Wednesday, June 3, 2009

Tip No. Six: Do Your Homework

My advice is to know something about your loved one's underlying medical conditions. Know what medications they take and what they are allergic to. If a new condition arises, say a stroke or cancer, then research what you can about it. No one expects you to be a doctor, unless of course you are one, but having some underlying knowledge about some of the issues at hand and the terminology that is going to get thrown at you will help you make better decisions. A couple of things brought me to adding this to my list: I can't tell you how many times in the last six months I have been asked what medications my mother is on. It's easy to answer now, because the nursing home hands me a rather thick folder to take with me to any outside appointments that contains a list of all her current medications. But, when this all first happened, I knew she took insulin, but not what kind or how much. I didn't even know there were different kinds of human insulin (one of dogs takes Vetsulin - that was the only variation I knew existed). And Mother took different dosages in the morning and the evening. And then her apartment was literally littered with pill bottles. I had no idea what she was taking all the time and what she just hung onto because that's what she does. And they'll ask you about surgeries and past hospitalizations. Some of it I knew, some I didn't, others I would forget about depending upon the stress of the situation, but it could all make an impact on how successful they can treat the patient. And make no mistake about it, you'll be the one answering the questions. My mother a) can't hear, b) can be combative and c) is addled to the point where you can't trust on the fact that she is following what you're saying. No one turned to her first to answer any of that data (which, of course, made her furious, but...)

Then you will quickly learn that medical professionals in a hospital setting are really, really busy. They also are not necessarily people oriented. Some, not all mind you, are fascinated by the work they do, not necessarily the people themselves. Think House without quite the attitude and probably a lot less money. So, they come sweeping in, tell you a lot of information in as brief a period of time as possible, using terms that sound Greek to you, but are in fact Latin, and then ask you if you have any questions, hoping to God that you don't so they can sweep back out. In the meantime, you're left with trying to wrap your head around what they just said and trying to make an informed decision about it. Modern large hospitals are a lesson in world culture these days as well. That is not a bad thing, but my hearing, thanks to way too many concerts with no ear plugs, is not what it used to, they are talking rapidly about things I'm not familiar with and, if you add any kind of accent to that, it was easy to lose me. Or, if I found their accent lovely or intriguing, I would find myself listening more their inflection or the lilt of their voice than what they were saying. In short, I let a lot of critical information slip through my shattered mind early on, so I would need to spend a little time later figuring out what they had been trying to tell me in dumbed down terms.

And, in the end, doctors and nurses are only human. They have opinions, they make mistakes. The less you know, the less likely you are to catch a problem before it's too late. I like how my friend Francine is approaching her mother's back problem. She and her family have considered the matter carefully. Francine researched the type of doctors who are qualified to handle the symptoms her mom has and had a list of them. She wanted two opinions, and the whole family conferred to help make the final decision to go forward with the surgery. Of course, they had some time. Sometimes, bad things happen in a flash. My father-in-law fell down the stairs in his home (I know, I seem to be a magnet for men who fall down stairs, but I was no where near them on any of these occasions). Everything changed in an instant. They thought he broke his back, then didn't think he did, then discovered later that in fact he had, and his health and quality of life declined rapidly from that point forward. No one could have foreseen that, of course. But once it was set in motion, understanding the treatments and options was vital. My mother- and sister-in-law cared for him at home for his last few years. They were very involved with his daily care and had to understand it.

Finally, if you have some basis of understanding what all these really busy people are tossing at you, and don't look like a deer caught in surgical lights, then they will tend to take you more seriously and, ironically perhaps, slow down just a bit and spend more time with you. Their respect level goes up a bit, and suddenly, I believe, they see you and your loved one a little more clearly as opposed to just scribbles on a chart. It certainly doesn't hurt. Figuratively speaking, that is.

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