Tag Archives: hospitals

October 12, 2012 · 6:14 pm

“I want to take him home”

As I mentioned recently, it’s almost been a year since Dad’s final round of hospital stays began. Most of the memories from that time period are sad, naturally. But there were a few innocent, sweet memories collected along the way.

When Dad came back to Ruidoso after being in the dementia wing of the nursing home in Roswell for almost a year, he ended up at the local hospital for a respiratory infection. It was the first time I had seen Dad since summer and I was shocked by his emaciated frame and his non-responsiveness. It was pretty clear that this appeared to be the beginning of the end.

One day, two fresh-faced nursing students were making rounds. They stopped into Dad’s room, perky and bright. One of them exclaimed about Dad: “He’s so sweet! I just want to take him home with me!”

She could have been talking about a puppy, but instead she was referring to my Dad, who was slowly wasting away before us. Yet in her youthful eyes, she saw something precious. Perhaps that was naive on her part, but it was refreshing in the moment.

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August 26, 2012 · 8:18 pm

Feeling like an alien in the healthcare system

As anyone knows who has served as a caregiver for a family member, you enter this world that operates quite differently from the so called regular world which you’ve grown accustomed to.

This world of illness and hospitals and nursing homes definitely works on a different time zone. Long hours are spent waiting, then all of a sudden there is a storm of activity that leaves you with whiplash when it’s over with. I really feel for those that have no one to help them through this, because everyone should have a healthcare advocate. There’s no way my mom or my dad would have managed dealing with the healthcare system without having someone in their corner to ask the important questions, to stand up for them, to be their support system.

I wish I had done more for Dad so I’m trying to erase that guilt by being here for Mom now. I certainly feel her gratefulness and appreciation, and know in my heart I have made the right decision to be here with her.

It’s frightening how we are at the mercy of the healthcare system to provide for our medical needs. The simplest task becomes an ordeal. You have to put so much faith in a bunch of strangers who are overworked and stressed out. Hospitals and nursing homes are woefully understaffed, but there seems little concern to addressing the issue, because when you are sick and in need of care, most often you will choose the hospital or care center closest to where you live. It’s not often that you hear of hospitals shutting down. Nursing homes don’t close up shop unless they are socked with a major infraction, like patient abuse.

When I receive a day or two of respite, I find it hard to try to adjust back to the normal world. The one where people are not always talking or thinking about illness, the one where people don’t spend all day in the hospital or care center. I feel a bit like an alien observing a different life form.

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August 21, 2012 · 5:50 pm

Doctor disconnected

We saw Mom’s surgeon today for a followup visit. I think he’s good at what he does, and I like the fact he’s honest and does not offer false hope.

But there is still that disconnect. Mom had questions about colostomy care, and I could see the doctor shrink back. “Well, we don’t handle any of the colostomy care issues here, there are nurses that handle that.”

Certainly I don’t expect the doctor to be changing bags, but it seems odd that he washes his hands of anything beyond the actual surgical procedure. The doctor creates the need for the extensive and complicated aftercare, but leaves it to strangers to figure out his handiwork.

A similar thing happened with Dad near the end of his life. Doctors who knew little of Dad’s health were prescribing medications without concern for side effects. They would see him once, scribble on a piece of paper and they were done.

This disconnect is nothing new, but when it involves family members, you really feel it.

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August 2, 2012 · 9:02 pm

Time warp at the hospital

Hospitals are pretty much the same all over. I spent a week hovering over Dad at a big hospital in Albuquerque, and I’ve spent much more time hovering over Mom in a small town hospital in Roswell. To sum it up: understaffed, long waits, crappy food, the constant beeping of machines and tense people in waiting rooms awaiting word if their loved one made it or not.

Today was no different. The doctor that did my mom’s blood clot removal procedure yesterday came in at 8:40 a.m., said she looked great and that she was ready for discharge … once the hospitalist came in and gave the discharge order.

The hospitalist did not arrive until 4 p.m.

Grrrr. Make that double grrrr.

Once the hospitalist finally arrived, she stayed less than a minute, and then Mom’s discharge process began in earnest. But what a waste of a day, and Mom was eager to start back up rehab. The doctor that did her vein procedure said she was to get up and walk multiple times today, but that didn’t happen, and now she’s behind a day. I understand that the sickest patients have to be tended to first, but Mom occupied a bed for several hours that could have been used by someone that was really sick. (She was in ICU under observation for the night.)

Mom and I had plenty of time to talk and Mom wanted to discuss memories of Dad which was nice, but still, it’s so frustrating sitting around waiting for a doctor to pop in and give the thumbs up so that the patient can be discharged.

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July 10, 2012 · 10:30 pm

One day at a time

The doctor stopped by to visit my mom today. She’s still recovering pretty well, but the doctor is waiting on a few signs to happen before moving her to the medical floor, and then back home. The road to recovery always has stops and starts. There’s a plan for the day, but things don’t always go as planned.

When Dad had his emergency gallstone surgery, there was no returning home for him. His mental decline, along with his weakened body, made returning home impossible. He went to a skilled nursing facility, then an assisted living facility.

For Mom, the plan has always been to return home. And I believe that will happen, but I also think she will need more care than the home health service may be able to provide. As to be expected, major surgery takes a lot out of an older person. I have to accept Mom may never regain that spring in her step.

Or maybe she will surprise us all and come back strong. I hope for her sake she can stay as independent as she can for as long as she’s able to comfortably. With Dad, placing him in an assisted care environment was different, because he had lost sense of what home was. Mom still knows, and while she is the model patient, I don’t think she would be happy in a group home environment.

But as the doctor said today: “One day at at time.” It’s good advice, yet hard to follow.

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July 8, 2012 · 7:03 pm

Being on hospital time

Another reminder of my dad’s last few months of life resurfaced today. I forgot what it was like to be on hospital time, which follows no rules or structure, just whenever they are darn good and ready. Certainly one can understand that emergency cases can change the course of a day in a snap, but it’s still frustrating to be the relative (or the patient) waiting and waiting for something to happen. Then in a flurry, everything happens.

It was the same way with my dad when he was in CCU at the hospital in Albuquerque. There would be maddening delays between a machine sounding a warning beep and a nurse coming in to attend to the issue. And trying to snag the doctor? You’d be more likely to obtain an autograph from Brad Pitt than have the honor of the doctor’s presence in your room. It really is scary how much power the doctors wield in the hospital setting, considering their physical presence is so fleeting.

Today, after Mom’s surgery was delayed due to an emergency surgery, I stepped out, only to return and find that Mom had been whisked away to surgery in my absence! Luckily, I was able to see her in the prep area before she was sent off to surgery. And more good news, she made it through surgery just fine.

Still, as stressful as it is to have a loved one in the hospital with a serious medical condition, you also have to endure hospital time, which can be so maddening. Hospitals can’t control the amount of cases that walk through their door, but they could be better at communication.

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July 7, 2012 · 6:10 pm

The eyes and smile of a fragile parent

Mom is headed to surgery tomorrow. All best wishes and prayers accepted!

As I was watching her rest today in the hospital, she opened her eyes from a nap and rested her gaze slowly on me. A dawning realization spread across her face, and a weak smile greeted me. This was the same reaction I got from Dad, though with less recollection of who I was. Still, he always seemed grateful to see me at his bedside. It is such a sweet, innocent, pure gesture. It’s love in action, in its simplest form.

It’s beautiful and heartbreaking, yet rewarding at the same time.

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July 6, 2012 · 6:24 pm

Hospital nightmare begins again

Mom is in the ER and we’ll be headed to surgery soon. She’s going to Roswell, where Dad spent most of his final year of life.

Not the way Mom wanted to spend her 75th birthday I’m sure.

Entering the nightmarish world of the hospital again. This time with a different parent.

And hopefully a different outcome.

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June 22, 2012 · 8:17 pm

The downside of small-town living

With my mom’s health in jeopardy now, I’m reflecting back on my dad’s healthcare from the time he started suffering from dementia. The conclusion I’ve come to is that it’s okay to retire in a small town as long as you are reasonably healthy. My dad had COPD and emphysema but those were easy enough to manage, since he didn’t have any major symptoms.

But once you need more specialized care, you may be in big trouble. Certainly it wouldn’t make economic sense for every small town in America to have a horde of specialists at your beck and call. But for many Americans (and I suspect this applies in other countries as well), the high cost of living in a big city is just not feasible. Nowadays, people worry about living too long, and blowing through their meager savings, even if they live on a tight budget like my parents. So small-town life seems appealing. It’s easier to navigate around a small town and become familiar with your surroundings and maybe some of your neighbors. The cost of living is lower. It’s a more relaxed way of life.

It all makes sense, until you get really sick. Then one discovers, like I did with Dad, that the only care center that would accept him is over an hour’s drive away. The hospital in town is mediocre at best, and can afford to be, as they are the only game in town. It becomes disheartening to deal with the indifferent medical staff at doctor’s offices and at the hospital. You want your loved one to have the best of care, and you know this isn’t it. But you can’t just pick them up and drop them in a big city and have the best and brightest doctors treat them. Well, I guess you could if you won the lottery or something. Mom already did that, but she didn’t win enough.

I know my Dad’s care was not as good as it could have been, and now I fear the same fate for my Mom. In a weird twist, I felt like Dad’s dementia may have protected him from some of the medical gaffes that he suffered. My mom’s mental state has taken a hit, but she’s much more aware of what’s going on than Dad was. I fear she will be more aware of suffering. Sometimes I get tired of the rat race of city life and long to run to the mountains. But there’s no such thing as an oasis. Wherever you go, death will find you.

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April 16, 2012 · 6:17 am

Dementia and the ER don’t mix

I started a new job this past week and one of my managers had a terrible bicycle accident after work, and suffered serious facial injuries. He’s going to be okay, thanks to some fine work at the local trauma center hospital. However, he’s also diabetic, and despite telling the staff multiple times, they didn’t even bother checking his blood sugar until the second day he was in the hospital. Luckily, his wife, a registered nurse, arrived at the hospital and was present to be his medical advocate.

This incident made me think about my dad’s final ER visits. He had a bit of a revolving-door relationship with the local hospital during the final two months of his life. When Dad came back to Ruidoso to move to a local assisted living facility that finally had an opening, he was quite ill with what was most likely pneumonia. When the nurse did the intake process at the local care facility, I was told the red flag went off in their computer system when they entered the drugs that Dad had been prescribed by the other facility. I took a look at all of the medications he was on, and Risperidone was on the list. This is not FDA approved for use in elderly patients with dementia and essentially is used by care centers to “gork” out the residents so they are less trouble. Studies suggest the drug may have contributed to an increased risk of stroke in elderly patients.

When Dad was taken to the ER because he was so ill, he was also very lethargic. I asked the medical staff there about the Risperidone, and perhaps they could start weaning him off that, since it is known to make people groggy and clearly Dad was not a “problem” patient at the moment, due to his medical issues.

The doctor just shrugged his shoulders and said their policy was just to keep them on whatever drugs they are currently prescribed. While this might make sense in most cases, wonder if the assisted living facility had been giving him a combination of drugs that was making him ill? Shouldn’t the hospital take that into consideration, instead of blindly feeding my dad pills just because they were on a list?

I’m not usually a fan of being a bitch, but when it comes to hospital care, often, the nice and meek finish last. You have to speak up for yourself and the loved ones you are caring for, even if the staff roll their eyes and get frustrated with you. When someone’s life and well-being are at stake, you have to fight back against an often indifferent healthcare system.

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