My husband has suffered a massive MI. In the past 8 wks, he has been hospitalized, I have been amazed at the lack of knowledge the medical community has of ALZ. My husband has had Psych consults called at two different hospitals, put on Haldol twice, even though they were told he had a severe reaction to the med the first time. What's with the psych consult. I kept asking for a neruo ALZ consult, no can do they told me. Attending docs, kept telling me how they couldn't understand the ALZ dx because he seemed alert. They dismissed his confusion as just a result of being in the hospital. The bottom line is when an ALZ pt has a serious medical condition they are treated as if they are a psychotic patient with a serious medical condition. How unfair and dangerous. Giving psychotropic drugs to an ALZ is not fair. Treating them as if they are psychotic is not fair. Why can't the medical community recognize that ALZ pts. have serious medical situations too and they need to be treated with respect, dignity and understanding. Don't just label them psychotic. Thank you my rant is over, but no I don't feel better.
Marsh? Sandy? Any ideas on educating the medical community on Alzheimer's Disease? I know that Marsh speaks to medical groups.
I do understand completely that not every doctor can possibly be knowledgeable in every field, BUT considering the explosion of AD cases now, and many more in the future, shouldn't it be part of continuting professional development seminars for most doctors?
marsh, I know doctors are required to get continuing education, but I'm not sure how that works. Is there a way to encourage classes on dementia syndromes for GPs and/or neuros?
Our community has an outstanding hospital written up as one of the best hospitals in the country...my husband had to be put in this hospital for a brain operation to drain fluid from hematomas that had formed. The staff was very cooperative with me but asked me if I could stay with him in the recovery room as they didn't know how to communicate with him. The ICU nurse was not knowledgeable about Alzheimeer's at all, the social workers assigned to the case didn't have a clue about Alzheimer's and asked me what I needed . The hospital kept my husband for two days only and urged me to return him to the nursing home as soon as possible which I did as I am sure they had no means to supply the care he needed. They were very forthright in their lack of knowledge but I have wondered why they did not know more about the disease.
Everytime he has had to go to the ER, I have learned to be there as soon as possible as they try to treat him as one who is uncooperative and uncommunicative, and it is a very frightening situation for him. I have tried at least at two of the ER's to tell them that he is unable to be treated as other incoming patients but my experience has been that the workers there don't understand Alzheimer Dementia and differeniate it from mental illness.
My husband is functioning on about a 2 year old level. If he had to go to the ER I would ask that procedures be explained at that level-but not in a "baby talk" voice. I think staff would undestand that.
I feel we are short changing our ALZ spouses when we need to deal with general or emergency medical care. It is so frustrating. There must be a way of communicating that ALZ needs to be included in the pt care plan and understand your pt may at one time be cognizant only to be confused in the next conversation. It is frightening for them. I know there are so many areas that need to be addressed but this seems to be right up there as I would think as we boomers age this is going to be a more pronounced problem.
My wife has been in the hospital since Wednesday afternoon. The tests are painful and frightening to her. I have been at her side at least 22 hours each day. It is helping her run interference through the maze of attending physicians. Fortunately she is not combative unless they try an roll her over, which is extremely painful for her. She's had every blood test know to man. Tomorrow's decision is whether to allow a bone marrow biopsy. I am home for a hour to get a shower. Not looking for advice. I will already have made the decision by the time I see any resonses. The biopsy is to determine if it's "cancer, lukemia or something else". There's been an underlying, unspoken, "we don't really believe the AD dx, she's too young" theme. I think something terrible is wrong in addition to the AD. I can't change horses, we are too far down this road.
I am getting concerned about the Family Doctor situation. Here and I imagine elsewhere, Med. students are going into specialties instead of the Family Practice. Seems specialists make triple the money as Family Doctors. Here it is now difficult to get started with a new Family Doctor because they soon go to "no new patients."
My own Family Doctor for 45 years had 2 sons who went into his practice with him a few years ago and all of a sudden there was a notice in the paper they were closing their office. They are going to a Quick Care place and full-time for them will be 15 days out of the month. I know the Father was devistated and now he is stuck with an office building and the only Doctor there. He assured me he is not planning to retire now but economics may dictate otherwise.
Insurance Companies usually want referrals from Family Doctor before you go to a specialist so what is going to happen. Quick Care places are cropping up everywhere. Do you think the Insurance Companies will accept a referral from them?
Two notes: I gave the "understanding the dementia experience" to our internist the other day when I went in. I said, I've never brought in notes from the internet to ask you to give me meds; I just want you to read this and have the other doctors here read it, and make it available. He was very interested, actually.
Next: fifteen years ago and nine years ago when my husband was hospitalized when his chronic phlebitis flared up, I had to be at his side all the time. Not because of the AZ, which developed since the latter hospitalization, but because he didn't hear well, couldn't understand accents, and had a complicated situation. It was also a teaching hospital, and the later time he was in, in August, which we all know is a difficult time because of the new interns and residents. This last time, a few weeks ago was no different but I refused to let him be on the teaching rotation.
Once again, a very very sensative Blog. I won't go there. Dking, if your getting vibes of "she's too young", your wasting your time. Is it possible to get your wife to Mayo? They care, they listen, they understand there are actually human beings involved and they aren't afraid to be frank. My 2 cents. Thenneck
Family Practice has become a specialty, so there are actually lots of family practice doctors out there today. What no longer exists is the general practitioner.
We also seem to be doing OK in this are of Pennsylvania which was a rural area that no MDs wanted to be involved in 20 years ago mainly because this is an area where the DOs were accepted early on. And there is a more or less local DO medical school in the general area. Both of the main hospital groups in the area allow DOs to practice in those hospitals, and many of the specialists we have gone to started out as DOs. Still most DSs go into family practice even here.
I never heard of a DO when I lived in Massachusetts. Here if Florida, it seems as if there are more DO's than MD's. Can Marsh or Sandy D please explain the DIFFERENCE?
Joan-originally DO's were more hands on and holistic. When I was in nursing school in Philadelphia we were told to stay away from them. The students were those who could not get into Med. schools or were from ethnic and religious minorities with a quota for admission. That has all changed. Their education is the same as traditional med schools as is their treatment of patients. You are correct about their numbers being greater in Florida. Heart Institute has several on their staff.
In WV Do's are very common and I don't know about the difference. There is a DO school in WV that most of ours seem to come from and it is not the University Med Schools in the state. Perhaps it is easier to obtain a degree there. Don't know. Used to be the Universities only accepted x number of Med students a year and I don't know if that is still true or not.
They still do get the hands on body manipulation training, they just don't do much of it anymore. I know that as last as the 70s, their schools were easier to get into, not because the students weren't as good, but just because the MD schools had lowered the numbers of students. You could be a straight A student and still not be able to get in. My sister had a friend who's oldest son went the DO route because a student from New York City could not get into a MD school no matter what he did.
In addition, the DO schools tended to serve rural areas, like he middle of Pennsylvania, Arizona (where I met my firsst DO), West Virginia. All the places that the MDs didn't want to bother with.
We also see more Physicians Assistants doing real doctoring around here. Same reasons.
My Dr. for the past 15 years has been a DO...she is by far the most intuitive,caring, professional medical practitioner I have ever had. She was the one who spotted G's disease by my description of his personality change, and gave me the name of the Neuro to see right away. She has been with me thru several biopsies, depression over G...always with a hug for good by and "take care of you first". Last visit I gave her this website to pass on to others in the same situation...she gratefully received it.
Well, whatever the designation - DO, MD, PA, RN, LPN - They all need to be educated about Alzheimer's Disease. It doesn't have to be extensive. A professional development seminar of a couple of days - a basic overview of Alzheimer's Disease as a BRAIN disease, how to handle AD patients when treating them for an illness or emergency, and an understanding of the caregiver's role and stress. Just enough so we don't end up in an emergency room with staff that are completely ignorant of the disease as ASY did.
Very important is also an understanding that just because the patient isn't completely oblivious to his/her surroundings, doesn't mean they can't have AD. As in some of Sid's doctors telling him - "Well, you don't look like you have AD to me."
lmohr, my father (a general practitioner) told me to choose a doctor who specialized in Internal Medicine for my PCP. They are pretty much general practitioners, except they don't do surgery. For older patients, if you can find one, a specialist in geriatrics is best. (This is a fairly new specialty, so there aren't a lot of geriatricians yet ... and many of the ones who do exist limit their practices to patients in nursing homes.)
Joan, What was that doctor expecting, DEMENTIA stamped across the forehead. You would hope the medical profession had more insight. I don't think the majority of dementia suffers look on the outside as if anything is wrong. I know until you are in a conversation with my husband, no one would guess he has dementia. He is not what the outside world thinks someone looks like with Alzheimer's/Dementia. I know myself thought of dementia always as an older persons disease, even when my Mother-In-Law started showing signs, I thought well she was over 65. Boy! did I get a rude awakening. I sometimes wonder if my husband's Neurologist really thinks my husband is as far along as he is. Of course he sees him every 3 months, not 24/7
Bluedaze's description of the "difference" between DO's and MD's is right on. The trainings in medical school are essentially the same, although DO's have more emphasis on preventive care and nutrition. Although there are Osteopathic hospitals, most DO's get their internship and residency in general hospitals that have both MD's and DO's. The degree (MD vs DO) depends upon the school they attended. We have several DO's in our area. The AD "specialist" my wife is going to is a DO Internist.
Sunshyne, the other difference between Internists and Family Practioners is that the Internists generally see only adults, no children or infants.
True, Marsh ... I wasn't even thinking about our members who are so young they still have children at home. (Plus I prefer Internists for exactly that reason ... the waiting rooms generally aren't full of unhappy kids.)
When my husband and I went on our last vacation his doctor call me several times along our way to see how I was doing. When my husband was Baker acted to a psych hospital I didn't know to which one. Dear old HIPPA-patient confidentiality. This same doc called around and finally called me at 11pm when he finally located him. Wonderful doctors are still out there.
The last time my husband was in the hospital for pneumonia, I was shocked several times. They left his food where he could reach it by himself - he ended up wearing it. They left the phone where he could reach it - he kept hitting the buttons and swearing at it. The one that I had the most diffiuclty with was the fact that they did not belt him to the bed. When I asked about this I was told that he could not be belted down for 24 hours before leaving the hospital. He did have the alarm on him (the one that is clipped to his clothes and a big box), but I was concerned that he would be up and moving before they could catch him and he would do serious harm to himself because he still had an IV and catheter. I noticed that they got him out of there 72 hours after he was admitted though.
This thread is ironic. I was just talking to one of my co-workers whose mom has AD. She went into the hospital for a stomache problem. The staff left her that night without the sides of the bed up and without lowering the bed. She tried to get up, fell and crushed her hip. So now the poor woman has had to have her hip replaced and will be going through physical therapy. She is probably in stage 5 of the disease.
Moral of story - it is important to have an advocate at the hospital with our LO as the workers there may not understand the disease nor are they familiar with how our LO is with the disease. The comment of when you have seen one case of AD you have seen one case of AD really applies here.
Yes, the family is suing the hospital on this one.
Our DO retired about 6 years ago. We were fortunate enough to find another DO, a younger man, near our home. He has been a real God-send. He is quick to refer if needbe. He also is big on nutrition and preventative med. I don't like it when a doctor is so busy he can't spend more than 2 minutes and then prescribes a bunch of pills. I like my DO and do not plan on quitting him. He's so good with DH. Listens to him. Listens to me. tells me I need to take care of me. He explains things. Wonderful man.