An older person often needs a special kind of a doctor -- someone who knows and understands geriatrics.
Unfortunately, there are only 500 or so such doctors in the country. Still, you can be on the lookout for this type of doctor or one who has a good, general understanding of treating older people.
A good place to start is the nearest university medical school. More and more of these schools are setting up special departments and "teams" that deal with older patients. Or, someone at the school may know where geriatric specialists can be found.
Why is it a good idea to find someone who understands the special needs of the older patient?Because all too often an internist or general practitioner will not solve your problem and will just say: "This happens when we get old."
Dr. Bobert Butler, the head of the National Institute on Aging, tells the story of an older man who saw his doctor about a pain in his knee. The doctor looked at the knee and shrugged, saying: "These things happen when we get older."
The patient was furious. He replied: "To hell with that 'get-old' stuff, my other knee is fine and it's the same age as the one that hurts."
The patient was right.
"We have a team of people that works with older patients," says Dr. Valery Portnoi, director of geriatric medicine, George Washington University Medical School.
"You don't give routine checkups and just react to pathology with older patients," says Dr. Portnol, explaining that "you have to determine how the patient is functioning in the home and in the community."
Instead of giving the patient tranquilizers (which are costly and potentially dangerous), Dr. Portnoi's team finds out if something is depressing the patient. Maybe it's worry about the rent money or loneliness or some other non-medical reason. Then, a social worker or a legal-aid specialist goes to work to help solve the problem.
There are certain things that should be checked every year, and in many cases the chekups can be done at no charge to the patient, or for a modest fee.
Blood pressure is an important item, according to Dr. Donald M. Vickery and Dr. James F. Fries, who wrote the book "Take Care of Yourself -- A Consumer's Guide to Medical Care." In many communities the local heart association gives free blood pressure exams and free heart checkups.
Eye tests for glaucoma are important, especially if there has been a history of this disease (which can cause blindness) in your family. Again, some communities offer free glaucoma exams through eye associations. Ask your local health department.
Tests for blood in the stool might be offered free through local Cancer Society chapters or at very low cost through your doctor. They can be done easily at home and mailed back to the doctor (who can send you the tests by mail). No expensive doctor's visit is necessary.
If something is bothering you -- no appetite, can't sleep, something has changed (swelling, lump appears, become hoarse, whatever) -- see your doctor and make sure you get enough time to be heard. Your doctor should have a good "history" on you and be hesitant to prescribe medicine.
Don't ask your doctor for medicine. If you're taking three or more medications daily (unless you have some very serious illness), you should be suspicious. See if you can stop one or all of your medications.
Your doctor should understand that older patients have certain needs. If you've got this kind of doctor, you have it made.
Q: How does the Social Security "direct delivery system" (where checks are sent to a beneficiary's bank or savings institution) deliver special information that normally is included in checks sent to the home? This information is most important, advising about new laws, changes in benefits and the like.
A: When you have your check mailed directly to a bank or savings institution, the "envelope stuffer" material is mailed separately to your own address. These bulletins do not come every month, so don't expect them with each check.
It's a good to have Social Security, Veterans Administration, disability and other checks mailed directly to a bank or savings and loan. This way, you avoid the problem of having checks stolen from your mailbox or the problem of being ripped off after you've cashed them at a local store. You can use a checking account or money orders to transport cash.
Q: Can latex paint be applied to a surface that has been painted with an oil-based paint? I recently purchased some latex paint and the directions said I could apply it to any surface as long as I sandpapered or roughed up the old paint. I did that, but now the new paint is peeling.
A: The paint experts tell me you're not supposed to use latex on top of oilbased paint. Perhaps the directions on your paint can said you could paint over an enamel surface, but the enamel is supposed to be latex.
Latex paints are mixed and cleaned with water instead of turpentine, which is used with oil paints. The latex needs to "breathe." Oil paint doesn't provide a breathing outlet, and moisture gets trapped in between the layers, which causes the peeling.
The only way to fix it is to scrape and sand the whole mess and start over. When in doubt, find out what paint surface you're covering before you buy new paint. Keep them matched -- latex on latex and oil on oil.