Tender Loving Eldercare» Doctors & Hospitals

How Connected Are We Really? Lessons Learned from a Medical Emergency

Linda Abbit — Mon, 24 Jan 2011 09:00:26 +0000

Two weeks ago my friend, Penny, passed out while out dancing at a night club with a group of friends, including me.

Here are lessons I learned from this frightening night that may be helpful to people of all ages. As I write this, Penny remains in the hospital but, thankfully, is on the road to recovery. (Her name has been changed to protect her and her family’s privacy.)

While we live in an age where we think we’re constantly connected to each other via cell phones, when it comes to an emergency situation, how connected are we really?

The Emergency

Penny is a 63 year old, single woman who lives with her adult daughter, age 30, and her granddaughter, a teenager. When she collapsed that evening, she was unconscious and unable to speak or respond to us or the paramedics.

After she was rushed to the Emergency Room by the paramedics, her friends who were there tried to reach Penny’s daughter by phone. Each of us only had Penny’s home phone number in our cell phones. We knew her daughter’s name but did not have her cell phone number. We knew her son’s name but no one had his home or cell phone numbers in our phones.

As it happened, Penny’s daughter, Judy, was out for the evening and didn’t get the urgent messages we left on their home answering machine. Luckily, Penny’s granddaughter (instructed not to answer the home phone when she is home alone at night) heard us leaving the messages, called Judy on her cell phone, and she then called us from her cell phone.

This is a good reason NOT to give up your land line, as many younger people seem to be doing. How would we have reached Penny’s daughter if we couldn’t leave a message on her answering machine at home?

While We Were Waiting

As we were sitting in the waiting room of the ER, it dawned on us – did any of us have each other’s contact information in our cell phones? Would our friends know whom to call in case we were the patient in an emergency like this? The answer was a resounding “No!” We all knew our spouses’ or children’s names, but did not have the best number to reach them at, nor know whom we should call first.

On the spot we exchanged these contact numbers and entered them into our cell phones. I realized that in a stress-filled moment, I may not remember all of my friends’ family’s names so, for example, I entered “Tonys Daughter” as the first and last names in my contacts list.

Do Emergency Personnel Recommend “ICE”?

I remembered reading about “ICE” a few years ago, but wasn’t sure if it was a good idea to enter in my cell phone or not. I wondered if paramedics would look on my phone for such information if I was injured?

Yes, they do.

I called our local Police Department dispatch officer, Fire Department and local hospital emergency room staff. They all recommended people enter whom they want called and what number to use under “ICE” (which stands for “In Case of Emergency”) in their cell phones. If you want more than one person contacted in case of emergency, list them as ICE 1, ICE 2, etc.

ICE is a great idea, but what if the cell phone is damaged in the emergency, password protected, or gets separated from the injured person?

A Backup Plan for ICE

Along with having your driver’s license or some form of ID with you whenever you go out, keep a written list with emergency contacts, doctors’ contact information, and any important medical information on it. Have it with or adjacent to your ID card.

If your cell phone is damaged or separated from you, this information will be available for first responders in an emergency. The Los Angeles Fire Deparmtment wrote this on their blog in 2005:

“Please encourage your interested friends and colleagues to make a free ICE entry in their cell phone, especially if it will give them peace of mind – but never at the expense of written emergency contact and medical information.”

Because it was a crowded dance venue, Penny had left her wallet locked in the trunk of her car and did not bring it into the nightclub. The paramedics kept her cell phone, jacket and car keys with Penny, so we didn’t have a way to access the car’s trunk once they left for the ER. Luckily it worked out and we reached her family to tell them what had happened, but it did make me think about this situation long and hard. It doesn’t matter what age we are, it’s smart to be prepared for any and all emergencies.

Have you been in an emergency situation like this? What lessons did you learn? Please share them in the comment section below.

This blog post is part of a month-long series of ideas, tips and quotes for family caregivers. View additional posts from our “Caregiver Thought of the Day” series on our Facebook Page every day in January.

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Photo Credit: daryl_mitchell’s Photostream

Positive Signs of Change in Hospital Care for Seniors

Linda Abbit — Mon, 01 Nov 2010 09:00:05 +0000

While visiting an elderly family member in the hospital last month, I was pleasantly surprised by these signs posted on the wall of her room:

Hourly Rounds Explanation

Close Up of Repositioning Schedule Guidelines

Repositioning Schedule (Left-Back-Right)

She also sported an orange neon wristband which alerts all staff at a glance when a patient is a potential fall risk. Hospitals are finally becoming more sensitive to our aging population’s needs! I was especially gratified to see the sign about repositioning because my mom had an ongoing battle with bedsores at the end of her life. In spite of excellent caregivers and as much wound care as possible, her 95+ year old skin just kept breaking down.

Have you seen other signs of sensitivity to seniors’ health care in hospitals, doctors’ offices, or pharmacies recently? Please share them in the Comments section below.

Medical Treatment vs. Quality of Life for Our Aging Parents

Medical Treatment vs. Quality of Life for Our Aging Parents

Linda Abbit — Mon, 27 Apr 2009 10:00:23 +0000

My mom has been troubled by bedsores on and off for the past two years. A bedsore forms, gets worse and then very s-l-o-w-l-y heals (as in taking months to completely close up). She presently has three in various sizes, places and stages of breakdown or healing.

Contrary to what most of us believe, I’ve learned bedsores do not occur as a result of neglect. In my mom’s situation, her skin breakdown is due to the thinness and fragility of her skin, her weight (she’s only 90 lbs.) and the fact that she can no longer walk. The caregivers at her board & care are all top notch and are constantly battling any signs of skin irritation to keep new bedsores from forming.

The Current Medical Treatment

The worst bedsore is on her coccyx and the doctor ordered her to be in bed 99% of the time now. The caregivers are vigilant about turning her from one side to the other side every two hours and changing her diaper to keep moistness away from all the sores. She uses an alternating pressure air mattress which is always moving slightly to massage her skin. The hospice nurse provides specialized wound care every second or third day. I know medically these are correct steps, because with the attentive wound care and the “staying in bed regime” the sore is not getting worse, and is starting to heal. For that I am grateful.

So What’s My Dilemma?

Why is this medical treatment bothering me?

Because it is also a quality of life issue.

When she’s in bed 99% of the time, Mom misses out on the social activities that go on in the living room and kitchen of the house. She can’t partake in musical sing-a-longs or arts & crafts sessions three times a week. She misses mealtime conversations and visits from other residents’ families. Even though her ability to speak, participate or interact are limited, I still believe she gets stimulation and enjoyment by being in these social situations. Or just by viewing the changing indoor “landscape” in front of her eyes. When she’s lying in bed in her room, she’s isolated and misses out on this liveliness, except what I bring her during my visits.

If I knew the medical treatment was just for a few days or even for a few weeks, I could live with it. But based on how long it has taken previous bedsores to heal, I see her staying in bed for months to come.

A Balancing Act

It’s a matter of balancing her medical needs and keeping her quality of life at a decent level. It’s a balancing act that I’m not sure we’re winning. Yes, her bedsores are healing, but at what cost? It’s frustrating and it makes me sad.

Have you found yourself in a similar caregiving predicament?

How have you dealt with it? Let’s discuss . . .

Eye Care Because I Care

Linda Abbit — Mon, 02 Feb 2009 17:22:07 +0000

Due to the current economic downturn I worry that senior citizens on fixed incomes could start to neglect their health in order to save money. In fact I even caught myself questioning whether I really needed to go back to the doctor for a recheck blood test he recommended. Yes, I made the appointment and went. Our aging parents’ health (and our own) is just too important and not a place to cut corners in order to save money! Please be certain your Golden Oldies are not putting off necessary doctors visits or laboratory tests, now or ever.

I recently read about a program that can insure our aging parents’ eye health is not neglected. EyeCare America offers a year-round program for U.S. citizens called the Seniors EyeCare Program. It is designed for people ages 65 and older who have not seen an ophthalmologist in three or more years. Eligible patients are matched with a nearby volunteer ophthalmologist, receive a comprehensive medical eye examination and up to one year of care for any disease diagnosed during the initial visit for FREE.

The participating ophthalmologists have agreed to accept Medicare and/or other insurance reimbursement as payment in full, resulting in no out-of-pocket cost to the patient. Seniors without insurance receive care at no charge. It can’t get any better than that!

By age 65, one in three Americans has some form of vision impairing eye disease. Most do not know it because there are often no warning symptoms or they assume that poor sight is a natural part of growing older. By detecting and treating eye disease early through annual, dilated eye exams, seniors can preserve their sight.

To see if your aging parents qualify for this eye care program, call 1-800-222-EYES (3937), or read more about it at EyeCareAmerica.org. The organization also offers programs for glaucoma, diabetes and children’s eye disease detection. Their site is definitely worth a look see.

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And while we’re on the subject of eyes . . . . Lions Club International has been collecting glasses for nearly 80 years. Adult and especially children’s eyeglasses are needed. Prescription and nonprescription glasses and sunglassses are gathered from their many donation centers and sent to one of the Lions Eyeglass Recycling Centers here in the U.S. (there are 17 centers worldwide). Volunteers help clean and sort the glasses before shipping them to developing countries, where they are given to those in need.

So if you’re hanging on to old eyeglasses you no longer can use, go to the Lions Club web site or call the club in your area to find a list of donation centers where you can drop off or mail your old eyeglasses. Helping to improve someone’s eyesight is a simple yet wonderful thing to do!

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“The real voyage of discovery consists not in seeking new landscapes but in having new eyes.”

~ Marcel Proust

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These items caught my eye in the “Hints from Heloise” newspaper column and I am pleased to share them with you. Thanks, Heloise!

When Your Aging Parent Is Hospitalized – Part 3

Linda Abbit — Thu, 26 Jun 2008 03:58:23 +0000

This is Part 3 of a 3 part series on this topic.

Click here to see Part 1. Click here to see Part 2.

When my Dad had surgery to replace his broken hip at age 95, he spent one week in the hospital recuperating and then almost two more weeks in a rehabilitation facility. We were all ecstatic when he was told he could go home!

Then it got rather interesting. I had to look at many facets of my Dad’s daily living with a new perspective because the rehab nurse handed me a 38 page manual covering the basics of post-operative home care for hip replacement patients. It included precautions, exercises, transfer techniques (i.e., getting in and out of bed, cars and chairs), walking with a walker, stair-climbing (thankfully he didn’t have stairs at home), dressing and bathing. Yikes!

Things I’ve learned from this experience (and also when my Mom was hospitalized briefly) that can help you and your aging parent in this transition from hospital or rehab facility to home are:

Meet with the doctor, nurses, physical and occupational therapists to get clear written and verbal instructions your Golden Oldie will have to follow at home, and for how long. Will it be just until a re-check with the doctor in a few days or for weeks, perhaps months, until fully recovered?

If possible, attend physical and/or occupational therapy sessions before your parent is sent home. The more information you can take in about your parents’ physical needs, the easier it will make it at home. Some people learn best by watching, not just talking with the therapists. They will be happy to have you “practice” with your parent in front of them to be sure you and your parent understand. For example, a simple thing we do every day, such as sitting on the edge of a bed, bending over and tying one’s shoes was a definite “no-no” for my Dad after hip replacement surgery. Another thing I learned was how my Dad should use the walker when getting up or sitting down in a chair. None of us had ever even owned a walker before. Some Golden Oldies may need a wheelchair when they first leave the hospital, and properly using one is another learning curve for you all to tackle. I’m the worst at steering those things (with no reflection on my car driving abilities however!).

Anticipate how any new medical equipment your parent needs will fit into their home environment. For example, will the wheelchair be able to roll into the bathroom they use the most, or is the doorway too narrow? If they need a hospital bed, coordinate with the hospital staff to see that it is ordered, delivered and set up before discharge. Will they need a commode temporarily near the bed? Will they be able to go into the kitchen to eat or will they need a tray to eat meals in bed at first?

Hospitals and rehabilitation facilities are usually very good at going over medications with the patient and family before discharge. Be sure you are present when this is done, because your Golden Oldie may be weak or unable to concentrate fully at discharge time. You should be the “technical interpreter” and be clear about the names of all medications, what they are for, dosages, when they are taken, and other special instructions (such as take only on an empty stomach). There may also be special dietary items and/or restrictions you should learn as well. The staff may be willing to call in the prescriptions to your favorite pharmacy right before discharge. You can then pick them up on the way home, and not have to leave your parent alone at home because you need to fill their prescriptions. It won’t hurt to ask if the nurses can make the phone call for you.

Sometimes the smallest things make a huge difference! At the time of my Dad’s hip replacement surgery, our family had a mini-van and a sedan automobile. I had always used the sedan to take my parents out and about on errands. However, after the surgery, it was much easier for Dad to get in and out of the mini-van. Because the seat was higher it was easier to slide onto the seat, plus it met the important post-surgical hip precautions. The sedan’s seat was 1) too low, and 2) could not be moved back far enough to give him adequate leg room. You may even need to have someone else drive you and your parent home.

Your Golden Oldie may be weak when they first arrive home — very happy and relieved, but weak and/or slightly disoriented from their ordeal. Just as you did when they were in the hospital, if you feel they need extra TLC for awhile, arrange with other family, neighbors and/or friends to spend the first few days with them until you are certain they are able to manage again on their own for longer periods of time. They will hopefully bounce back quickly from whatever setback they had and resume their normal activities.

Last but not least — food! If you can stock your parent’s refrigerator with the staples that will also save you both a trip to the grocery store that first day home. Even better, if you have time, prepare some of their favorite foods to fill the frig. Classic comfort foods, such as meatloaf, mashed potatoes, pot pies, chicken noodle soup, beef stew, macaroni and cheese or other pasta, and casseroles may appeal. Of course, be sure your Golden Oldie doesn’t have any dietary restrictions to follow, and if they do, be sure the foods you prepare or buy follow all of the requirements.

The key to making this transition go smoothly is for you to anticipate as much as you can. As I mentioned in Part 1 of this series, thoughtful planning makes everything less stressful when faced with family emergencies or challenges. You’ll usually have an idea when your Golden Oldie will be discharged, so use that time to your advantage.

And remember, being home and surrounded by familiar people and things is great medicine for our Golden Oldies!

Warmly,

Linda

When Your Aging Parent is Hospitalized – Part 2

Linda Abbit — Thu, 19 Jun 2008 23:54:03 +0000

This is Part 2 of a 3 part series on this topic.

Click here for Part 1. Click here for Part 3.

Being in the hospital can be scary for people of all ages. If your aging parent is hospitalized for even a short time, here are some things you can do to make it easier for them.

Bring some favorite things from home to decorate the stark hospital room. This can include family photos to be put near the bed where they can easily see them, a special throw blanket or pillow(s), and flowers or plants. Have your children, nieces or nephews make Get Well cards to display. An iPod or small CD player may also be brought in loaded with their favorite music.
Many hospital rooms have a combination bulletin board/white board on the wall facing the patient’s bed. If so, write messages to your parent to read while you’re away. Use a thick black or dark marker and write in large print on the white board because often times they don’t wear their eyeglasses when in the hospital. I would write something like “Dad, Follow doctors’ orders and keep getting well fast. I will be back at 6:00 pm today with Jeff and Robbie to visit.” When I left in the evening I would write, “Have a good sleep and sweet dreams. I will be here in the morning at 9:00 am to visit.” The bulletin board side is perfect to hang Get Well cards on, so bring some thumbtacks from home.
Along with creating a friendlier and more interesting physical environment, I believe it is vital to create a positive-thinking environment when visiting. Try your best to be positive, upbeat and calm in front of your parent, because I truly believe they read and pick up on our “vibes.” They are probably already scared by just being the hospital, so by your staying calm and in control it won’t increase their level of anxiety and may even decrease it. Even if the diagnosis is serious, I believe it is important to stay positive in front of the patient and share your worries or concerns with the hospital staff and doctors when you are sure your parent won’t hear the conversations, either behind closed doors or far down the hall from their room.
Be a patient extender, the person who helps your parent fully explain him- or herself to the doctors, nurses or other providers. This goes beyond their medical history or current condition; it includes the “every day” things, such as letting the nurses know they aren’t wearing their hearing aides, but if the staff faces them and speaks slowly the patient can read their lips. Or, their glasses are for distance, not for close up reading. Or, they’d prefer apple sauce instead of water to take their medications with.
Be your aging parents’ advocate. Write down what the doctors and nurses tell you each time you have a conversation. Then, write down follow up questions as you and your parent think of them, so that you can be sure to get them answered the next time either MD or RN returns to the room. Be persistent in getting all of your questions answered clearly and completely!
Become a technical interpreter, the person who helps doctors and other providers explain themselves to your parent. While communicating with the hospital staff and even family members who are visiting, do not talk in front of your parent as if they’re not there and aware of what’s going on! Even if you think they are asleep or sedated from medication, they may be conscious. As long as they have the ability to comprehend and participate in the health care decision, include them in the discussions as best as you can. They may be ill, but they are still alive and have the right to understand and have input about their health care decisions.
If you are unhappy with something that occurs, speak up in an assertive way. Remember, your parent probably cannot handle a difficult situation themselves at the moment, so you are representing them and their best interests. Being assertive yet firm will yield a better result than being unpleasant or aggressive in your approach to the hospital staff. (As the old saying goes, you get more flies with honey than with vinegar.) And if you do have a complaint, state it away from your parent’s room so as not to upset them further. They might not have even realized something upset you, so keep it that way!
Depending upon your parent’s age, medical condition and your own daily responsibilities, you may want to hire a companion/health aide/licensed vocational nurse (LVN) through an outside agency to stay with your parent when you or other family members can’t be with them. Many Golden Oldies may have a decline in their normal level of functioning or get confused temporarily when they are in an unfamiliar environment, and having someone with them (especially during the night) may help. If you have a large family, try to arrange a schedule for your siblings, their grown children, and/or other family and friends to be with your parent during their stay. Hopefully any confusion or decline in functioning will return to normal once your aging parent is back in their own home.

Having a parent in the hospital isn’t easy on any family, and not all problems can be prevented. But hopefully the steps above should help make it an overall more positive experience for everyone involved. In Part 3 I will cover issues regarding hospital discharge and the transition from hospital to home.

Here’s to more Tender Loving Eldercare!

Warmly,

Linda

When Your Aging Parent is Hospitalized – Part 1

When Your Aging Parent is Hospitalized – Part 1

Linda Abbit — Thu, 12 Jun 2008 18:39:35 +0000

This is Part 1 of a 3 part series on this topic.

Click here for Part 2. Click here for Part 3.

Last week a friend’s Mom, Golden Oldie age 80+, was taken to the emergency room unexpectedly and was then admitted to the hospital for a few days. Luckily, it was nothing serious and she will be going home soon.

An unexpected emergency like this can be much less stressful for you as a family caregiver if you prepare a few things in advance. Emergency Kits traditionally include bandaids, ointment, gauze pads, scissors, etc. The Aging Parents Emergency Kit I created has different contents, but is something I could grab and be out the door with in no time flat. Kind of like the suitcase I packed when I was expecting my first baby!

Prepare a folder, envelope or accordion file with the copies of the vital information the hospital will need upon your parent’s arrival in the ER, including but not limited to:

Advance Health Care Directive. This legal document appoints a person to make health care decisions for the patient as well as instructions for future health care.
Power of Attorney for Health Care. Depending on your state of residence, this may be a separate legal document or it may be incorporated into the Advance Health Care Directive (above).
Durable Power of Attorney. This legal document may or may not be requested, but it deals with the patient appointing an Attorney-in-Fact regarding financial matters in general. Again, each state could have different documents, so please check with your attorney in advance as to what your state requires. The hospital may not need all of these, but it is better to have them handy then to have to go home, find them, copy them and then bring them back.
List of Medicines, Vitamins and/or Supplements. The exact name and dosage of each as well as when they were last taken by your parent.
Copy of Medicare Card, Secondary Insurance Card and any Pharmacy Plan. It is good to have the pharmacy phone number handy for when your parent goes home, too, so the hospital can order in advance any prescriptions for medication that may need to be continued at home.
Medical History. Including major illnesses, surgeries, current medications being taken and any recent medical conditions. Writing this down in advance is very helpful and then easy to add to and keep current. Create the record with your parent so that you can get the dates as accurately as possible.
Current doctors’ names, addresses and phone numbers.

I also recommend you include some comfort items for yourself. Waiting in Emergency Rooms can be much longer than expected. I’ve found it helpful to have on hand:

Snacks and/or Beverages. You may not be able to get to the hospital cafeteria, or the cafeteria could be closed. (Do not give any food or beverages to your parent unless the hospital staff gives their OK.)
Sweater or jacket. Hospitals and ER’s are generally cold. You may also want to bring a warm jacket or sweater for your parent. Seniors in general feel colder than the average person, so if you’re feeling cold, they probably are as well.
Something to do while waiting. This is both for you and your parent. For example, a newspaper, magazines, books, or crossword puzzles you can do together. The patient might not feel good enough to do anything, but it is nice to have a few things handy just in case.
Cell phone. So you can call relatives and/or friends to keep them updated. Or you may need to call a doctor’s office to let them know your parent is in the ER.

Have you had to take your aging parent/Golden Oldie to the ER? Is there anything else you can suggest I add to my Aging Parents Emergency Kit? I’m all ears!

Warmly,

Linda

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