Forty-Seven Years Ago Today
Elder Thanksgiving Preparation

The Return of the TGB Geriatrician

category_bug_geriatrician.gif Newcomers to this blog may not know that back in 2008, one of our contributors was Dr. Bill Thomas, a world renowned geriatrician who is also an author, blogger, creator of the Eden Alternative and it is one of his books, What Are Old People For? that has informed this blog from its beginning.

BillThomas2010 Most recently, Dr. Thomas has partnered with the Picker Institute, a leading foundation for health care reform that places a person's needs, interests and desires at the center of their care. Together, Picker and Dr. Thomas have created an advocacy program called RealCareNow that uses blogs, videos and other social media to promote patient-centered care.

And now, Time Goes By will be part of that reform movement. Beginning today and regularly thereafter, Dr. Thomas and I will chat via video about elder health.

One day last week, we recorded the first episode. I've coached a zillion people about how to relax on camera but as you will see, I'm not very good at it myself. So please forgive my awkwardness – I'll get better.

I'm looking forward to the future of this collaboration. Edited versions will be posted here and at YouTube. Soon, there will be live episodes that will incorporate a chat function so that you can send your comments and questions during the show.

Another way that we would like you to participate is to send in your elder health and medical questions for Dr. Thomas. You can do that today, in the comments below and we will select some for future shows. The only caveat – I'm sure you are aware of this – is that Dr. Thomas cannot answer questions specific to your personal health issues.

I'm so pleased and proud that Dr. Thomas as rejoined Time Goes By. As Bogart once said, I think this is the start of a beautiful – and healthy – friendship between Dr. Thomas and TGB readers.


At The Elder Storytelling Place today, B.J. Allen: Waiting Room

Comments

To use some youthful lingo about your video, "how cool is that." Look forward to all the future videos. Especially, ones on "slow medicine" for elders -- a concept I am unfamiliar with. You did well Ronnie. -- barbara

"Slow" medicine - I've never heard that phrase, but it surely makes excellent common sense. Doctors are so overworked and pressed to see x amount of patients per day, and efficiency and speed are the rules of the game: 10 minutes per patient and onto the next.

Though I am not a full time care giver for my elder mother and mother-in-law, I am guilty of wanting to get my "chore" - whatever it may be - for them over and done and move on with my own life.

I don't begrudge them any of my time, but it does seem that it just complicates things when I try to rush through any given task with them.

And because they often feel guilty about requiring my time, they tend to not fully explain what it is exactly that they truly need or want done.

I will try to take the "slow" lesson to heart, Dr. Thomas.

Great first start, Ronni!

Ronni, this is absolutely fantastic. You look great onscreen. I hope your ex-bosses see this and poop their collective pants over what a smart woman they let go.

Dorks.


The video was just fantastic and I was able to hear every word. I had been afraid that I would not be able to participate due to not having captions, but you both enunciated so well I heard it all.

This is a great idea and I am looking forward to the next video.

I wonder if 'slow medicine' means that the health care provider allows the elder patient more time than the quick "How are you? What can I do for you today?" that doctors now greet you with.
I am anxious to hear more.

You have a beautiful smile, Ronni, and I don't see how you can improve. You were very professional.

Excellent, loved seeing you do your thing, you're really great at it. I'd like to see the issue of overmedicating elders addressed. Many of us do not metabolize or pass off meds as fast or as throughly as younger people and are at risk for being overmedicated or overdosed.

Awesome....as my grandkids say.

My biggest issue is my inability to explain what's wrong with me...or sometimes even remember what's wrong with me.

Topic suggestion: caregiving that involves the very old. My impression (may be wrong) is that most of your postings on health-related issues seems to involve folks in an age range of, say, 55 to 80. That may be partly because computer use drops off sharply after that age. But I'm the primary caregiver for my 93-year old mother whose issues are a bit different & I'm guessing there are others like me among your readers. Resources, online or other, are meager for us. Thanks for everything you do.

Bert - you are correct, partly. My mom is 79, and my mother-in-law is almost 87.

My 79 year old mother has worse health issues than my 87 MIL, but both are to the point where someone needs to personally check on them every other day if not daily.

They both live alone, and are still driving small distances, but that's on a day to day basis.

Tomorrow may be a whole different ballgame.

Loved it, Ronni. Beyond the match you two are, and almost seeing your inner wheels turning, your smile and blue-green eyes wowed me (and I remembered your late spring/early summer discussions on dentures. Kudos to the technician!). You are holding a cell phone, and I only do so when I'm living in Israel with no landline and associated chunky receiver... something solid to really hang onto! About content/question input... people remember short lists. Perhaps Tips on XYZ might be a useful conclusion to each segment.

Ronni, I can't hear you because I need a new sound card, which will be added to my computer in two weeks. I watched the video anyway. You look good and you have wonderful teeth, which I assume are all yours.

This is terrific! I missed any nervousness, Ronni. I really like the statement that adult medical care is as different from elder medicine as it is from the medical care for children. This is something that really needs to be absorbed into to mainstream thinking.

I was appalled at how my Mother was treated by her doctor. He completely ignored her being in the room and talked directly about her situation to my sister and I. I was too shocked to respond appropriately at the time but I know this happens often. It was an experience I will never forget!!

Perhaps somewhere in these conversations about our care, can we offer some responses to these kinds of situations that will serve to strengthen the medical relationship? How do we address our needs without distancing the physician?

Again, great idea!

Schmidley...

Well, the teeth are nice, but the upper ones are not my own. Last spring I wrote about my denture adventure. Here's one of them.

Fantastic! I am imagining a format sort of like Suzie Orman's, with many different questions being brought up by individuals!

Can you use a lapel mike or would that not be loud enough? Would be nice to be able to ditch the cell phone. My brother-in-law, Gunnar Akner, trains physicians in Sweden in geriatric medicine. We have great conversations when he visits!

Bravo!
I'm looking forward to the conversations.

Wonderful! And, looking forward to more Q&As!

Great news that Dr. T is back. Loved the video exchange. Some of my concerns: Portable medical records, use of PAs and/or Nurse Practitioners in elder care, Drs. refusing new Medicare patients, education of the consumer as their own advocate, getting respect (being listened too) and the differences in aging medical incidents, if any, between men and women. I've always thought that men tend to go along pretty well and then have a fatal incident with a quick end while women tend to come apart piece by piece, sort of like the Chinese water torture. Is this true? It sure feels like it from where I sit! -- I'm looking forward to future episodes.

Great job! Great idea as well! A topic I would like to see addressed is what I perceive to be a tendency to medicalize normal aging (whatever that is). It is difficult for me sometimes to know what needs treatment and what is just the new status quo. MDs often approach everything as a symptom that requires working up. I'm all for reasonable intervention, especially if it improves quality of life but I really don't want to spend all my time in the doctor's office either. By the way, I'm a retired RN. I feel as though I should be able to figure this out but my experiences with my father before his death taught me otherwise. I look forward to this series!

It is really too bad about the lack of geriatricians. And it's true that other physicians and other health care workers will have to take up the slack.
You look very good and professional, Ronnie. I am looking forward to more of these videos.

If it is true that in order to get into heaven one must rack up points for good deeds done while living, your dance card is about full.
Take a bow for another well done deed. This one with the Doctor will make a difference!
Tamar, um, the tips on XYZ? ...when I was busy raising sons xyz was a signal for the boys to 'examine your zipper'.

Ronni, your voice is so wonderful! It is a pleasure to hear you speak. So strong and forthright.

It was such a pleasure to see and hear you after reading your blog for so long. And I agree with the others that you look great with a wonderful smile!

I'm a (nearly) retired RN who accompanies her (nearly) 90 yr old mother to the doctor. I am so pleased with how he treats her. He takes the time to listen, has a great sense of humor, removes meds when I suggest she may not need them, as in this case, her BP was low enough to make her dizzy. He prefers to not add new medications unless absolutely necessary precisely because of the side effects, particulary on the elderly. I think he could be the poster doc for geriatric medicine--and it's not even his specialty.

One possible topic to address (though I know you have yourself in the past) is the usefulness of geriatric care managers. My mom has me; however, if I were not nearby, she would really benefit from someone checking in with her regularly to ensure her needs were being met, that she was eating well, and just for social stimulation.

So glad to see you two teaming up!

you did a great job both in bringingout this segment and on your first episode.you were tense only for a couple of seconds at the start and after that it was smooth.It was nice to finally see Raring to go Ronni and hear the voice of our fav blogger.

Good to see this here. I was aware of the Eden Alternative many years ago, but haven't heard of it since. Is it still going on?

Can't imagine what you meant by awkwardness....you seemed real and sincere. Congrats.

I enjoyed this video, and am looking forward to the videos to come. Looks like we oldsters have a lot of work ahead of us -- to educate our health care providers as to how to take care of us! I am fortunate here in Northern Michigan to have doctors that actually take the time to listen to me and are, as much as possible, tailoring their care of me to meet MY needs. (Now if I could just get rid of winter.)

This sounds like a really good new feature for TGB coupled with the added exposure through YouTube.

Look forward to the videos and ideas discussed. Will pass along a link to all this to my Doctor who, perhaps, has come to think blogging may have significant value after all my proselytizing.

I am so looking forward to this series. Thank you Dr. Thomas and Ronni for re-establishing this relationship.

Dr. Thomas, could you please return to the explanation of slow medicine and discribe in detail and with examples what this sort of medical practice means to you as a doctor? If I know about you practice, I can, as a patient, be more active in trying to observe how my own doctor does or does not offer the various points.

Could you also please mention any examples of exercise plans you know that center on health and not just fitness.

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