We woke up to a distressed call from my dad. It was about 1:00 am, and his voice was shaking and frail. "Sugar, I feel really bad." My husband and I got up immediately, put on our robes and walked down to the house my folks have lived in for the past ten years - a guest house on our property that became their home. We found my dad sitting on his bed, white as a sheet, trembling. We knew he'd been feeling under-the-weather; he'd been coughing for what seemed like weeks, but this was more than a cough. I took his temperature - it was high. After a conversation with our doctor, we decided to take him to the emergency room. He would now be counted among the approximately 110 million visits to emergency rooms that are estimated to take place this year.
I was on auto-pilot, jumping into sweatpants, grabbing my purse and car keys. Part of me was still shaking off the shock of being dragged up from dreamland into a cold, stark reality where my 83-year-old father looked weak and frightened. But shocked or no, we wasted no time. We'd done this before - my dad has had two stents put in his heart, so we know he knows when things are not right. We left my 81 year-old mother home with an expression that bespoke both confusion and fear, and drove my dad to the hospital.
Wrapped up in his bathrobe. - his snow-white hair pushed up in back where he'd tried to lean against the car seat headrest -- my dad was vulnerable and tender. My husband and I curled our arms around him and guided him to the check-in station. He was holding his current medications in a zip-lock bag, and clutching his wallet and insurance card, which he gave to me for safe-keeping. These images of him shuffling along in his slippers, with his baggie in hand are tough for me to recall. There's something about the frailty, and perhaps the loss of dignity that I, as his oldest daughter, would have loved to shield him from. But alas, such is life. Dad's cough produced deep, rumbling, wracking spasms that made me shudder. Thankfully, our doctor had alerted the emergency room staff of our impending arrival, so we advanced through the paper-chase inherent in such visits relatively quickly.
An IV was run, blood was drawn, and vital signs were collected. Our doctor began the process of asking my dad questions - trying to tease out the true medical threat, and ascertain the best way to treat it. Dad's voice was small and weak, his breathing shallow and labored. The coughing took most of his strength, and the worry took the rest.
As all of the activity swirled around my dad, my husband and I watched patiently, talking to my father in supportive, gentle tones. Our doctor was sensitive and concerned, and made my dad - and us - feel better just knowing he cared. They started him on antibiotics, and gave him something to reduce his fever. Apparently, my father had contracted a bad case of one of the strains of flu, and was suffering complications associated with it. I'm happy to report that after three days in the hospital, my dad came home - nearly recovered, though still a bit fragile.
The lesson here? We were lucky. Lucky to have a doctor who could respond so quickly and so thoroughly in the pre-dawn hours; lucky there was a hospital near our home; lucky the hospital's emergency room was still open - i.e., hadn't been closed down due to budgetary concerns; lucky the emergency room still had a bed to spare; lucky the emergency room doctors and nurses on duty that night had some experience treating elderly patients. Actually, in our case, luck had very little to do with it. We had chosen our doctor with care, and had gotten to know him as a friend. He had already treated my parents on numerous occasions, and therefore knew a bit about them. And unlike millions of Americans who are struggling to find healthcare they can afford, we have the resources to be able to take care of our aging parents, above and beyond what Medicare and my dad's secondary insurance company can provide. For this, we are truly grateful.
But our experience in emergency rooms with my aging parents has opened my eyes to a reality in life; senior citizens require special attention, and they don't always get it. Reimbursements to doctors from Medicare are low, and since older patients often take more of a doctor's time, they can be a financial drain on the doctor's practice. Elderly patients are often prescribed multiple medications with various limitations and restrictions, and require extra time from a doctor to help them sort it all out. Also, many elderly patients suffer from chronic health conditions, like diabetes, rheumatoid arthritis, and neuropathy - and would benefit from a health practitioner who could spend some time just listening to them. But even though Medicare reimburses for many tests and procedures, it doesn't make it easy for doctors to help elderly patients maintain their health, prevent diseases, or cope with chronic conditions.
My dad is nearly back to his spunky self, and nothing could make us happier. But I'm aware now that the issue of elderly care is something we should all pay attention to and get prepared for in the best way we can. By 2030, the U.S. population age 65 and up will exceed 70 million - nearly double the number counted in 2000. Unless we tackle the health care system to make sure emergency rooms stay open, and unless we find a way to ensure that everyone has affordable healthcare, and unless more medical students decide to go into the relatively un-sexy specialty of geriatrics, we baby-boomers are going to find ourselves -- out of luck.