I recently received a letter from a reader concerned about a problem some of her friends are facing. Either they—or their spouse—have been released from the hospital but remain weak and in need of care. These are couples in their 80s or 90s, and she wonders if any type of medical support is available after hospital discharge.

Let’s begin with the discharge process. Before a patient leaves the hospital, the medical team—including social workers and discharge planners—assesses the patient’s condition, care needs, home environment, and available support. The goal is to determine whether it’s safe for the patient to return home.

Whose responsibility is it to remind older adult patients of their next programmed appointment?

Let’s say a patient is supposed to have an in-office procedure every six months. For whatever reason, that appointment was not booked in advance.

In a perfect world, both the physician’s office and the patient would share responsibility for ensuring the patient adhered to their treatment plan. The office may explain to the patient that they need to make a repeat appointment in six months, and the patient may put a notation on their calendar to make that appointment in the future.

But is that enough?

Last week, the administration sent a memo seeking to pause potentially trillions of dollars in government loans, grants, and financial assistance. That memo was later rescinded, but it did create confusion and uncertainty, particularly in the nonprofit world.

While we are not sure what the future holds, a substantial amount of local Meals on Wheels funding is through the federal government, handed down to states and counties through Older Americans Act grant funding.

Each year, through Senior Concerns’ Meals On Wheels/Home Delivered Meals programs, we deliver over 65,000 meals to 450 homebound seniors. These seniors reside in Thousand Oaks, Newbury Park, Oak Park, Westlake Village and Agoura Hills.

Right after the Thanksgiving holiday, while we were chatting on the phone, I asked my 90-year-old mother what she was doing.

She told me she was in the den in her recliner with her feet elevated. She explained that for the last few days her ankles were swollen and her legs felt tired.

She said, “Yesterday, I elevated my feet very high. The swelling has gone down a little, but one of my legs feels very heavy.”

She attributed it to too much salt.

When I explained to her that swollen feet and ankles and heaviness in her legs might be signs of a heart issue, she said ardently, “I know, I read that on the internet.”

Recently, my mother’s 88-year-old sister fell.

As she went down, her husband said, “You just broke your hip.”

I am not sure if being a medic in the army sixty years ago qualified him to make that diagnosis, but he was right.

My aunt and uncle live about 90 minutes from their only daughter, my cousin Beth.

As Beth rushed to the hospital, I am sure she was thinking of her mother, but also about her husband who was currently receiving chemotherapy and radiation for a tumor in his throat. He had been having an extremely difficult time eating and lost almost twenty pounds in a matter of weeks. The doctors were talking about inserting a feeding tube that week.

Beth arrived at the hospital and learned her mother’s surgeon wanted to perform a total hip replacement. They were checking her heart to ensure it was strong enough for the surgery.

Conversations with aging parents require compassion

I recently witnessed a conversation at a restaurant between a woman and her mother. The woman appeared to be in her fifties or sixties and her mother in her seventies or eighties.

The waitress was quickly listing the specials of the day, looking down at the table as she poured waters for the ladies.

The mother, who appeared to be having difficulty hearing the waitress, remained silent as she tried to piece together the jumbled words.

As the daughter waited, she used the situation to say, “See mom, this is why you should not be driving anymore, you can’t hear.

Many years ago, I volunteered at a hospital. 

One of my duties was filling in for the floor secretary (remember, it was years ago) when she went to lunch or was on break.

As part of the job, I had a copy of the census or a listing of all the patients on that floor, so that when a physician or lab tech came to see a patient, I could direct them to the right room.

Next to each patient’s name was their primary diagnosis.

Almost half of the patients had a diagnosis of sepsis. The Internet was not around at the time, and I left my encyclopedias at home with my parents when I graduated college, so I really had no way of knowing what sepsis was, but I could tell it was prevalent.

With the issue front and center in President Joe Biden's bid for reelection, discussions about age-related memory challenges are receiving much attention these days.

Here at Senior Concerns, we frequently hear these concerns. It is often the reason that someone reaches out to sign up for our free neuropsychologist-led memory screenings.

When people call, they say “I don’t remember information as well as I once did. Last week I could not remember where I parked the car in the mall parking lot,” or “I’m having difficulty coming up with the right word at the right moment, and the harder I try to remember, my brain locks up.” They want to be tested to see if their concern is warranted.

The cognitive test the neuropsychologist uses is a short, quick test to check how well a person’s brain is functioning. These tests don’t diagnose specific diseases. Instead, they identify a problem with cognition and the need for more in-depth testing.

Our body is a wonderous interconnected organism.

We learned that fact as kids. Remember that old song, “Dem Bones.” The leg bone's connected to the knee bone. The knee bone's connected to the thigh bone. The thigh bone's connected to the hip bone. Now shake dem skeleton bones!

As we get older, that system is more fragile, and when it is thrown out of balance, a warning, in the form of pain, may appear in a totally new place. That’s what happened to me.

At almost 66 years old, I have been fortunate to never have lower back pain. Until now.

Lying in bed hurts, sitting in a chair hurts, walking hurts and bending down to pick up something off the floor hurts. Not incapacitating hurt, but I certainly have new appreciation for the folks who have back pain in their lives.

I am unsure how it came to be, but over the last number of years I have become rather involved in the topic of end-of-life choices.

For one, I sit on the Steering Committee for the Ventura County Coalition for Compassionate Care (VCCCC), a nonprofit organization advocating for the discussion and documentation of end-of-life wishes.

One of our projects I am most proud of is a 15-minute public service video we produced with Kerri Kasem, the daughter of radio host Casey Kasem. Along with others in the video, she demonstrates the importance of making healthcare decisions in advance, documenting them, and discussing them with physicians and family. You can view the video at www.vcccc.org.

Secondly, I sit on the Clinical Ethics Advisory Committee for a local hospital.