According to the Merriam-Webster Dictionary, advocacy is defined as “the act or process of advocating or supporting a cause”. I believe that our seniors very much need advocacy when interacting with our healthcare system. Even an office visit to their primary care physician, can be more beneficial to the information conveyed to the physician and from the physician for the senior to take home and follow through with. There is a phenomenon called “white coat syndrome” which means an increased level of stress on the individual seeing the doctor usually reflected in a higher than usual blood pressure. I think seniors also tend to have a stress affect in which they cannot remember all the information told by the doctor. I have also seen many a visit in which the senior tells the doctor how well everything is going and forgets to make the doctor aware of recent occurrences like falls or fainting or dizziness. For this reason, I believe that with each healthcare occurrence it is beneficial to the effectiveness of the encounter to have someone with that older person to be their eyes and ears and to remind them of the things they wanted to tell the physician.

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As I grow older and think about my own health and well being and the inevitable and eventual decline, I think about what I want for care and services and how I want to live. Most data shows that nurses and doctors are more reality oriented when it comes to their own desires and options in their later years. Perhaps it is because they have seen so much over the years.

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Life is full of choices. In looking at the choices of the senior generation, the number of things we must choose can be downright daunting. We should grow accustomed to the concept of making choices in the long course of our lives, but for some of us that never gets any easier. One consideration may be when should I retire? Can I afford to retire or should I drop back to part time employment. Right about age 50, we usually receive an invitation to become involved in AARP. It seems ironic that we receive that notice and yet for most of us retirement is still many years away. We often do not choose to think of ourselves as belonging to that “aging club” yet. We might be lured by the benefits in the way of discounts and deals. Hopefully, most of those choices are not made for us through layoffs and closures during these volatile economic times.

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If you ask a hospice nurse or many nurses in the acute care setting about their view of death, they generally don’t miss a beat in stating, “don’t ever let that happen to me”. We have all seen the deaths that were prevented or the prolonged high tech deaths that are so agonizing for everyone. But since none of us has a crystal ball to give us future information of how and when we will die, we must rely on what information we have about our own health and plan for what might lie ahead. Personally, I am a strong believer in quality of life rather than quantity of life.  Seven years ago when my 90 year old mother could not answer the question of what her wishes might be should the end be near. Her answer was “if I could have quality then I would want to live, but you and your sister should decide”. That was NOT the answer I was hoping for. My siblings and I considered ourselves fortunate when fate dealt mom its blow. She suffered a massive hemorrhagic stroke and did not remain conscious. We had time to gather and say good-bye and keep her comfortable for the short time she had still barely breathing on her own. We were all granted our one wish of a non-agonizing prolonged death for the mother we revered.

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