When an older patient comes to see me, I add to the vital signs a simple question with profound significance to our encounter. Do you feel lonely? Are you happy? Patients are often surprised by my interest in other areas than their anatomy.
You may want to know my definition of an older patient. It is actually not defined by the number of years lived so far but by the quality of life you have lived or experienced.
A good sign among the vital signs is the fact that the patient made the appointment and actually came to see me. You will note if the patient is by him/herself or accompanied by a family member or a friend. Those are clues to start a conversation about whom they live with, what they do, retired or not, asking questions, organizing a family gram. That is the names and members of the family. I add next to the names, any known medical history such as diabetes, hypertension and any other medical issues.
Every patient has had parents even if adopted. I like to ask first names for their family members, dead or alive and also for their friends. I make a theoretical person a real person with a name and perhaps I find more information through them.
Another vital sign is to understand the cultural background of the patient and the family roots. We in the US are a nation composed of many peoples from the Native Americans to the most current immigrants. So many different ethnicities and languages, cultures as distant as possible, foods of different countries adapted to our own US cuisine. Is there a typical US cuisine? Well, it depends on which State you live, the Southern biscuit, the Californian kale and grass salad, the Maine lobster, the every State Burger and hot dog.
Is the Covid-19 pandemic a lingering shadow for loneliness in our society? It is certainly a reason to explore the patient’s status in his/her milieu. Isolation, loneliness preceded the pandemic or worsened it?
At the height of the pandemic, lockdowns, social distancing and restrictions on gathering were measures to try to contain the virus. Social interaction was disrupted, families and friends were forced to be isolated. Remote work and online schooling replaced face-to-face connections. The human in-person interactions were no longer. Isolation was a necessity. It became a daily routine.
While loneliness affected people across demographics, certain groups’ particularly older adults were hit particularly hard. This group of older adults already at higher risk for social isolation, experienced loneliness due to health related limitations and fear of getting contaminated by the virus. Many senior care facilities restricted visits and the older population was challenged to adapt to digital and technological solutions, tools they already had difficulty with.
If you have elderly parents, make sure they participate in your life, socialize as much as possible, and exercise on a daily routine. Walking is an exercise, stretching and strengthening your muscles imperative as well. Watch television with family and friends, learn or resume card games and any other social game they take interest in. Walking through nature, Central Park is readily available, free and beautiful. Call your family often. Visit them when possible. Bring flowers or chocolates or whatever will make them smile and happy you thought about them. Do it frequently.
Don’t forget it is your turn now to look after your elderly parents and friends.
DR. ALBERT LEVY
Family Practice Physician
www.manhattanfamilypractice.com