The gentle breeze of the summer evening embraces my hometown of Suwon, Korea. Holding my hand, my grandma takes small, deliberate steps forward. Two months into my fourth year of medical school, I am back home for a short break before beginning the residency application process.
The COVID-19 pandemic’s devastating effects upon our nursing homes has highlighted the vulnerabilities of this sector of our health system. With increased attention to the issues in such a growing and vital part of our society, we have a once-in-a-lifetime opportunity for change.
With a growing interest in geriatrics, I began to wonder what resilience looks like for elderly patients, who unlike children, present their life trajectories to physicians much later. This is perhaps challenging and even uncomfortable to discuss for those who perceive resilience as a long-term goal — overcoming significant barriers in order to improve over time. Resilience may not seem as relevant for elderly patients who may be nearing the end of their lives.
For many of the elderly and their families, the COVID-19 pandemic has been a scary and trying time. A major concern has been the physical health and safety of this vulnerable population. In addition to community infection control measures like social distancing and avoidance of public gatherings to slow the initial spread of the outbreak, public health officials have also endeavored to protect high-risk populations by recommending electronic visits with loved ones, whether they are at private homes, nursing homes, or in the hospital.
Every time we’d ask the physical therapists to take him on a walk to get better oriented with his surroundings and see some sunlight, Mr. G. would refuse. He was a stubborn man.
To my dearest dying patient: / May I emulate half your strength, / and a portion of your wisdom, / just a part of your life’s length.
“If I begin to repeat myself, just tell me. I have Alzheimer’s. At least, I think I do,” the elderly gentleman said with a smile. This elderly patient of mine was a jovial gentleman and in fantastic shape with unremarkable vitals on physical examination. If it was not for his diagnosis of Alzheimer’s disease, the physical and emotional state of this patient given his age is nothing less than enviable.
She asked me if I was from New York. I told her I wasn’t. I was from California, actually, but enjoying myself in New York City while I was here. I asked her where she grew up. She said Brooklyn. She asked to see my referral card. I asked her to clarify. She said she wanted to see my referral card. For coming here. And did the super know I was here? Where was my card?
Challah bread is traditionally prepared for Jewish holidays and the Sabbath. We made ours on a Wednesday night. Helen and Marie stare warily from their wheelchairs as a dozen medical students file into the retirement home lounge, toting tubs of flour and challah dough. “We’re not playing bingo?” Helen asks, looking disappointed, as students and octogenarians begin matching up for the evening.
Now six months away from graduating from medical school, I’ve started to reflect on the patients who hold a special place in my heart and memories, who taught me invaluable life lessons. We were in the assisted-living home of an elderly couple who had agreed to meet with us so we could practice our interviewing skills as first-year medical students. The old woman was sitting in a reclining armchair, leaning back. She had multiple medical problems, …
The art of medicine encompasses healing of both the body and the mind, and thus, an understanding of the complex relationship between a patient’s mental well-being and physical disease state. This psychological and physical interplay is even more important in the elderly population, as they are more susceptible to physical disease, and more vulnerable to preventable, psychological neglect. Providing comprehensive care to our large elderly population is a public health necessity. A recent study showed …
I’m sitting in a class on dementia. The doctor is lecturing about the condition’s prevalence, prognosis, neuropathology, diagnostic criteria, risk factors, deterministic genes and pharmacologic treatment. On a slide entitled “Non-pharmacologic Management,” the doctor tells us that dementia often leads to wandering. Half of those who wander and are not found in 24 hours are found dead. To try to prevent patients from wandering far, some assisted living centers have installed fake bus stops. When …