I've noticed lately there seems to be two groups of pt's we've had lately.They're either in their late 80's to 90's, or they are in their 50's.
we've also had quite a few of those 50's ( and even late 40's) die from eschf, or esrd.
and believe it or not, a lot of those 80-90 y/o are still living at home( and some of them still driving:wideyed: )
Interesting- is it the older are taking better care of themselves, have medicare, got to retire, enjoy medical advances,; and the youngers usually have no jobs( cant work ) no insurance , and no hope?
Any thoughts- anyone notice this on their general med floors?
I really can empathize with you. I too have experienced the consequences of my parents' lifestyle choices...and other members of my family as well. I didn't observe as much violence growing up, but I definitely feel like my experiences have strongly influenced who I am - good and bad.
My Mom died at 40 from a persistent inability to get her life together and manage her multiple health problems, many of which could have been handled through what we call lifestyle modification today. I was 8. I then went to go live with my Dad, who was definitely living an 80s kind of lifestyle and had priorities that didn't involve child rearing. I started out with four half brothers; I've lost one to acquired cadiomyopathy and liver failure due to alcoholism, and another has been in psych residential treatment since his early 20s. I am on speaking terms with my Dad, who lives several states away, but we have an odd relationship. My kids literally grew up without grandparents! (ironic laugh) All of my other family has passed away. (An aunt and uncle I was very close to)
I've been lucky enough to build my own family over the years -- I too have a somewhat muted affect. I have compassion for my patients in a way, but one thing that has actually been an attribute to me in nursing school and in my previous career was that I can effectively compartmentalize feelings; I view procedures and people very biologically. I'm pretty introspective, and there are some things I've been working on, but overall I feel I function well. My kids are successful and are strong, independent thinkers. Occasionally I get some weird feedback. I had a nursing instructor tell me, after a patient crisis, that I should have been born a man. I'm sure she meant it as a compliment but who knows LOL I just let it roll off my back. :)
Not to sound like a greeting card, but I try to see how my personal history has helped me to be very resilient. Sometimes I feel grateful that I can just keep plowing forward, no matter what blows up in front of me. I have flashbacks and stuff as well, but I try to leverage my negatives in to positives when I can. Running and meditating usually make me tolerable to other people LOL :)
It sounds like you have immense strength and resilience! I wanted to reply because your post really resonated with me. And to the OP, (so I'm not totally off track) I agree with your observations as well. I've had some very interesting patients just in my limited experience who were the same age as I (early 40s) and experiencing an unbelievable list of maladies. I'm not a health nut, but let's just say the year I turned 40 was pretty interesting for me....I experienced some big time health anxiety for the first time in my life, but just tried to leverage that in to changes I could control, and it really helped.
Commuter, thank you for sharing your experiences and ALL you contribute to this community! You really showed me that you never know what type of post is going to resonate with someone. :)
I read the obits daily. I commented to my husband that there seems to be an increase in the deaths of 50 somethings. That's scary to me as I'm a 50 something.
I'd not given the cause of the increase much thought, but reading this thread, has opened my eyes.
I have more of a restricted affect. My face displays some emotion, but not quite the same depth of feeling as most 'normal' individuals. I think I view people as objects and have the restricted affect due to early childhood traumas that no child should witness.
I witnessed occasional scenes of domestic violence as a kid, such as my father hitting my mother, yelling at her, or destroying the household furniture. One memory that resurfaces on a daily basis is of my father destroying the glass dining room furniture with a lead pipe to humiliate my mother in front of the houseguests. He also used a knife to cut up the sofa and loveseat set. As a kindergartner this memory traumatizes me to this very day.
Another memory involves my mother putting a rifle to her head, threatening to commit suicide.
And of course, there are memories of my father splitting his crack cocaine rocks with a razor blade at the kitchen table in preparation for smoking them. Meanwhile, bills went unpaid and the refrigerator remained perpetually empty because a significant amount of household money went to support his drug habit during these years.
I was diagnosed with PTSD about 10 years ago, although I have never spent a day fighting a foreign war. I feel really ashamed to admit that I have constant flashbacks, unresolved anger and deeply rooted resentment toward my parents from incidents in the past, but it is what it is.
I know I veered off-subject, but the hard living and years of unhealthful behaviors are reasons why they have multiple chronic illnesses in their 50s. I know this sounds cold, but I sometimes wonder what life would have been life if I had been born to people with better coping mechanisms.
PTSD can occur with witnessing trauma as well; I think we had this discussion on another thread as well; having my own PTSD from my own trauma due to DV, I'm surprised that I have survived, although therapy (I have two therapists) and a little atypical antipsychotic helps allow me to cope much more healthy than in the past.
What I have found is most of my pts who are in their mid 50s have had hard living and their own traumas, demons, and unhealthy coping; in turn their health suffered, or co morbidities from side effects from medication can occur; the medication I'm in had a risk of weight gain (check) and high cholesterol (have to check that tomorrow); Despite working in LTC, I have found the time to discuss these issues with each of my patients-I have 60 as a supervisor and 30 when I'm on the cart, so I have gotten to know each of them very well, despite the heaviness of med passes, unexpected send outs and falls, and required regulatory paperwork.
My floor is most unique due to the fact there are many with co-morbidities of health problems and mental health disorders, including drug and alcohol use, and harrowed socioeconomic issues, which has made me more cognizant due to my own path of life of how to approach pts; getting my own health in order has certainly helped me understand the WHY of how people cope, and how I can manage their health much better by meeting them where they are.
Yes, most are not in the hospital, but when they are, at least in my area, it is not surprising how many have such issues; the only thing I can do is be a "health manager" and meet them where they are, do what I can do in the here and now, and help them whether they make the choice to change-or not.
I read the obits daily. I commented to my husband that there seems to be an increase in the deaths of 50 somethings. That's scary to me as I'm a 50 something.
I'd not given the cause of the increase much thought, but reading this thread, has opened my eyes.
I hadn't even considered it as socio-economic.
How could I not?
I think with focus on many things, most who are dealing with the socio-economic issues will evade or deflect this issues; especially in certain short-term settings; some may speak-up, however, eliciting the information in discharge planning has probably had an uptick of people asking for help or being honest that they are homeless and being placed in LTC settings and social work assisting these pts to enter transitional housing; at least what I have seen in my area.
I think with focus on many things, most who are dealing with the socio-economic issues will evade or deflect this issues; especially in certain short-term settings; some may speak-up, however, eliciting the information in discharge planning has probably had an uptick of people asking for help or being honest that they are homeless and being placed in LTC settings and social work assisting these pts to enter transitional housing; at least what I have seen in my area.
I agree - one of the hospitals I was assigned to had an inpatient program for opioid dependence and/or CIWA that included comprehensive wraparound services for outpatients and extensive discharge planning options. Likewise, for the patients who are more open with their needs, my community has some extensive resources for health management, including socioeconomic issues that may be barriers to good health. Most are relatively new programs but the reported success rates seem to be good. I worked previously on that side of healthcare, predominantly with families who had small children and needed all kinds of help. I enjoyed it, but it wasn't where I ultimately wanted to focus.
Morbidity and mortality rates are higher among the jobless.
Don't forget the underemployed; those who have jobs but can not afford health insurance, yet live in a state that doesn't expand or eliminated access to healthcare, of eliminated parts of it where it's virtually no insurance.
I agree - one of the hospitals I was assigned to had an inpatient program for opioid dependence and/or CIWA that included comprehensive wraparound services for outpatients and extensive discharge planning options. Likewise, for the patients who are more open with their needs, my community has some extensive resources for health management, including socioeconomic issues that may be barriers to good health. Most are relatively new programs but the reported success rates seem to be good. I worked previously on that side of healthcare, predominantly with families who had small children and needed all kinds of help. I enjoyed it, but it wasn't where I ultimately wanted to focus.
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Along with disease management programs, they are (hopefully) a direction that healthcare will get into successfully.
Don't forget the underemployed; those who have jobs but can not afford health insurance, yet live in a state that doesn't expand or eliminated access to healthcare, of eliminated parts of it where it's virtually no insurance.
Or those of us who have health insurance, but simply can't afford to meet the deductible. Or can't afford the 20% insurance doesn't cover.
Hard living usually ends in poor health. My grandmother was an alcoholic and smoked and gambled a lot in her youth. Doctors warned her that if she continued on with her drinking and smoking, she would end up on dialysis. She almost died at 73. Now, at 79, she is on dialysis. She has been in poor health as long as I can remember. Meanwhile, her ex-husband, my grandfather, is 80 years. He lives on his own (as well as his 81/82 year old brother) and he travels the country in his RV with his wife. He has worked as a volunteer firefighter. My grandmother, on the other hand, would spend her days lying in bed and watching tv and still does. My other grandmother who will be 89 in a couple of weeks is in much better health than her. And then there is my late grandfather who died at fifty-two from heart disease and poor diet.
You reap what you sow. I've seen some 59 year olds who look like they are in their mid seventies, and I've talked to some ninety year olds who are unbelievably with it and independent. I hope I'm the former and not the latter.
) no insurance , and no hope?
kalycat, BSN, RN
1 Article; 553 Posts
Commuter,
I really can empathize with you. I too have experienced the consequences of my parents' lifestyle choices...and other members of my family as well. I didn't observe as much violence growing up, but I definitely feel like my experiences have strongly influenced who I am - good and bad.
My Mom died at 40 from a persistent inability to get her life together and manage her multiple health problems, many of which could have been handled through what we call lifestyle modification today. I was 8. I then went to go live with my Dad, who was definitely living an 80s kind of lifestyle and had priorities that didn't involve child rearing. I started out with four half brothers; I've lost one to acquired cadiomyopathy and liver failure due to alcoholism, and another has been in psych residential treatment since his early 20s. I am on speaking terms with my Dad, who lives several states away, but we have an odd relationship. My kids literally grew up without grandparents! (ironic laugh) All of my other family has passed away. (An aunt and uncle I was very close to)
I've been lucky enough to build my own family over the years -- I too have a somewhat muted affect. I have compassion for my patients in a way, but one thing that has actually been an attribute to me in nursing school and in my previous career was that I can effectively compartmentalize feelings; I view procedures and people very biologically. I'm pretty introspective, and there are some things I've been working on, but overall I feel I function well. My kids are successful and are strong, independent thinkers. Occasionally I get some weird feedback. I had a nursing instructor tell me, after a patient crisis, that I should have been born a man. I'm sure she meant it as a compliment but who knows LOL I just let it roll off my back. :)
Not to sound like a greeting card, but I try to see how my personal history has helped me to be very resilient. Sometimes I feel grateful that I can just keep plowing forward, no matter what blows up in front of me. I have flashbacks and stuff as well, but I try to leverage my negatives in to positives when I can. Running and meditating usually make me tolerable to other people LOL :)
It sounds like you have immense strength and resilience! I wanted to reply because your post really resonated with me. And to the OP, (so I'm not totally off track) I agree with your observations as well. I've had some very interesting patients just in my limited experience who were the same age as I (early 40s) and experiencing an unbelievable list of maladies. I'm not a health nut, but let's just say the year I turned 40 was pretty interesting for me....I experienced some big time health anxiety for the first time in my life, but just tried to leverage that in to changes I could control, and it really helped.
Commuter, thank you for sharing your experiences and ALL you contribute to this community! You really showed me that you never know what type of post is going to resonate with someone. :)