What to Expect & How To Prepare

Exactly what Happens in my House?
Dr. Elovitz or his associate (an examiner/psychometrist) will try to replicate their office (which is soundproofed and private) inside your home and treat this as a professional visit. We’ll ask to turn off the TV and radio and
unplug the phone. Also, since we are working and wearing business clothes, during the summer kindly close the windows and turn on the AC, it avoids wind blowing our papers around and helps us stay cool enough to concentrate. If you don’t have AC, we’ll cope with it – but, please, let’s use it if you are lucky enough have it!

You do not have to entertain us. Please: no coffee, tea, hors d'oeuvres, coffee cake, water – no nothing. (Well, home made cookies “may” be OK once we’re done.) We know you want to be kind and solicitous to your parent, but please no soda, water, coffee or tea for the patient as it winds up getting spilled on our expensive testing materials every 3rd or 4th visit. That can shut down the assessment, and remember it may take months for another appointment. Everyone can go for a while without a big glass/bottle of water at hand and, we take bathroom breaks during which we can get the patient a drink. Remember, Dr. Elovitz and most of his colleagues are seniors themselves and also need frequent access to the bathroom! Getting old is not for the faint of heart!

Pets:
Kindly lock up dogs that jump (this includes "service" dogs, friendly dogs, "he just likes everyone dogs," etc.) as Dr. Elovitz has tired of replacing many pairs of pants and getting dog nail scratches on his legs treated. Yes we all love dogs, but dogs jumping on you every day becomes a drag, and after 42 years of doing this, and being rather old and frail himself he often gets knocked down by large jumping animals. He’s even been knocked over by a big cat! Not a good way to start. Restrain dogs before we arrive as most excited dogs will eventually relax, and you can let them out after a few minutes once the examiner is safely seated. If you have constantly barking dogs (or a hyperverbal parrot, yes that’s happened more than once) please make an appointment for an office visit.

Children:
Also, if grandchildren, babies, or toddler are going to be present, please arrange to have a baby sitter, ideally elsewhere or at least in another room, so we can all concentrate. We cannot test a person who is also babysitting their grandchildren at the same time. It is difficult to spend an hour or two offering feedback and guidance to a patient's daughter with a baby on her lap. We love kids, just not during a professional evaluation. You wouldn't bring them into your doctor's exam room, and that's what we are trying to emulate in your home when we visit.

Last Requests:
Most important, we will ask you to temporarily disconnect land line phones and turn off all cell phones. Phones ringing, the answering machine doing its thing, and the cognitively impaired patient’s powerful, automatic need to answer – usually junk – calls will ruin the testing and, remember, the next appointment could be nine months off. It will suffice just to take all the cordless receivers and stick them under a pillow in a bedroom, if you can’t turn them off. We will have to unplug or turnoff the answering machine if it is near the testing site.

Kindly have the patient's hearing aides installed and find his/her eye glasses and have them available. We carry hearing aides with us, if needed. Our visual test stimuli are all in large print, to accommodate older eyes. Keep any previous medical or psychological reports that you have handy, so we can review them during our visit.

Finally, have all medications including over-the-counter (OTC) drugs and remedies, sleep aides, pain killers, supplements and vitamins on and on the table. Please no lists, we need to see the actual bottles to verify them – this is a big reason we do home visits. Also, have any pill box or dispenser handy, as we may count the pills to check for accurate compliance. “Trust, but verify” is our code. If we can find something to fix a person’s memory, how cool is that!

Home Safety
We’ll look for your File of Life (FoL) which is a red plastic magnetized pouch that should be visibly attached to your refrigerator–one for each senior in the house. On at least three occasions Dr. Elovitz has found his patient on the floor having fallen while waiting for him. He calls the local rescue squad and then stands by. Here’s what he has seen: Rescue personnel arrive, drop off their tackle boxes of equipment, step over the body on the living room floor and go straight to the refrigerator. If they find the FoL, they review it and start treatment. If they do not find a FoL listing medications and physical ailments, they can do nothing more than start oxygen.

Without a FoL, the rescue people won’t know if a patient is on Coumadin (warfarin) for atrial fibrillation, etc. Intubating such a patient could cause them to bleed out. You can get an FoL at most fire departments and at your local Council on Aging (COA-often called the “Senior Center”) program, or order it on line. Fill out your medications in pencil (so you can change them) and
date it each time you modify it! Like an undated contract, an undated FoL is worthless.

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Other safety issues: We want to see bright lights everywhere, this is not a place to conserve energy in a senior's home using dim low wattage lights or those squiggle replacement bulbs. 50% of people over 60 are dead within one year of a fall. They survive the hip fracture surgery, but then catch MRSA in the rehab center, or become de-conditioned by being confined to a wheel chair and thus become a target for pneumonia, more falls, etc. Tape down with double faced sticky tape all carpets and throw rugs, or better yet get rid of them. If you allow it, we’ll go through the house with you looking for these and other risk factors and consult to you.


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