Monday, July 8, 2019

The Challenge of Caring for a Stroke Patient - The New York Times

Kelly Baxter was 36 years old and had just moved to Illinois with her 41-year-old husband, Ted, when he suffered a disabling stroke that derailed his high-powered career in international finance. It derailed her life as well.

"It was a terrible shock, especially in such a young, healthy, athletic man," she told me. "Initially I was in denial. He's this amazing guy, so determined. He's going to get over this," she thought.

But when she took him home six weeks later, the grim reality quickly set in. "Seeing him not able to speak or remember or even understand what I said to him — it was a very scary, lonely, uncertain time. What happened to my life? I had to make big decisions without Ted's input. We had been in the process of selling our house in New Jersey, and now I also had to put our Illinois house on the market and sell two cars."

But those logistical problems were minor in comparison to the steep learning curve she endured trying to figure out how to cope with an adult she loved whose brain had suddenly become completely scrambled. He could not talk, struggled to understand what was said to him, and for a long time had limited use of the right side of his body.

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Doctors are ageist — and it's harming older patients - NBC News

When I accompanied my 85-year-old father to a doctor's appointment not long ago, his primary care physician brushed off his complaints about chronic back pain, as well as my observations about his failing memory and balance problems. It's normal at his age, he told me. When asked about the 14 different medications and supplements he's on, the PCP quickly scanned several pages in the electronic record but decided not to make any changes since other specialists prescribed them for good reason. He mentioned that he wasn't comfortable overruling another physician, though he also wouldn't take any action on his own, like supplying him with a walker.

My dad, sadly, is not the only elderly patient to take so many medications — and to have his doctor dismiss his concerns about them with a shrug. The problems start early in the drug treatment process: Frequently excluded from clinical trials are the very older adults the medications are meant to help — and whose changing physiology causes them to metabolize drugs differently. Similarly, some doctors fail to recognize when standard medication doses are only appropriate for much younger patients.

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