Family Conversations That Can Change--or Save--a Life

The American Assn. of Retired Persons says there are 9.9 million Americans, 65 or over, who live alone, 7.6 million women and 2.3 million men.

The organization has put out a brochure on “family conversations,” advising children of old people how to talk with them on such matters as money, their health and independence--without using a sledgehammer.

I bring this up because I’ve just had an experience which illustrates how consumers of health care who are elderly and living alone must take special care to be alert to their own problems and listen to their children and others about them.

Being a consumer is more than simply purchasing goods and services with a credit card or an Internet connection. A consumer must have the ability to make sensible choices.

I didn’t do that when I took ill recently.

I’m 61 and I live alone.

On Nov. 18, as best I can judge, I suffered a ruptured, or burst, appendix. I thought at first it was either the stomach flu or food poisoning.

For 12 days, though, I got weaker, finally leaving work to go home, barely able to walk to my car. The next day, Dec. 1, when my daughter, Kathy, made one of her frequent calls from Washington, D.C., she found me “not lucid,” and within minutes my son, David, 25, who lives and works nearby, arrived at my house and declared, with considerable force, “You’re going to the doctor. I’m going to drive you.”

Soon thereafter, my physician, Ray Matthews, began his examination by saying, “I know this is serious. You would never come to see me nonscheduled, otherwise.”

Matthews could feel what was left of my appendix. He committed me immediately to Good Samaritan Hospital, where I spent five days hooked up to an IV getting bagfuls of antibiotics. A week of recuperation followed at home, with more antibiotics. I’m still on them.

I had called in to my doctor’s emergency line at 1 a.m. the night I think this happened, and the pain was greatest, but when I told the doctor on duty that I had no fever and wasn’t throwing up, he said it probably wasn’t appendicitis.

Later, when Kathy and my son-in-law, Ken, came to see me, she discovered my thermometer wasn’t working.

Why didn’t I act faster, before my children intervened? I feared I might have something worse, and procrastinated in hopes it would disappear. When I finally had to leave work, I told my editor I had tried to stay because I was afraid, once out, I would never come back.

I was foolish, not nearly alert enough to some major changes I was undergoing that absolutely required seeing my doctor. I did not eat regularly for nearly two weeks. And the last three or four days, I wasn’t reading The Times carefully. That should have been sign enough, because I have read this paper carefully since I was 6.

*

So what lessons are there here for other consumers of health care, and their friends and loved ones?

I asked experts to explain my behavior to me.

Martin Bayne, a New York spokesman for the frail and elderly, told me that I was an example of what often happens to older people, especially when they are self-sufficient and determined to hold on to all their independence even while having “a medical problem and fearful of seeking health care.”

“For so many older people, there’s the thought of going into nursing homes . . . being parked in wheelchairs in hallways, being a throwaway in our society.

“It stands to reason someone a little bit older with a medical problem is deathly afraid of being thrown into that situation. It’s exacerbating our medical problems. We have to change [attitudes].

“Probably the more successful you are, the more afraid you are of losing your independence.”

Stephen Moses, head of the Center for Long-Term Care Financing in Seattle, said that a failure to seek proper medical care may be triggered by a cognitive impairment.

“By 85, 47% have Alzheimer’s,” he declared. “Aging people living alone, it creeps up on you. . . . An individual who is married or has constant visitors, others may notice the change of behavior before one does oneself.”

But in the 60s, he reassured me, Alzheimer’s affects just 1% or 2%. Still, he said, “You were showing aberrant behavior, and because your children weren’t right there, it went unnoticed.”

At the American Assn. of Retired Persons (AARP), Barbara Herzog, a manager of programs, including its “Independent Living Week,” said reluctance to seek medical care is not uncommon at any age. “We’re all human and we often don’t want to face up to these things.” But, she said, communication is vital, particularly between elderly parents and their children.

She faxed me brochures. The “family conversations” one warns, “When it comes to talking to older parents about their needs, one thing is clear: You cannot start the conversation too soon.”

Of course, the AARP acknowledges, there may be resistance to having their children advise them.

“While deciding whether and when to press the issue is necessarily personal,” the brochure tells children, “experts agree that the stakes rise steeply when a parent’s health or safety is at risk. Other kinds of “crisis” situations may also demand a conversation, such as health care costs depleting a bank account.”

I was lucky. I had good insurance, and Good Samaritan Hospital’s care was everything I could have hoped for.

As for my children, a change occurred in our relationship. For the first time, they filled the parent role and I was the child. I didn’t object--at the time.

Ken Reich can be contacted with your accounts of true consumer adventures at (213) 237-7060 or by e-mail at [email protected]