Hospital Experiences - Part V

This is the fifth post in a series with thoughts about my recent experience having an elderly family member in the hospital - focusing on how life continues on with that disruption.

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I am resting up for my shift at the hospital. Mine is the overnight one. Our family member is improving but we are not comfortable leaving her alone at the hospital for long periods of time.

The mind muddling medications are becoming a thing of the past and we are gathering magazines, crossword puzzles, CDs, slide shows…..anything we can think of to stave off boredom for the patient and ourselves. She is not a person that watches a lot of television normally (television is usually the only diversion offered in the hospital rooms). The particular room she is in has a view of a construction project with three cranes being very active on the top of the emerging building (see previous post for a picture); we’ll have to position her reclining chair to take advantage of that view.

This is one of the first experiences with an extended hospital stay for the family. While most of the care has happened at a pace in sync with our expectations - there is one area that always has problems (the patient has to wait a long time on a gurney or the procedure is cancelled at the last minute because a conflict with some other patient’s procedure has occurred). Being a technical person - I now see it as a process problem since the problem has occurred repeatedly and am seeking a way to communicate the observation to the hospital so that they can improve.

Another issue is the coordination of care with multiple specialists. It does not appear that the primary doctor is always cognizant of what the specialists are doing and the specialists or not aware of each other either. It should not be up to the family to ask questions and insist that the care be coordinated. But that sometimes appears to be the case.

In general - our medial system appears to be a loose conglomerate of specialists treating illness rather than an integrated system toward health - or restoration of health. The skewing has become so acute that it is quite challenging for the patient (and the family) to understand the mental and physical actions that would move the patient toward a ‘healthiest they can be’ state.

Hospital Experiences - Part IV

This is the fourth post in a series with thoughts about my recent experience having an elderly family member in the hospital - focusing on how life continues on with that disruption.

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The joy of finally being released from the hospital was dashed by readmission in less than 24 hours. Now - two days later - we can see that the hours just before release from the hospital and then at home were steps backward. I am glad that now the steps are moving forward again but there are lessons the family has learned: 

• Be very reluctant about a Friday release from the hospital since there are not as many medical people in their office on the weekend. The primary option on the weekend is to go to an emergency room.
• Make sure that the sign off for release from the hospital is holistic. Our relative was sent home with swollen feet and trouble breathing when she laid flat (enough that she could not sleep easily).
• Patient advocacy is a role that family members should learn quickly. Be diplomatic but be assertive on the patient’s behalf because they may not have the energy to do it for themselves. Some examples from our experience are:
  • Waiting alone for more than a few minutes on a gurney should never happen. Ask to remain within hearing distance.
  • Multiple blood draws in short time proximity (ordered by different specialists) should be consolidated. Talk to the nurse about it and they can help make the request.
  • Ask questions - with the patient present and participating if they want and are able. In our case, the patient was interested in all the answers but was too ill some of the time to think of all of the questions.
• If there are multiple family members in the advocacy role - create a log that stays with the patient to make the transitions easier. 

Now that I am looking at this list, I am realizing that these lessons apply for anyone trying to assist a loved one in the hospital. They are certainly true when the patient is elderly.

On a personal level, I have developed some hospital room activities to keep myself collected and positive: taking a few minutes to observe life outside the hospital window, light reading, and doodling on 3x5 cards. There is a construction site outside the window that was active even on Sunday.

Hospital Experiences - Part I

This is the first post in a series with thoughts about my recent experience having an elderly family member in the hospital - focusing on how life continues on with that disruption.

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Our initial strategy was that we approach the hospitalization as an event that trumped anything else going on in our lives. Now that is has been ongoing for weeks, we are in the mode of developing ways to sustain that high level of support and stay healthy (emotionally and physically) ourselves. In retrospect - that should have always been the strategy.

Even with help from extended family - developing a ‘shift’ mentality for who is at the hospital - everyone is tired and somewhat frazzled. Tempers are frayed, requiring considerable will power to maintain. Everyone wants to behave in a way that will not cause later regret…but that does take energy.

As I write this - the family Christmas has been partially unpacked for the past 4 days. There are still boxes and bags of ornaments - ready to be hung but no one has time to do it. There were needles shed from the artificial tree as it was put up on the floor for days. Finally they were vacuumed up.

Everyone is achy because we are more sedentary than normal being in the hospital room. I am planning a walk to look at the building I worked in almost 40 years ago (when it was new) that happens to be across the street from the hospital.

Is this post a little disjoint? I attribute it to mild sleep deprivation!

Personal Rhythms - Annual

This blog item is the fourth in a series about the rhythms we choose for our lives. Today the topic is annual rhythms.

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What activities do you do every year? I find that putting these on a calendar (either electronic or paper) is very worthwhile - so that I don’t forget. I’ve listed some examples below.

• Birthdays/anniversaries/other yearly celebrations. I set up a re-occurring item on my electronic calendar for these.
• Vacation. Taking at least a week off to do something completely different than the other weeks of the year helps sustain your focus on what is truly important in your life. Generally I reserve the days on my calendar well before I know for certain what I am going to do.
• Physical/medical checkup. Most medical plans encourage some kind of annual checkup. Use the data to make appropriate life style changes (and minimize medication over the long term).
• Thorough house cleaning. Many people still do ‘spring cleaning’ because it works to keep the home in great shape. Some elements of thorough house cleaning (that aren’t part of weekly or monthly cleanings) might be:
  • Cleaning windows inside and out
  • Taking everything out of a storage area, cleaning it, putting back only what is still needed, donating/trashing the rest
  • Getting all the spiderwebs and debris from the garage floor and ceiling
  • Cleaning under furniture (may involve moving the furniture)
  • Checking the pantry for old/forgotten/expired cans or boxes of food
  • Emptying the refrigerator, cleaning the shelves (hopefully not finding any long lost items that should have been eaten or thrown away long ago)
• Resolutions. Most people do this at the beginning of the year but it can be done any time. The idea is to set some longer term goals…and the ways you will measure them for the next 12 months.

 Are there other things that should be added to this list for annual consideration?

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Previous posts in this series about personal rhythms can be found here: monthly, weekly, daily.