Thursday, November 19, 2009

Tips to Help the Elderly through Their Medical Tests

What seems like a simple medical test to the average adult can be significantly more challenging to the elderly person whose health may be more frail.

Here are a few reasons to take extra care when an older person requires a medical test.
The elderly are more likely to have vision, hearing, and cognitive impairments that make it difficult for them to follow instructions or understand what must happen for the specimen to be properly collected.
Older people have more problems with balance and mobility, factors that can make some samples physically harder or more dangerous to provide.
Even a blood test can be more difficult because the skin is thinner, the subcutaneous tissue is less resilient, and the veins are more fragile and prone to tearing when punctured. The person may prefer one phlebotomist in particular who handles them well.
For a person with dementia, even a brief sample collection procedure can be traumatic and lead to a catastrophic reaction by the patient. In this case, the need for testing must be even more carefully scrutinized.
On top of all the physical and emotional challenges, financial constraints and details can deter an elderly person from undergoing a test that can make a significant difference in the person’s health care and quality of life.

If testing is a burden for someone you know, talk to the physician about the situation. "Always discuss why the test is needed and how it will affect ongoing care or alter the course of therapy," emphasizes geriatrician Rebecca Elon, MD, MPH, Medical Director of North Arundel Senior Care, Severna Park, Maryland. Be sure that any test ordered will provide necessary information for clinical decision making. The following are suggestions to help elderly patients through some of the practical matters of collecting a test sample.
The Challenge of Getting There
Transportation problems are common for the elderly, who may not drive and may be dependent on someone else to take them to their medical appointments. Reducing stress on the driver can make for a more positive experience.
Planning AheadIf you must go somewhere unfamiliar for a test, get good directions on where you must drive and where you must walk; this will help eliminate stress. Find out if it will be easier for the person having the test to be dropped off at a certain entrance. You may also want to inquire about busy times and plan to avoid them.
Staying HomeIf the person who needs the test does not drive and has difficulty arranging for a ride (or even for someone to transport the sample), inquire about onsite or home services.
Issues of Safety
Falls are common and especially serious in people over age 65, and bathrooms can be particularly hazardous. Pay attention to safety when you are collecting a urine or stool sample, particularly for individuals who have mobility or vision problems. Your focus on the collection process may prevent you from noticing hazards or unsafe conditions in the room, so gather what you need and plan ahead.
Trippingbefore you begin, you can remove scatter rugs and loose mats.
Slippingbe on guard for spills and a slippery or wet floor.
FallsEncourage use of grab bars or other supports near the toilet area to help prevent injuries from falls.

The Need for Help
It is not uncommon for an elderly patient to need some assistance or accommodation when taking a medical test. A person with arthritis, joint stiffness, or other mobility problem may find it difficult to obtain a urine or stool sample without some help. A woman with dementia may be unable to follow the instructions on obtaining a "clean catch" urine specimen; she may also become confused or agitated when someone tries to do this for her. A person who does not see well or has poor manual dexterity can have trouble using the required equipment, such as specimen cups or blood glucose monitors for diabetes.

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