Using staff to gain senior care client compliance
Sep 01, 2002
Owners are critical components to the successful senior program. Comprehensive histories are especially critical in senior medicine. Owners should be instructed to note changes in water consumption, appetite, body weight, activity level, skin masses and especially behavior. Owners are in the unique position to note subtle changes in daily routines. Behavior changes should not be discounted as "senility" without our best diagnostic efforts.
Early detection leads to earlier intervention. Complete diagnostic efforts are critical because senior pets frequently have abnormalities in multiple body systems. Routine monitoring is especially helpful so trends can be followed and diseases recognized as soon as possible. Routine monitoring of clinicopathologic data is critical in the management of geriatric patients.Gaining owner compliance is often the most difficult component of veterinary medicine and senior care is no different. Our practice earns compliance through a five-step process, which takes very little time (usually five extra minutes) yet reaps huge rewards for the patient, the client, and the veterinary team.
Definition of senior Defining a senior pet is somewhat arbitrary since genetics, nutrition and environment influence health and vary between patients. Guidelines proposed by Drs. Richard Goldston and Johnny Hoskins use body weight as the determining factor thus emphasizing the importance of weight control in older patients.
Common senior diseases Diseases common to senior patients are frequently the same diseases common to their senior human counterparts. Clients frequently recognize the common geriatric diseases such as diabetes, heart disease, hypothyroidism and cancer. Educating clients about senior diseases also educates about diseases senior citizens might encounter.
Common canine senior diseases include: Degenerative joint disease, obesity, dental disease, cardiovascular disease, cataracts, keratoconjunctivitis sicca, prostate disease and incontinence. Others commonly encountered include neoplasia, hyperadrenocorticism, hypothyroidism, anemia, hepatopathy, immune-mediated diseases, chronic renal failure and diabetes mellitus.
Common feline senior diseases include: obesity, dental disease, hyperthyroidism, chronic renal failure, cardiovascular disease, neoplasia, anemia, hepatic lipidosis and diabetes mellitus.
Comprehensive health screening is very important in the early recognition and successful management of many of these diseases.
Defining the senior health program Clients should become familiar with the definition of a senior pet and understand the medical benefits of early disease detection. Recommend testing patients when they enter their senior years according to the age analogy chart. Many senior patients require anesthesia for surgical or dental procedures. This is an excellent time to recommend health profiling to improve anesthetic safety and establish baseline values. Explain in layman's terms the components of your program. Use analogies, as most clients are familiar with blood testing, ECG and blood pressure through association with human medicine. The minimum senior canine database, accessible to all practitioners, includes the CBC, biochemical profile with electrolytes, and complete urinalysis. The minimum senior feline database, accessible to all practitioners, includes the CBC, biochemical profile with electrolytes, complete urinalysis and total T4. Practices should include electrocardiography and blood pressure measurement if available. Other components of the senior health program might include radiography, ultrasound, endoscopy, ocular tonometry, endocrine testing (ACTH stimulation, low dose dexamethasone suppression, free T4 by equilibrium dialysis) and others, depending on the particular case.
Senior health program benefits Earlier detection allows earlier intervention and therefore, improved treatment success. Senior profiling improves anesthetic safety by permitting the postponement of anesthesia or altering the anesthetic plan. Furthermore, pharmaceutical safety is increased through detection of underlying diseases, which may preclude the use of certain drugs. Many dietary recommendations are based on disease diagnosis making senior profiling an important dietary database. Finally, earlier disease management by improved anesthetic, pharmaceutical and dietary recommendations offer our patient's and client's the best medical management possible. But how do we make clients understand and say "Yes?"