When my mother was sliding deeper into her years and what eventually was diagnosed as a form of dementia, we were at a loss as to what to do.
My parent’s family doctor was doing all he knew how to do, and in fact acknowledged that he’d reached the edge of his knowledge and expertise. My mother’s behaviour was becoming more and more erratic and unpredictable. The cocktail of medications he’d prescribed just didn’t seem to be doing anything that gave my mother sustained peace and comfort.
I was told to go to the Alzheimer’s Society and check out workshops specifically geared to family members. I did that, signed up, attended the series, got a lot out of it, but it still got me no closer to discovering some kind of specific help for my mother and at that point, our family.
That’s about the time when a family friend who was a retired nurse suggested I get my mother to visit a geriatrician. A what?
Geriatricians are a huge help
It took me a while to find one. That’s because there are so few of them. Across Canada there are less than 300 geriatricians. They’re booked pretty solid, overworked, underpaid and amazingly dedicated to their calling.
A geriatrician is what I call a holistic medical physician for the aging and elderly. A geriatrician looks at all aspects of an aging person’s life: mental, physical, emotional. A comprehensive assessment is the first step, followed by a review of all medications, lifestyle, and current issues and behaviour. Then a recommended program for moving forward that is realistic and helpful to the patient and the family.
What we got from the experience
I organized for my mother to see her geriatrician about every two months for the first three years of her steady but managed decline. It always was a difficult visit; he was always behind, and my mother was always tense and apprehensive.
Yet when the appointment finally got underway, it was always good and productive. He was the epitome of patience. She got calmer, more articulate, and more cooperative. And appointments usually lasted at least half an hour or more; no rush.
The big win for us all was that her geriatrician took that holistic look and approach to her health. And he was incredibly astute in reviewing all her medications, and I mean all: physician prescribed, over the counter drugs, naturopathic-recommended pills. Each was examined and reviewed for interactions, benefits, and possible benefits and cautions to be carefully considered. Plus he tracked any specialists my mother was seeing and outcomes of appointments and any tests.
As important, he was a very gentle, understanding person, which in turn helped make my mother more calm and cooperative.
Staying with it
My mother ended up in a nursing home and slowly but surely deteriorated on all fronts. We knew a cure was out of the question. The challenge for us all was to keep her calm, comfortable, and safe; to give her the best possible quality of life as she got into her mid nineties and was ever more consumed by her dementia.
My mother remained relatively stable for several more years. And I made it a point to have not only her nursing home physician see her regularly, but to get my mother to her geriatrician on a quarterly basis for another two years. It was only when she started failing physically and sliding downward cognitively that we agreed the actual process of moving her to the geriatrician’s office for an appointment was too stressful; that the benefits of his care were declining on par with her health.
So we stopped going, though on a fairly regular basis I called him or his assistant with updates and to ask for advice, which was always gladly given.
Find one; be patient
There are three ways to find a geriatrician. Ask your family physician. Check with your local hospital or health network, or go to www.canadiangeriatrics.ca and use the ‘contact us’ section to get in touch with this group.
Because there are so few geriatricians in Canada it usually takes time to get an elderly parent or other loved one in for even an initial visit. So be patient, get in line sooner than later (get a referral from your parents’ family physician if you can, or yours), and be persistent.
From my own experience and all I’ve learned from others across the country, a good geriatrician can make a huge difference for the better in your family’s journey into the world of aging and all its related issues and challenges.