Thursday, July 10, 2008

Dental Care and the Elderly - How Far Should We Go?

This is an off-the-cuff personal observation about dental care and the elderly. No research done, no statistical information sought, and no expert comment from others included - just my own raw opinion.

Dad visited the dentist last week for his scheduled cleaning and I believe that’s important to his health. He will be eighty-six-years-old in a few months, and has numerous health problems including diabetes and an arrhythmic heart. I know from years working in the health care industry, preventing bacteria from making its way to his heart through his blood stream could avert a serious health event.

The dentist wanted to do some work around a tooth near the front, then place a crown on the tooth. As an alternative, she could pull the tooth and leave the space empty. Of course, the former was labor intensive, far more expensive, and included additional painful visits. She mentioned other dental work he needed, but this was the most pressing.

Last year he and I discussed this very subject and it was his strong opinion he wanted no more dental work other than routine cleaning, as he did not want the pain or the expense other work would require.

This time as I was sitting in the waiting room, I heard him say, “You better ask my daughter. She makes all the decisions.”

Oh, really? And this started when?

What is the best for Dad? Considering his age, at what point do we stop preventative or cosmetic care? Because of the location of the tooth, the real question was, should we pull the tooth and leave a space or place a permanent crown.

Dad’s comment that I should decide led me to believe he was thinking he should have this work done, but didn’t want to make the decision himself. Otherwise, he probably would have said no upfront.

As a team, we discussed our options including the amount insurance was likely to pay, and I decided that we should proceed with the crown. I made an administrative decision, there were smiles all around, and Dad seemed okay with that, even a bit relieved.

Because my nature is to look to the future, how can I deny Dad the same opportunity? Rather than say to him by my actions, if not specifically in words, it’s time to give up, lets not do anything more, what I am saying is “you have a future and we need to prepare you for that future”.

I’m not ready to make decisions based on thinking it’s time for him to let go and die, and at the end of the day, neither is he.

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