like Auburn, Lincoln, Rocklin, Roseville, Sacramento, Placerville, and Woodland.

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  • January 16, 2014 /  Resources

    I have been doing some more wandering around the worldwide web and have discovered some amazing resources. Please visit my resource page for the links connecting to these organizations.

    Family Caregiving Alliance, National Center on Senior Transportation.

    I have reorganized my resource page to incorporate a Special Needs section for families. It now includes ARC (which was previously listed elsewhere), Achieving Independence, and Special Needs Alliance.

    My resource page keeps growing so come back periodically and see what is new!

    resourceBooks

    I serve the counties of El Dorado, Placer, Sacramento, Solano, Sutter, Yolo, and Yuba, as well as cities like Auburn, Lincoln, Rocklin, Roseville, Sacramento, Placerville, and Woodland.

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  • December 10, 2013 /  Difficult Conversations

    Each of the 5 tips listed below are shared with us courtesy of Help Guide.org about effective tips when having this type of conversation with an aging loved one about driver safety, or possible confiscation of car keys. 

    • Be respectful. For many seniors, driving is an integral part of independence. Many older adults have fond memories of getting a driver’s license. At the same time, don’t be intimidated or back down if you have a true concern.

    • Give specific examples. It’s easier to tune out generalizations like “You just can’t drive safely anymore.” Outline concerns that you have noticed, such as “You have a harder time turning your head than you used to,” or “You braked suddenly at stop signs three times the last time we drove.”

    • Find strength in numbers. If more than one family member or close friend has noticed, it’s less likely to be taken as nagging. A loved one may also listen to a more impartial party, such as a doctor or driving specialist.

    • Help find alternatives. The person may be so used to driving that they have never considered alternatives. You can offer concrete help, such as researching transportation options or offering rides when possible. If your family member is reluctant to ask for help, it can lead to isolation and depression.

    • Understand the difficulty of the transition. Your loved one may experience a profound sense of loss having given up driving. Don’t dismiss their feelings but try to help with the transition as much as possible. If it is safe, try slowly transitioning the senior out of driving to give them time to adjust. For example, your loved one may begin the transition by no longer driving at night or on the freeways, or by using a shuttle service to specific appointments, such as the doctor’s. ~ Source: Help Guide.org

    This can be a difficult conversation for several reasons including sensitivity some aging loved ones might feel, or head strong aging relatives like Uncle Oscar who are used to having everything their way.

    Join our conversation and share with us any helpful tips and suggestions on what can make this sometimes dreaded conversation end with a favorable result.

    A friendly reminder is the week of December 2nd is National Older Driver Safety Awareness Week, so these helpful tips are ideal for future reference information.

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    I serve the counties of El Dorado, Placer, Sacramento, Solano, Sutter, Yolo, and Yuba, as well as cities like Auburn, Lincoln, Rocklin, Roseville, Sacramento, Placerville, and Woodland.

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  • November 27, 2013 /  Basics

    I found these tips on the Mayo Clinic website. But as a quick aside, Seniors First has a Handyperson program that assess the safety of your home and will install any missing safety features within the parameters of California non-contractor laws. You may call them at 530-889-9500.

    Fall prevention: 6 tips to prevent falls

    Falls put you at risk of serious injury. Prevent falls with these simple fall-prevention measures, from reviewing your medications to hazard-proofing your home.

    By Mayo Clinic staff
    http://www.mayoclinic.com/health/fall-prevention/HQ00657

    Fall prevention may not seem like a lively topic, but it’s important. As you get older, physical changes and health conditions — and sometimes the medications used to treat those conditions — make falls more likely. In fact, falls are a leading cause of injury among older adults. Still, fear of falling doesn’t need to rule your life. Instead, consider six simple fall-prevention strategies.

    1. Make an appointment with your doctor

    Begin your fall-prevention plan by making an appointment with your doctor. Be prepared to answer questions such as:

    • What medications are you taking? Make a list of your prescription and over-the-counter medications and supplements, or bring them with you to the appointment. Your doctor can review your medications for side effects and interactions that may increase your risk of falling. To help with fall prevention, your doctor may consider weaning you off certain medications — such as sedatives and some types of antidepressants.
    • Have you fallen before? Write down the details, including when, where and how you fell. Be prepared to discuss instances when you almost fell but were caught by someone or managed to grab hold of something just in time. Details such as these may help your doctor identify specific fall-prevention strategies.
    • Could your health conditions cause a fall? Certain eye and ear disorders may increase your risk of falls. Be prepared to discuss your health conditions and how comfortable you are when you walk — for example, do you feel any dizziness, joint pain, numbness or shortness of breath when you walk? Your doctor may evaluate your muscle strength, balance and walking style (gait) as well.

    2. Keep moving

    Physical activity can go a long way toward fall prevention. With your doctor’s OK, consider activities such as walking, water workouts or Tai chi — a gentle exercise that involves slow and graceful dance-like movements. Such activities reduce the risk of falls by improving strength, balance, coordination and flexibility.

    If you avoid physical activity because you’re afraid it will make a fall more likely, tell your doctor. He or she may recommend carefully monitored exercise programs or refer you to a physical therapist. The physical therapist can create a custom exercise program aimed at improving your balance, flexibility, muscle strength and gait.

    3. Wear sensible shoes

    Consider changing your footwear as part of your fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make you slip, stumble and fall. So can walking in your stocking feet. Instead:

    • Have your feet measured each time you buy shoes, since foot size can change.
    • Buy properly fitting, sturdy shoes with nonskid soles.
    • Avoid shoes with extra-thick soles.
    • Choose lace-up shoes instead of slip-ons, and keep the laces tied. If you have trouble tying laces, select footwear with fabric fasteners.
    • If you’re a woman who can’t find wide enough shoes, try men’s shoes.

    4. Remove home hazards

    Take a look around your home. Your living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards. To make your home safer:

    • Remove boxes, newspapers, electrical cords and phone cords from walkways.
    • Move coffee tables, magazine racks and plant stands from high-traffic areas.
    • Secure loose rugs with double-faced tape, tacks or a slip-resistant backing — or remove loose rugs from your home.
    • Repair loose, wooden floorboards and carpeting right away.
    • Store clothing, dishes, food and other necessities within easy reach.
    • Immediately clean spilled liquids, grease or food.
    • Use nonskid floor wax.
    • Use nonslip mats in your bathtub or shower.

    5. Light up your living space

    Keep your home brightly lit to avoid tripping on objects that are hard to see. Also:

    • Place night lights in your bedroom, bathroom and hallways.
    • Place a lamp within reach of your bed for middle-of-the-night needs.
    • Make clear paths to light switches that aren’t near room entrances. Consider trading traditional switches for glow-in-the-dark or illuminated switches.
    • Turn on the lights before going up or down stairs.
    • Store flashlights in easy-to-find places in case of power outages.

    6. Use assistive devices

    Your doctor might recommend using a cane or walker to keep you steady. Other assistive devices can help,

    too. For example:

    • Hand rails for both sides of stairways
    • Nonslip treads for bare-wood steps
    • A raised toilet seat or one with armrests
    • Grab bars for the shower or tub
    • A sturdy plastic seat for the shower or tub — plus a hand-held shower nozzle for bathing while sitting down

    If necessary, ask your doctor for a referral to an occupational therapist. He or she can help you brainstorm other fall-prevention strategies. Some solutions are easily installed and relatively inexpensive. Others may require professional help or a larger investment. If you’re concerned about the cost, remember that an investment in fall prevention is an investment in your independence.

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    I serve the counties of El Dorado, Placer, Sacramento, Solano, Sutter, Yolo, and Yuba, cities like Auburn, Lincoln, Rocklin, Roseville, Sacramento, Placerville, and Woodland.

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  • November 18, 2013 /  Dementia

    I ran across an article from BBC news on a study that there is initial evidence that autism may be detected in babies as soon as their second month. It looks like more study needs to be done but the initial study lays the ground work of hope for future studies. I’ve included the link to the article below.

    http://www.bbc.co.uk/news/health-24837462?goback=%2Egde_1905451_member_5804455875665997827#%21

    Early-Detection

    I serve the counties of El Dorado, Placer, Sacramento, Solano, Sutter, Yolo, and Yuba and cities like Auburn, Lincoln, Rocklin, Roseville, Sacramento, Placerville, and Woodland.

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