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Toby Laping Associates www.WNYCareManager.com
Eldercare News |
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You Need To Know . . . Health Care Providers by Toby F. Laping, Ph.D., C.S.W. I've written before about the problems of finding a primary health care provider who understands older people and enjoys working with them. That issue came back to me acutely the other day when I received a call from a client. She had been feeling rotten lately with aches and pains unlike anything she had felt previously. She called her doctor, described her symptoms, and asked when she could see him. To her dismay, the doctor asked her what other way she expected to feel since she had recently turned 86 years old. He said there wasn't anything he could do for her beyond telling her to take several Tylenol each morning. My client was incensed, and I felt she had a right to be. We spoke about ways that she could get her physician to pay closer attention to her, but she had tried them all without success. She was frustrated and angry. She and I finally agreed that it sounded as though her physician didn't particularly like ministering to older people and that she was entitled to an evaluation and explanation, and treatment as appropriate, of problems that were new to her. I also told her that there are many primary care providers including internists, geriatricians, and nurse practitioners who thrive on addressing issues of older people. it was clearly time for her to make a change in the way she was receiving her health care. I gave her the names and telephone numbers of several people that I knew would listen to her and help her and that I was pretty sure she'd like. She made the calls, selected one person with whom she now has an appointment, and knows she took the right step. We are not just consumers of health care. We are also customers, and if we don't feel the products we're buying are what we want, we should do the same thing we do when a store doesn't stock the merchandise we want: we walk away. This principle applies to all types of health care providers. If you're recovering from a hip fracture and the physical therapist assigned to you is much more interested in sports injuries, it may be appropriate to ask for a different physical therapist. If you're receiving home health care but the aides aren't doing what it was agreed that they would do, it's time to ask for a different aide or perhaps even a different agency. If the nurse who comes to your house is brusque and unpleasant, there's no need to put up with that. There are many other nurses around who are kind and sensitive to the needs of their patients. Although it sometimes feels as though this is a money issue, this isn't just a matter of who is paying and how much is being paid. All providers are delighted with people who are full private pay patients or for whom Medicare and medi-gap insurances pay full rates. But that doesn't disenfranchise people for whom Medicaid is the ultimate payer. If a patient on Medicaid home care has an assigned aide who is unpleasant or is often absent or consistently tardy, that patient has the right as well as the responsibility to tell the agency that the present situation isn't working. That patient has a legitimate reason to feel that the person assigned to her is not the right person for her case. I know this isn't so simple as I make it sound. The agency may have no one else who is available. But if that's the case, perhaps the Medicaid caseworker or the agency itself should determine whether another agency could more readily meet the needs of the patient. Or, if no other agency can be found to do better, perhaps the assigned agency should flag this case as one that needs to be more appropriately serviced as quickly as possible. We are patients but none of us need be passive recipients of services that don't meet our needs or don't live up to our expectations. Under those circumstances, it's appropriate to show discomfort and even unhappiness, and ultimately to use the final option of consumers everywhere: shop around and take a walk to a competitor down the street.
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