From Dr. Jane's Notebook

Hospitals patients need an advocate

There are few things worse than when a child has to be in the hospital.  Hospitals are scary places where unpleasant things happen at all times of the day and night. Any adult who has been through a hospitalization with a child can attest that the experience is so frightening for both that it is difficult to leave that child alone for even a moment. But what if the patient is not a terrified child but really your parent who has dementia?  Here are a few more thoughts on the matter.

·        Loss of mental capacity. When people become mentally impaired, they regress to more child-like states of mind… and like most children; they don’t like to go to see the doctor!  In 1995, Hales and Hales, co-authors of Caring for the Mind estimated that 15% of Americans over the age of 65 lose mental capabilities gradually through Alzheimer’s disease, vascular strokes, and Parkinson’s disease.  Today, WebMD warns that by age 80, half of us will have some symptoms of dementia. The Hales’ further estimated that while in the hospital, 50% of elderly patients experience some form of temporary delirium episodes due to metabolic imbalances, surgery, changes in medication, trauma or infection. Poor handling of these vulnerable patients can lead to suspiciousness and paranoia in all future medical matters.

·        Little children in big, old bodies. Patients who suffer from dementia provide a special challenge. While dementia robs individuals of certain memories and reasoning abilities, it does not rob them of their feelings and fears. My Mother, who suffers from dementia, recently became ill and needed to be taken to the hospital. While it was initially assumed that my Mother would not voluntarily submit to either an ambulance ride or consent to being hospitalized, comforting words from an emergency medical technician won her full cooperation. When I arrived, she had submitted to the installation of an IV, she had allowed a blood test in the emergency room, and she was resting peacefully in her hospital bed. Her problem had been diagnosed as a urinary tract infection which could be easily treated with an anti-biotic. But to be on the safe side, we were told that she should stay overnight for observation.

·        Expect the Unexpected.  Just as my Mother and I were settling into our hospital pajama party, a Lab Technician arrived at my Mother’s side and proceeded to wrap a tourniquet around her arm. My Mother objected loudly and told the tech to stop.  After a few moments of gentle explanation, my Mother consented to the tourniquet and allowed it to be re-applied. But when a surprise needle came with the package, my frail and fragile Mother tore the needle from her arm and began hitting the tech to push her away

·        Patient’s Rights. Instead of backing off, the tech threatened my Mother that another technician would surely be sent. When I stepped in and asked about patient’s rights, the technician quickly disappeared, leaving my Mother’s fears and lack of trust fully amplified. Soon, the Floor Nurse entered the room and after I told her what had been going on, she turned to my Mother and said, “I’ll put it in your record, ‘no more needles’”.  My Mother and I both breathed a sigh of relief. The next day, the physician said that the additional blood tests had been ordered simply to rule out other problems.

My Mother has always been an advocate for human rights. She is still teaching me important lessons. That day, I learned that we don’t have to feel like helpless victims just because we are in the hospital. And we don’t have to give carte blanche to every possible item on the hospital menu. Sadly the elderly and infirmed in our society lose status, lose esteem, and are stigmatized even in hospitals that are designed to care for them. At every age, some of the best medicine for the infirmed continues to be tender loving care, accurate information, and reassurance that they are still in charge of themselves and in control of their lives.

©Copyright, 2010, Jane R. Rosen-Grandon. All rights reserved.            

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