Respect for Seniors

While medical horror stories are not new, I suspect that few Canadians have ever experienced health care through the eyes of a 99-and-a-half-year-old woman. If they had, they would know that advanced age and illness could be a toxic combination.

I have no background in medicine, but I know that a heart or stroke victim should be given priority in an emergency room. The death of my father-in-law years ago taught me that quick intervention could possibly minimize the effects of a stroke. And yet last month, my mother-in-law sat in the emergency room of the Lakeshore General Hospital for eight hours before seeing a doctor. Her symptoms? She fell, couldn't get up or walk, right leg semi-paralyzed, right arm semi-paralyzed and occasional garbled speech.

Even without the CT scan that later confirmed a stroke diagnosis, shouldn't there have been a little inkling by the triage staff? The Heart and Stroke Foundation of Canada lists five symptoms of stroke, and weakness in the face or limbs is one of these symptoms. A second symptom the Foundation describes is difficulty speaking. (The other symptoms are vision problems, headache and dizziness).

According to the Canadian Stroke Network, if patients are seen within three hours of the onset of symptoms, quickly given a CT Scan and the blood-clot dissolving drug t-PA (Tissue Plasminogen Activator), lives would be saved. Long-term damage would also be limited. If my mother-in-law had been helped within three hours instead of languishing in the waiting room for eight hours, there is a possibility that she might be walking today instead of being wheelchair bound and permanently exiled from her home.

Because blaming this interminable wait on triage staff ignorance of stroke symptoms is impossible, I am left with the heart-crushing observation that the triage calculus in Montreal might result in less urgency for seniors in distress. I fear that someone has decided that geriatric patients, who may never get their groove back, should not be given priority because of their advanced age.

I know that for years my 90-yearold father has joked about his GP's boredom with his aches and pains. He even believes that his doctor writes prescriptions for a full year so that he won't return and bother him so often. My father senses his doctor's indifference, and yet he has nowhere else to go. My mother-in-law has a GP who has a different modus operandi. Call for an appointment and the receptionist will inform you that if the doctor decides to see you, she'll call you back.

I had never heard of appointments by invitation only. I know that my mother-in-law never got a call back. Should she have used her American Express card to go to the front of the line, or is it her age that renders her unworthy?

Unfortunately, the medical nightmare only began with that eight-hour emergency wait. The next hurdle was a surprise diagnosis of dementia instead of a focus on her physical stroke symptoms. Before her arrival at the Lakeshore General Hospital, she was not spry but she was a chic, well-dressed woman in pearls who read mysteries, did crossword puzzles, played bridge, did her own banking and loved going to the dining hall on Fridays to sip wine with her friends.

This truth of her pre-hospital cognitive abilities fell on skeptical medical ears. On her fourth or fifth day, when they had moved her to an overflow room called Geriatric Daycare (which sensitive person thought up that moniker?), an attendant offered her diagnosis. "She's spoiled and used to getting her own way," we were told when we found her tied into bed, wearing a diaper.

While I'm sure that a neurologist tested and measured and analyzed, and while I do not doubt a hospital diagnosis, there are other, more primitive ways Lakeshore staff determined dementia. One day, a delirious Amy Winehouse-clone had usurped my mother-in-law's bed. When we found her delusional and so high on drugs that she could barely open her eyes or do more than mumble, we feared the dementia diagnosis was not only correct, but also that she was rapidly deteriorating. But soon after our complaints about a possible drug overdose, my mother-in-law returned to almost her natural, pre-hospital state.

Another way to prove dementia at the Lakeshore is to speak quietly, mumble and address an English patient in French, a language she doesn't understand. When a patient is hard of hearing, I think some attention should also be paid to volume and enunciation.

One day, a nurse informed us my mother-in-law had begun to deteriorate again. Fortunately it was just a hearing-aid battery that had died.

While identity theft is usually not attributed to hospitals, I can see how suddenly one's identity disappears when trapped in the health-care system in Quebec. After 70 years of being a Mrs., my mother-in-law was suddenly referred to by her maiden name. No one ever addressed her by her married name. Actually, few ever even addressed her or even established eye contact with her, preferring instead to address her visitors.

Growing old is no happy hour, but a senior should be able to find authentic medical treatment with a side order of dignity. That's not too much to ask for.

Freda Lewkowicz is a teacher at Rosemere High School in Rosemere and often writes about education.

Credit: FREDA LEWKOWICZ; FREELANCE

Word count: 758

Copyright CanWest Digital Media Mar 11, 2011


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