Wednesday, 25 May 2016

Care Partner Wednesday--The Care Partner at the Hospital


I haven't spent a lot of my life in hospitals. I was born there, and sometimes around my third year of life, I had my tonsils out in a hospital. Each of my children arrived in one, and a few years ago, I got rid of a troublesome gall bladder there. Of course, that's just me.

The year Bill was sick, I spent more time in hospitals than I can count. It seemed every few weeks, another crisis led us back to the emergency room of a hospital, and inevitably, admission. Every night after work and full days on the weekends, I was there. I learned things and saw things and did things I hope never to repeat.

The day after Hunter and I were married, we travelled to a different hospital, where he had quadruple bypass surgery, and for the next several days, that hospital was home for me.

Being care partner to someone in hospital is a stretching, exhausting experience, and this is never more true than when the loved one is frail and elderly.

I would love to give you a list of tips to make this particular journey easier, but there are too many variables. The staff in some hospitals are wonderful and responsive. You ask for help and you get it. You want to contact the doctor and he calls you back or meets with you, and actually answers your questions. The food isn't even too bad. In other hospitals, staffed are rushed and overworked, or perhaps don't seem to care that much. Contacting the doctor is like playing an ongoing game of Where's Waldo. He can't be found. No one seems to know anything, or if they do, they're not telling.

Seared in my memory is one Saturday visit. Bill was admitted over a week ago to have a defibrillator inserted. He had been bumped a few times, and no one seemed to know when the surgery would happen. His appetite was increasingly poor, and he was weak. When I walked in, he was sitting in bed with a cup of coffee in his hand. In his weakened state, he had drifted off to sleep, and the coffee was everywhere--on his gown, on him and all over the bed. There was no staff to be found, so I got him up in a chair, washed him, found a new gown and sheets, made the bed and got him back into it. I kept a cheerful "this is no big deal" expression on my face, while I was crying inside to see my proud, intelligent husband neglected like this.

Paul Taylor recently wrote in the Globe and Mail about the problem of delirium in the elderly during hospital admission. "According to various studies, up to 25 percent of elderly patients develop delirium after being admitted to hospital... Symptoms vary and include having trouble paying attention, not making sense, restlessness and even hallucinations. Some patients may not recognise their own family members and become suspicious and hostile to those around them. Others are docile, withdrawn and can't seem to stay awake. Symptoms can also come and go over the course of a day."1

There are many reasons for this.

  • An unfamiliar environment with strangers everywhere asking questions and poking and prodding. 
  • If they are able to move, they aren't encouraged to do so.
  • "Don't eat or drink because you surgery is immanent." Except when you get bumped, but it might be tomorrow, so still don't eat or drink.
  • Many seniors are on a veritable stew of drugs, and often a few more are added in hospital. Sometimes the prescribing doctor doesn't have training in geriatrics and the unique way many drugs act in a frail elderly body.
When your elderly loved on is in hospital, you are their advocate. This is your primary role. Don't antagonise hospital staff unnecessarily, but there will be times you need to be firm. You need to know the plan of treatment. You need to talk to the doctor. You need to approve any new medication prescriptions. You need to ask your questions until you are satisfied.

The hospital, the doctors and nurses, the whole experience is not the enemy.  They are a tool to bring healing to your loved one.

Your job is to ensure the tool is working correctly.

1. How a disorienting hospital visit can lead to delirium, Paul Taylor, The Globe and Mail, May 3, 2016

2 comments:

  1. It's not coincidence that yesterday I attended a "Fearless Caregivers' Conference (don't mess with me!)" Though I was a caregiver to my mother many years ago, I'd never had had exposure to these kind of helps. It was sponsored by "Today's Caregiver" magazine (caregiver.com). I heartily endorse the value and will attend these annual events in the future. Secondly, my husband, now 80, and I have just experienced the hospital/rehab scene since February this year, and it is all you described. Dementia and depression are now firmly rooted. The doctors say the anesthesia and heavy drugs necessary to control the pain were the contributing factors. However, this surgery was critical and the chances had to be taken. It is good to find others who share your experience and find comfort and encouragement for the long haul. You are performing a needed service.

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    1. Thank you, Judy! I remember meeting you two years ago at FCWC, and have been following your journey on FB. I prayed for you and your husband. Thanks so much for the encouragement.

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