Vail Daily column: Be prepared when the need for advocacy arises
People who take on the caregiving role for elderly family or friends either know ahead of time, or quickly find out, how very difficult it can be to manage and advocate for a loved one.
Our Visiting Angels office advocates for many clients on a daily basis. We collaborate with medical providers and family members about the status of our clients after medical office and hospital visits; we maintain copious notes on our client’s medications, eating, exercise and all-round wellbeing. Therefore, when I recently had to go out of town to take care of my mom, who was rushed to the hospital, I thought I would be quite prepared. Surprisingly, it was not so easy.
Last week I arrived to the hospital at about 12 p.m. to find my mom was still in the ER. I had anticipated that by the time I arrived, she would have already been admitted to a room. After spending the first four to five hours in the ER, it became clear that this place was crazy busy. At no time was there a moment of calmness. My brother and I laughed with each other that this place reminded us of the movie “Jacob’s Ladder.” This was a Trauma Level 1 hospital in San Diego. This was a long way from the cozy comfort of our Vail Valley Medical Center and Valley View Hospital.
Somewhere near 9:30 p.m., a nurse informed us that a hospitalist would be coming soon to help get my mom to a room on one of the medical floors. Not too long thereafter, a hospitalist arrived.
In order to facilitate my mother’s transfer from the emergency room to either a medical floor or a specialty unit, the hospitalists asked my brother Josh and I a litany of questions about my mother’s medical history, medicines she takes, her physical condition, her cognitive condition and overall health. We were prepared. Proudly, I pulled out of my backpack a folder containing answers to every question she had.
Yep, this is what I do; of course I would be prepared. The hospitalist was surprised at my preparedness and thoroughness. This made me feel good. Unfortunately, this self-assured feeling was short lived.
Near midnight, we were finally escorted to a specialty unit within the hospital. After getting my mom into one of the rooms, a floor nurse entered the room with a mobile computer station and once again started to ask my brother and me many questions about my mom and her health. Incredulously, my brother and I looked at each other. I stopped her mid-question and asked if she was aware that we had already provided answers to all these questions a few hours before. She had no idea what I was talking about and found no information in her computer system. So, once again, we went over all of my mother’s information. Somewhere near 2 a.m., my brother and I left the hospital and went home exhausted.
We arrived back at the hospital at about 9 a.m. to find my mom sleeping. After introducing ourselves to the nurses, we sat on some chairs just outside my mom’s room. Somewhere near 10 a.m., a nurse came by with a medicine cart. This was strange because her meds were not due until 12 p.m. My brother questioned the nurse over what meds she had intended to give my mom and found out that the nurse had thought that my mom’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 leaving him just a bit grouchy. Josh and I were astounded how this error could have occurred. After all, we had given detailed information to one of the unit’s nurses just hours ago.
BRIEFING NEW NURSES
As the day proceeded and shift changes occurred, we were diligent about making sure each new shift nurse was informed of her overall medical history, recent changes to medicine quantities, doses, and times. It didn’t take too long for the nurses and staff to talk among themselves about Josh and me such that when a new shift came on, 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 came on shift, they too often were unaware of a recent break of my mom’s arm. When adjusting my mom in bed and/or helping her walk, they would grab her injured arm. While my mom’s sudden scream of pain would quickly inform them of their error, Josh and I found this difficult to observe, so we posted a large note next to the whiteboard in my mom’s room where the staff write the names of the incoming staff. Problem solved.
ADVOCATES ARE IMPERATIVE
Over course of the past seven days, other inconsistencies occurred. Had we not been present at the hospital, who knows what could have happened.
Our medical system is complicated. Many medical providers are forced to see 20-30 patients a day. State, government and private insurance too often force people out of the hospital prematurely. Often communication between providers is complicated by electronic medical records not being easily accessed or shared.
Managing the interests of family members, collaboration among medical and nursing providers, and crash courses in legal requirements has become an increasingly harder task. Like never before, we need a college course called Managing Our Health Care and Our Parents 101.
It has become clear to me that there is a direct correlation between my family and friends’ engagement in advocating for my mother’s care and her outcome. Managing people’s care and advocating for them is what I do for a living and I love my job; however, my recent experience affirms how much I have to learn to educate others.
I cannot emphasize enough the importance of being prepared, when the need arises, to advocate for a loved one. The time spent preparing will make dramatic differences in your loved one’s wellbeing!
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. For more information, go to http://www.visiting angels.com/comtns or call 970-328-5526.
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