How To Survive Old Age (Your Own or Someone You Love)

Bits of the Book

OLD Cover  SMALL-watercolor-web copyRosalynn Carter calls "Hope I Don't Die Before I Get Old"

"A very useful resource and guide for successful aging"

For easy reference, each chapter concludes with  information boxes detailing   the topics discussed in the story.  From Chapter One:

Choosing a Doctor

Nurse Practitioners or Physicians Assistants
    These professionals are a good choice for some people.   The advantage is they usually spend
more time with you and their focus is on building health thru education and informed choice.
They will refer you to the proper specialist if one is needed.    
 Concierge Medicine
    MDVIP has a network of physicians nationwide. We were pleasantly surprised at what a difference there was between our new doctor and conventional medical practices. 


What Do They Do?
    For an annual fee,  you get 24/7 access to your doctor, no time limits on your medical appointments, and no waiting in the waiting room. If you are traveling or if you need a specialist, you have access to their network of doctors all over the country.  Their orientation is to build and maintain the health of their patients, not just to fight the fires when one gets sick.  In addition, they have access to the best testing and diagnosic specialists across the country and the privilege of fast appointments and no waiting extends to this network.  If you have ever suffered and worried while waiting for an appointment with a specialist, you will appreciate this feature very much. 

How Much Does It Cost? 
    The average yearly fee is around $1,500-$1,800 per person.  Some  practices offer family rates.  After that fee is paid out up front, then the doctor will take all the regular forms of insurance, including medicare, to cover office visits, medical procedures, etc. just like in a conventional practice.   As Nancy Udel of MDVIP explained, concierge services are different from conventional medical practices because “while a doctor in a conventional practice may have anywhere form 2500 to 4,000 patients, the doctors in MDVIP have no more than 600 patients. With fewer patients, the physician has time to really make plans to support a patient’s health and their progress towards their wellness goals.  Each patient typically has a 1-1/2 to 2 hour visit annually for this purpose.”
You can find a concierge doctor near you at the MDVIP web site:


Tips for a Successful Doctor Visit

  • Ask for enough time. Be sure the receptionist understands the reasons for your visit. If you have a lot of questions, tell her you may need extra time in the doctor’s schedule.
  • Get a spiral notebook to keep a log of questions that come up, symptoms, reactions, and improvements. Take it with you to the doctors and write the notes from the visit in it. Get the three-hole punched kind and put them into a loose-leaf binder along with some pocket folders for loose papers, brochures, recipes, etc. This keeps everything in one place for you and your fellow caregivers.
  • If going to a new doc, have medical records sent over ahead of time. Check the day before to be sure they were received.
  • Take a complete list of current medications and supplements, and include the dosing and frequency of taking them. Include over-the- counter meds. Or put all the pill bottles in a bag and show them to the doctor.
  • If you have a question about something you have read, bring a copy of the article along to show and leave with the doc. If several siblings or caregivers come to the appointment, have a plan of who does the talking. It is confusing if everyone chimes in, so decide ahead of time who presents what. Let the patient do as much talking as possible, but refer to your question list and don’t leave anything out.
  • At the end of the appointment, repeat back the diagnosis and the tests, drugs or therapies prescribed.
  • Ask for the plan for contacting you about test results.
  • Ask how or when the patient might be getting relief from symptoms.
  • If there are no answers yet, ask what the doctor thinks is causing the symptoms and why.
  • Once you are satisfied you have communicated with your doc, and you understand and agree with the plan, then keep careful notes of any progress.  Have a little patience but report any negative outcomes right away; such as side effects or worsening of symptoms or any new problems.
  • Tell the doc if the recommendations seem out of the realm of possible. For instance if something like jogging or cutting out sugar forever is advised, and you can’t do that then your doctor needs to know if you need extra help or inspiration to tackle something that may look easy to him but impossible to you.
  • Put follow-up suggestions on your calendar and really do follow up.
  • If you leave the room feeling smarter than your doc, go home and think it through. Did you feel respected by the doctor? Were your concerns and questions taken seriously and answered fully? Remember that the doctor is the expert here, but if you feel incomplete about the relationship, or have doubts about him or her, get some other opinions.
  • Ask for a copy of your medical records regularly. Request a correction if anything is wrongly noted. Reading your records is a great way to check on your relationship with your doctor and his staff.
  • If all else fails, get another doctor if you can. Sometimes doctor and patient are just not a good match, temperamentally. (For instance, if you and your family are nervous Nellies, you may not be happy with a confident, breezy style.) Many people choose to see nurse practitioners or physician assistants for their primary care or even specialty care. The advantages are that they often spend more time with you, their focus is on building health through education by working with the whole patient and offering informed consent about your care to you. 






Malnutrition and Dehydration

Malnutrition is a common problem and is often hard to spot in the elderly. Progressing slowly or rapidly over time, depending on individual situation, it leads to a rapid decline in health and vitality.

Possible causes include:

•   Medical problems that require medications that interfere with appetite or absorption of nutrients:

•   Restricted diets, no sugar, no salt, etc., can lead to poor food choices

•   Alcohol intake can interfere with nutrient absorption, appetite, and substituting alcohol for food often occurs

•   Limited income for food

•   Depression can lead to poor appetite

•   Social isolation

•   Digestive disorders

Signs of malnutrition:

•  Poor wound healing

•  Weight loss

•  Bruising easily

•  Teeth problems

•  An empty refrigerator or old food in kitchen

Dehydration is common in people over the age of sixty-five for a variety of reasons. Dehydration can occur at a faster rate in the elderly, so you should know the signs and symptoms. It is difficult to diagnose dehydration in its early stages; as a result severe dehydration often results in hospitalization. If not treated it can be life threatening and even result in death.

Causes include:

•   Decrease in muscle mass

•   Increase in body fat

•   Medications

•   Simple illnesses like colds or flu

•   Decrease in the sensation of thirst

•   Gag reflex weakens

•   Swallowing disorders

•   Purposely decreasing fluid intake for fear of incontinence 

Signs and symptoms:

•  Dark and malodorous urine; decreased output

•  Fatigue and lethargy

•  Confusion and weakness

•  “Tenting” of skin on back of hand. (Pull up the skin on the back 
of the hand, and if the skin does not return to its normal state 
within a second or two, it could be dehydration.)

•   Severe headache or dizziness


Drinking six to eight glasses of water a day, you may want to include electrolyte enhanced water which you can buy in most grocery stores.

Consume fruits and vegetables that contain water (strawberries, lettuce, cucumbers, watermelon, soups)


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