People who take on the role of caregiver to elderly family or friends know in advance or quickly discover how difficult it can be to manage and advocate for a loved one.
Our Visiting Angels office defends many clients on a daily basis. We collaborate with medical providers and family members on our clients’ condition after doctor’s office/hospital visits, and we keep extensive notes on medications, diet, exercise, and general well-being of our clients. Therefore, when I had to go out of town to take care of my mother who was rushed to the hospital in the early hours of the morning, I would be fully prepared. Surprisingly, it wasn’t that easy.
I took an 8am flight from Colorado and arrived in San Diego around 9:30am. After renting a car and having coffee, I arrived at the hospital around noon to find that my mother was still in the emergency room. I had anticipated that by the time I arrived she would already have been admitted to a room.
After spending another four to five hours in the emergency room, it became clear that this place was very busy. At no time were there moments of calm. My brother and I laughed together that this place reminded us of the movie “Jacob’s Ladder” – weird, confusing and fragmented. It was a level 1 trauma hospital in San Diego. It was a far cry from the cozy comforts of our Vail Health Hospital and Valley View Hospital.
At around 9:30 p.m., a nurse informed us that a hospitalist would be coming soon to help get my mother to a room on one of the medical floors. Shortly after, a hospitalist arrived.
In order to facilitate the transfer of my mother from the emergency room to a medical floor or a specialized unit, the hospitalists asked my brother (Josh) and I a litany of questions about my mother’s medical history, the medications she took. she is currently taking, her physical state, her cognitive state and her general state of health. We were prepared. Proudly, I pulled out of my backpack a folder containing answers to all the questions she had.
Yeah…that’s what I do, of course, I’ll be ready. The hospitalist was visibly surprised at my preparation and thoroughness. It did me good. Unfortunately, this feeling of assurance was short-lived.
Around midnight, we were finally escorted to a specialist unit within the hospital. After ushering my mother into one of the rooms, a floor nurse came into the room with a mobile computer station and again began asking my brother and me many questions about my mother and her health. . Incredulous, my brother and I looked at each other. I stopped her questions in the middle and asked her if she was aware that we had already provided answers to all these questions just a few hours ago. She had no idea what I was talking about and couldn’t find any of this information in her computer system. So, again, we went through all of my mom’s information. Around 2 a.m., my brother and I left the hospital and went home, mentally and physically exhausted.
We came back to the hospital around 9am the next day to find that my mother had fallen asleep again after having a bite to eat and taking her morning medication. After introducing ourselves to the morning shift nurses and going over a plan for the day, we sat on the hallway floor just outside my mother’s room.
Around 10 a.m., a nurse came with a medicine cart. It was strange because his meds weren’t due until noon. My brother asked the nurse about the medications she intended to give my mother and found out that the nurse had thought my mother’s Parkinson’s medication was due at that time. Josh almost lost control. I could see that his patience was thin and his lack of sleep was making him a bit grumpy. Josh and I were amazed at how this error could have happened. After all, we had given detailed information to one of the floor nurses on the unit only a few hours ago.
As the day progressed and shift changes occurred, we were diligent in ensuring that each new shift nurse was briefed on their general medical history, recent changes to medication quantities, doses and times. It didn’t take too long for the nurses and staff to talk amongst themselves about Josh and me, so when a new shift arrived our names were already known when they worked with our mother. Great huh? Yes and no.
An additional challenge we had to overcome was when new staff members came on duty for each of the following days. Although they eventually resolved the communication regarding my mother’s medication, all too often they were unaware of a recent fracture in my mother’s arm. Adjusting my mother to the bed and/or helping her walk, they grabbed her injured arm. As my mother’s sudden cry of pain quickly informed them of their mistake, Josh and I found it hard to watch. So we posted a large poster-sized note next to the whiteboard in my mother’s room where the staff write the names of incoming staff. Problem solved.
During my seven-day visit, other inconsistencies occurred; if we hadn’t been present at the hospital, who knows what might have happened.
Our medical system is complicated. Many medical providers are forced to see 20-30 patients a day, and public, government and private insurance too often force people out of hospital prematurely. Additionally, too often, communication between medical providers is complicated by the fact that electronic medical records are not easily accessible or shared.
Managing the interests of family members, collaboration between medical and nursing providers, and crash courses on legal guidelines/requirements has become an increasingly difficult task. Like never before, we need a college course to be created called “Managing Our Health Care and Our Parents 101”.
It has become clearer to me that there is a direct correlation between the engagement of my family and friends in advocating for my mother’s care and its outcome. Managing people’s care and advocating for them is my job and I love my job, however, my recent experience confirms how much I need to learn and educate others.
I cannot stress enough the importance of being prepared when the need arises, to defend a loved one. The time spent preparing will make a huge difference in the well-being of your loved one. Oh, remember one last important thing, if you find yourself or a loved one in the care of a hospital: let the hospital staff know that you appreciate their compassion and help. A “thank you”, a coffee, a muffin or a bagel as a gift are always appreciated.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our seniors and available to answer questions. His contact details are VisitingAngels.com/comtns and 970-328-5526.