A nurse advocates proactive care for the elderly in this manual.
Many older patients, writes Fitzpatrick (co-author: What to Ask the Doc, 2003), face “unnecessary treatments,” including “tests, surgeries, and medications” that may actually exacerbate health problems. Her sensible approach is to start with the simple question “What is the goal?” as a guiding principle to help caregivers and patients make wise medical decisions. This practical book lays out a clear path to answering that question in a variety of situations, each of them well-illustrated via real patient examples. For instance, the author relates the stories of her own mother and brother, demonstrating how a proactive caregiver who understands what her relatives want can lobby for an appropriate plan of care. Other anecdotes depict how undefined goals lead to consequences, the importance of informed consent, how to address the special requirements of a patient with dementia, and the differences between palliative and hospice care. In one case, a patient with advanced lung cancer “and his entire family needlessly suffered because they were on the healthcare conveyor belt.” But the book is not merely a collection of tales; it also offers helpful information about DNRs (“Do Not Resuscitate” orders), patient specifics like feeding tubes and pressure sores, things to consider before going to a hospital, and advice about nursing homes and medication management. In addition to 14 highly informative chapters, the author includes six useful appendices, such as a decision guide focusing on whether or not to go to the emergency room, detailed items to discuss at medical appointments, and a chart of potentially harmful medications. All of the material is presented in comprehensible text with a minimum of medical jargon. Fitzpatrick is consistently positive and goal-oriented throughout; she does not hesitate to put the needs of the patient first, counseling caregivers on how to question medical professionals and, if necessary, challenge them. Writes the author: “In my experience, both personally and professionally, planning and communication hold the keys to a lower stress level.”
A compassionate, thoughtfully considered approach to caregiving.