Episode Transcription:
DAVID: Hello everyone and welcome to our next episode of life conversations. This is David Chandler and I'm joined by my cohost.
CHRISTINA: Christina Chartrand, so glad to be here today with you, David.
DAVID: Yeah, we're gonna be talking about today one of the number one reasons why we see our seniors going to the hospital and that is not properly managing their medical condition. And so we're gonna be going through some tips and tricks for you to help your loved one or for you to help manage your own medical condition. And as we shared in our intro episode. We have a little bit of, Christine and I have different, a little bit different perspectives here, and Christina's gonna be bringing more of the care perspective of working with her mom as a caregiver, and I'm gonna be bringing a little bit more of that clinical background of understanding and knowing how can we best manage medical conditions and keep our senior safe home out of the hospital.
CHRISTINA: Yeah, I think this is a great episode. And I think I've learned a lot, obviously, about medical condition management. And yeah, talking about my own personal experiences with my mom is a great way to introduce this. My mom lives by herself, and she does have a chronic condition called COPD, where she has trouble breathing sometimes, and she does take medication around that. So I think... David, you decide we're going to talk about some different aspects around that. And I think one of the first things I'm going to say is, yeah, she's got COPD. So what, what next? What do I, what else do I need to know?
DAVID: Yeah, so first off I want to know does she, so she has COPD, does she have any other medical conditions, any medications that she's taking?
CHRISTINA: Yeah, she does take other medications as well, like for like high blood pressure. That's a medication that I know she takes on a regular basis. And I don't know, I can't remember all of them.
DAVID: So there's a few questions that I'd like to go through with you and we're going to introduce these to our listeners because these are great questions to go through with your loved one to see are they properly managing their medical conditions. So the first one I would like to know is does your mom know so she's taking does she take any medications for her COPD?
CHRISTINA: Mm-hmm. She does. She takes it in the morning time. And at night.
DAVID: Okay, and is it at night? And do you know what she's taking? Is it inhaler? Is it a breathing treatment?
CHRISTINA: It's like a breathing treatment that she does.
DAVID: Okay, great. And then you also mentioned that she has high blood pressure. So does she know what key vital signs she's supposed to be monitoring around her COPD high blood pressure?
CHRISTINA: Yeah, so she has pulse ox, so she does check her oxygen on a regular basis and she does check her blood pressure every morning.
DAVID: Okay, every morning. And how often is she checking her pulse oxygen level?
CHRISTINA: It depends. She always checks it in the morning, but if she's feeling winded, sometimes she'll take it throughout the day.
DAVID: Okay, well it sounds like she's doing really great. And what we've, I'm gonna kinda jump back and forth here between our scenario and what we may see in the real world. So a lot of times what we'll see with seniors is they aren't checking their vital signs regularly. And when it comes to things like blood pressure or oxygen level. A lot of times what we'll find is a senior will have a fall and it may look like they tripped or maybe they were getting up from the toilet and they had a fall, but if they're not regularly checking their vital signs, checking their blood pressure, if for example, let's say that your mom got up and this morning her blood pressure is 90 over 60, which is a really low blood pressure. And let's say she went ahead and still took her medication that day, then that medication is going to make her blood pressure go even lower. And so, an hour or two later, her blood pressure may be 70 over 50, which is a really low blood pressure, and you have a much higher risk of, for example, if anybody, if any of our listeners, if you've ever stood up a little bit too fast, and your vision, maybe you'll start seeing a little bit of stars, dizzy. That's because your blood pressure is trying to adjust to you suddenly standing up. and that's even amplified more for our seniors. And so if they're not checking their blood pressure, knowing when to hold that blood pressure medicine, they may have a fall that's related to their blood pressure dropping, and it's not because they were getting up from the toilet or they were walking and they just tripped over something. It's actually because they got dizzy and they weren't checking their blood pressure before they did that.
CHRISTINA: Well, I think you're bringing up a really good point, David. You're just talking about just having the right equipment in place, because I've gone out and visited seniors and went out and done an assessment, and I see the equipment, but they're not doing anything with it. That happens sometimes?
DAVID: Right, right. Oh my gosh. Or I can't say how many homes I've gone out to that I'll ask the senior, can you show me your blood pressure cuff? Are you checking it? They'll say, yeah, I check it every once in a while. And I say, all right, well, can you show me your blood pressure cuff? And we open it up and either there's no batteries or the batteries are all corroded. And like, it just, it's evident that they're not checking their blood pressure. So I'm glad.
CHRISTINA: I hope. So it sounds like it's really important to know what you're supposed to be checking, right? And have the right equipment.
DAVID: Right. Yes, absolutely. So know what you're checking. Be familiar with what vital signs to be checking. Make sure you have the right equipment. And then, so does, does mom know what to do? Like if her blood pressure, let's say she woke up one morning and her blood pressure was 180 over 100, would she know what to do in that situation? That's a high blood pressure. So would we lay down and hope that it comes down. And so that's the next step. So one, does mom know what vital signs to be checking? It sounds like she does, that's great. She's checking her blood pressure, checking her pulse oxygen level. She has the equipment, so that's the next step. She has her pulse oximeter, she has her blood pressure cuff. Now, the next step after that is, does she know what to do in a situation where she finds her oxygen level is dropping low? She checks her oxygen, it's 85%. We want to know that senior knows what to do in that situation. Are they calling the doctor? Are they we don't want them to we don't want them to do what mom's gonna do Which is lay down and rest and hope it comes down.
CHRISTINA: So how do you find out what to do?
DAVID: Well, we gotta get somebody to the doctor. We gotta get that senior to the doctor, talk with the doctor, ask them, and what we can do is have them actually write down in those situations what should somebody do in that situation, and having what we call parameters. If your blood pressure is above this or below this, this is what you do. If your oxygen level is below this, this is what you do, and have very specific instructions from that doctor so that way they know what to do in that situation, how to respond.
CHRISTINA: So this probably kind of alleviates panic, right? Or I don't know what to do or calling 911 or sitting there and doing nothing, is that correct? Yeah, that really makes sense and really understanding it a bit more. Okay, that sounds good.
DAVID: Right, absolutely. Yeah. Great. And so does mom know what she can eat, drink, and do that will affect her health condition? Is she on a special diet? Does she need to limit or increase her liquid intake?
CHRISTINA: That's a great question. For the most part, I think pretty good. I always do talk about hydration. I don't think she drinks enough water. Like she should be drinking. I think I've heard that kind of across the board with seniors, right? Hydration is not an easy one. Yeah.
DAVID: Oh yeah, critical. Yeah, one of the interesting tips that I really like about this is knowing what type, one way to help keep our seniors hydrated is to find out what type of water do they like to drink. Christina, you drink a lot of water. Do you prefer, do you prefer, there we go. Do you prefer room temperature water, water with ice, water with ice and lemon, what do you prefer?
CHRISTINA: I prefer just really cold water. So I like it plain, really cold. And I know a lot, no ice, nope, I don't need the ice. And it's so interesting because everybody does have a preference, don't they?
DAVID: They do, yes. My personal favorite is ice water with lemon. And if you give me that, I will drink a gallon of it. But if you give me room temperature water, it's gonna sit there all day. And so that's another great way. It's so important to keep our seniors hydrated. It helps in so many different areas, but really learning what is their preference for water, thinking about that yourself. Like, do I need to have some lemon on hand because that's gonna help encouraging me to drink more water.
CHRISTINA: Or alternatives, right? Like watermelon, like having alternatives to things that will help hydration. I think sometimes just people don't like water just in general. So things flavored water, something that has a little flavor to it. Maybe adding some electrolytes too.
DAVID: Yeah, definitely. All right, so we've talked about vital signs. We've talked about knowing what they are, writing them down. That's something else that I wanna mention really quickly is mom writing down her vital signs and tracking them. How's she doing with that?
CHRISTINA: Oh! Yes. It cracks me up because she has a calendar. She writes down something every day, but she's never shown anybody. I haven't even personally seen it, but I know she sits down and writes something every day.
DAVID: So that is another step that's really critical in helping keep our seniors' medical conditions managed and helping the doctor to know what does mom need is writing down those vital signs, writing down her oxygen level, writing down her blood pressure, and then not just writing it down, but then taking it to the doctor so the doctor can see it and say, oh, your blood pressure is trending over this direction over the last couple months. So let's either,your blood pressure's fine, we don't need to make any adjustments. Or let's go ahead and increase your medication, maybe we can decrease it. We're getting them out, we just had our, we talked about relaxation day in one of our recent podcasts, and so now we've gotten some more exercise, our blood pressure's starting to go down a little bit more, so maybe we don't need that blood pressure medicine anymore, or we can reduce it, but that doctor really needs to see those trends in order to make the best decision. A lot of times, what we'll see too, we'll go in and they'll say, oh, you know, maybe their blood pressure is high that day when the doctor sees them and they're like, oh, I just have the white coat syndrome, right? So the doctors like, yeah, the doctors are attributing it to that and really their blood pressure is high all the time, but then the doctor doesn't really know how it's trending. So they're making their best guess on how to prescribe medicine for this patient, but if they have a trend over time.
CHRISTINA: I hope we can. It makes me nervous and excited.
DAVID: Oh my gosh, I would I would love that if I'm a doctor to be able to see how are how are things going? How can I best help care for you? Yeah so the next question is does mom have a reconciled medication list and what I'm what I mean by this is has she been to her doctor recently, preferably within the last year? Because what we often see is that seniors will have a kidney doctor, a nephrologist, they'll have a lung doctor, a pulmonologist, they'll have a heart doctor, a cardiologist, and they're all prescribing these different medications and before we know it, you're on 15 different meds and they're all counteracting each other. So has mom been to see her primary care doctor to review all the meds she's taking and see that she's taking is interacting well and really what she needs to take.
CHRISTINA: So I know she's been to her primary care, but I don't think we have a really good reconcile list. I got a typed list from her, because I asked for a list, because I know we talk about this, David, right? So she typed up a list versus getting one from her physician. So that's a really good idea to get one from the actual physician.
DAVID: Yes, absolutely. So that would be an encouragement. And for any of our seniors or caregivers out there, if you haven't been to see the doctor within the last year, or if you've had some significant changes that have happened in the last year, get to your primary care doctor, let them review your list. You may be taking meds that you don't even need. Maybe we can get that medication list pared down from if you're taking a lot of meds, maybe we can narrow it down some.
CHRISTINA: You know, I think it happens a lot. I mean, when you start taking meds, let's just say in your 50s or your 60s, and you just stay on it, right? So by the time you're in your 80s, like who knows how many medications you're on, and do you really have to be on Ombud? It's a good question, and certainly something to be evaluated.
DAVID: Absolutely. Yeah. All right. So next question. Is mom taking her medication as prescribed? Is she consistently taking all of her medications?
CHRISTINA: So as far as I know, yes, but I know that can be challenging for many individuals because just having, making sure that it's all put in the proper place and are they remembering to take it. So do you have any good suggestions around that? Cause I've had questions from that from my friends.
DAVID: Yeah, I'm so glad you asked. We do have some great suggestions for that to help mom make sure she's taking her meds accurately. Is she currently using a pill box?
CHRISTINA: Yes.
DAVID: Metaplanner? Okay, great. And then when you go to her house, do you notice that she's taking it accurately? Like if you're going on a Thursday, are there still pills in the box from Monday, Tuesday, Wednesday? Or are all those days empty and she's up to date on Thursday still?
CHRISTINA: Well, that's a great question, because I really have never checked. I just saw that she had a med planner, so I just assumed everything's okay.
DAVID: Yeah, so that's a good thing to check, is to compare her medications. Maybe even ask her to show you how she's filling that metaplanner. Another great option that we found is a pill dispenser. One that we really love. We recommend the Hero Pill Dispenser, which is an automated pill dispenser. You can get the app on your phone and see has mom taken her medications, or it will give an alert if, you can see, she taking her meds, you'll get that alert on your phone. And you can stock that once a month with her medications. And I just, I love that as an idea to help keep track of, is my loved one taking their medications?
CHRISTINA: Yeah, that's a great idea. And I've also seen that pharmacists can put together like a blister pack, right? Which I think can be really nice and have it all taken care of so you don't even have to think about it.
DAVID: Oh yeah, blister packs, yeah. Yeah, and then you can track that just as easily. I love that's a great idea as well. So talk to your local pharmacy about if that's something that they can provide for you. There's a lot of providers that have started to do that. And then our last question, and this can be critical. Does mom have a reliable plan to get her medications when she needs them? If she's running out, if she's got three or four days left, or if, let's say for example, that she has an infection and needs to start an antibiotic right away. Does she have somebody or a plan? Can she go get her meds when she needs them? Or is that something we need to look at getting in place?
CHRISTINA: Yeah, I think that's a great question. I think for the most part she does, but I remember a time where she wasn't feeling well and it was really difficult for her to get out and to be able to go get her medication. So I think she skipped a couple of days. And so you bring up a really good point to have something in place when they're feeling good. It's also when they're not feeling good.
DAVID: Yeah, that's a great point, especially in those situations where if somebody has a UTI or pneumonia or something is going on, the flu, and they can't get out and get those medications, those are critical times that they need to continue to take those medications or get new meds if the doctors prescribe them. So what is that backup plan? So those are our seven questions that we recommend looking at. And hopefully as we get these addressed for mom, then we'll be able to help keep her safe and out of the hospital by addressing these areas.
CHRISTINA: You know, it's really interesting because if you break them down, they are, they really are basic and simple, but it's just so impactful when you put them all together. It really makes sense, doesn't it?
DAVID: It's critical. It absolutely is.
CHRISTINA: Well, good. This was really good information today, David. I got a little fine tuning to go back when I see my mom next.
DAVID: You're welcome. Yeah, absolutely. And we're always happy if any of our listeners, if you have questions about how to manage your loved one's medical condition, or you heard something that was shared today that you wanna learn more about, please reach out to us. We're very happy to take questions. We'll address them during our next episodes when we have time.
CHRISTINA: All right, thanks for joining us today with Life Conversation.
Thank you for joining us for Episode 3 of 'LIFE Conversations with Senior Helpers.' This episode's focus on effective management of medical conditions in seniors is a vital resource for caregivers and families alike. We hope the practical tips and expert advice shared will empower you to provide the best care for your senior loved ones. Stay tuned for more insightful discussions on senior care in our upcoming episodes.