(I hope this link works now. I had problems with it on AOL, but it worked on Internet Explorer.)
This was on another caregiver website—not for Alzheimer’s caregivers in particular, but any caregiver. It’s called “A Doctor’s Perspective”. I have problems with some of his views, but thought that it was important to read what he had to say, if for no other reason than I may need to be on guard against some of them in the future—like “…the doctor and social worker are the ones who must decide if you are capable; otherwise, for the sake of the patient they can insist on some other arrangement…”
I think a lot of caregivers find that at some point they are very disappointed by the knowledge of the doctors they deal with. (Not to mention a visiting nurse who thought that a bp of 80/40 was “okay” and “under control”.) We are criticized if we don’t know enough, but who censures the doctors and other healthcare workers who don’t know enough? Can we bring in adult protective services to protect our loved ones from them?
I’d love to hear what other people think about this article.
I have just read the article "A Doctor's Perspective". While I agree with some of it, there are a couple of points to make. First, if you have a doctor who knows you and the family there will be more interaction and discussion. If a specialist is in charge he/she is more likely to follow the letter of the law. Even if a specialist is the "admitting" doctor, your own PCP should be involved to help you make decisions. In the case of choosing a caregiver, the PCP is more likely to select the closest family member who is willing and able. He/she would also be able to suggest additional help if the selected caregiver is not fully able, thus not by-passing the willing family member, especially spouse.
The other point is to re-emphasize the need for getting both durable power of attorney and medical power of attorney, as well as having an advanced directive. If you do not have these documents you could develop the problem my wife and I had with her aunt. Aunt M was in a nursing home in Philadelphia. My wife, in Maine, was her next of kin. There were no others (except my wife's younger sister). Aunt M stopped eating, so the nursing home wanted to put in a feeding tube. My wife and I said "NO", but since there was no medical power of attorney they ignored us and went ahead. After Aunt M pulled the feeding tube out (the day of return to the NH) they called again for permission to insert the feeding tube again. Again we said "NO" and again they ignored us. After the 3rd time of having Aunt M pull the tube out they got her message and let her die peacefully. An advance directive and/or medical power of attorney would have been of great help in this situation.