Who Is Right?

An adult child responded to one of my visit reports in which I had written about her Mother’s use of portable oxygen. She replied that her Mother really didn’t need it; her attachment was all psychological. The adult child told me the Mother had been previously evaluated for respiratory functioning and found “barely qualified” for oxygen. I replied that my observations didn’t confirm that; Mother was currently gasping for air upon exertion.

After a hospitalization, the tests showed the Mother had pneumonia. Pneumonia can be subtle in the way it looks to observers. We might think of it as a disease that leaves the patient unable to breathe at all unless aided. Not really. In my years working with seniors I’ve noted a variety of presentations. Some seniors describe a “smoker’s cough”. Some seem to have a cough that just hangs on. Some report they have “allergies” (that present as a cough). Some of these self diagnoses turned out to be pneumonia. This is a factor that should not be left to chance.  Remember Jim Henson (the creator of the Muppets) died of an untreated walking pneumonia.

We need to check because what we can see may not be the whole story. For example, I asked one of my social workers about a reported reference to a senior’s cough. She said the senior had this symptom for some time. I required her to get the senior an evaluation.   The tests showed a severe pneumonia that required hospitalization!

How can caregivers know; we’re not doctors? When I talk to seniors, I keep these three points in mind; frequency, intensity, and duration. When the cough has hung on a long time, it’s a duration indicator. Ignore self diagnosis and get an evaluation. Why, because seniors are more at risk. They may not be as active, they may be overweight, or they may have compromised immune systems. Just because a senior was once evaluated doesn’t mean they are still functioning in the same way.
Who was right; both of us. The adult child observed her Mother clutching the oxygen tanks.   She did. I observe the Mother struggling for air when she transfers to and from the car. She did. The evaluation didn’t throw out either observation, it linked them. The Mother was struggling and responded by becoming hyper aware of her oxygen tanks.

It’s helpful to remember this tale when home care, or facility staff report an issue. Their report may differ from your observations. Evaluations help provide answers and directions. Ignoring reports can lead to more complications.