Where to Go When You Need a Hospital for Dad?

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How to choose hospitals that fit the needs of your senior in care. by francy Dickinson

HospitalDear Francy; We just got through with a horrible experience at our local hospital. We live in a bedroom community and my dad had been having trouble with pain in his stomach area. He had trouble going to the bathroom and his back hurt. So, we finally took him to the ER at our larger local hospital. We have two hospitals in the area; one is smaller and other is a big trauma hospital with a big ER. We went to the larger hospital thinking they would have a better ER to treat him. When we arrived the ER was packed and we had to wait and wait.  Then when he was in the ER room…there was no room for him! So he was on a gurney in the outer area while a police officer was patrolling the ER. There had been gang trouble and they were trying to keep two rival gang members separated while they treated them. Poor dad, was confused, in pain and totally unable to process why the police were there. It was a nightmare. Why do they let seniors take back seats to these horrible gang people?

I can understand your distress and I assure you they did not take the gang members over your dad. They do Triage and the gang members were in more high risk condition, than your dad so they went first. The problem was that the hospital itself is a haven for high stress when it is a trauma center. So, lets talk about hospitals and get the idea of how to choose them in your mind. Next time when an emergency comes up…you will be prepared and be able to guide the ambulance driver to the right place for your special care.

Triage Means:
noun(in medical use) the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or  casualties. verb to assign degrees of urgency to (wounded or ill patients)

I will assume your dad had prostate or blocked bowel, correct? Those are conditions that older men have and they are very painful. Elders often do not talk about their private bathroom problems with their care givers or family…until the situation gets painful. I understand that and I’m sorry you all had to go through that sad emergency experience. But lets roll back the clock and see how it could have gone differently.

Both elder men and women need to have a verbal check each day. Care giving is part immediate and part prevention. So everyday( I usually do it while I am picking up their breakfast tray) talk to them. “Dad how was breakfast, I see you did not eat very much of your cereal. How is your stomach feeling?” Dad says; “Oh, fine, I was just not very hungry.” You say; “Oh, well lets talk about it. Are you feeling OK..when did you last go to the bathroom?”

Then you go down the list; are you in pain…if so 1-10 how does the pain feel? When did you have your last bowel movement, or – you are going to the bathroom more often..why is that?” It may not be a hit parade topic for a father-daughter subject…but it pays off. You do this day after day and then he will get used to it. The conversation and your voice tone stay quiet and you sound calm…so your senior feels the conversation is normal. Pretty soon, you learn to take note of changes and you can make a quick doctor or nurse practitioner appointment. When you do that, remember to write down the symptoms your senior has been showing or talking about. As you arrive to the appointment, hand the paper over to the office person checking you in and ask them to attach it to the file for the doctor’s review. It will make the appointment go faster and easier for everyone.

As one older, very experienced in-home nurse said to me…”Francy, stay out of the ER as much as you can. It will usually mean more trouble than it is worth for an elder senior.” So, I try hard to catch problems before they get out of hand…but falls and extreme illness do happen and we all have to face them and learn to use the hospital system and keep as informed as we can.

Now, what I found after years of hospital visits is how to choose a hospital in advance to a problem. The smaller hospitals are perfect for ER visits when you have non heart related issues. So, if the senior falls, or has bowel or urinary problems, even stomach pains…that is something a small hospital does best. ERs are always busy…but less stressful in smaller hospitals because the “trauma'” issues are brought to bigger specially designed Trauma Centers…so car accidents, gun violence or heart problems that require loads of equipment and team efforts to solve a problem are their specialty. This huge effort for big care issues is much different then the smaller hospital ERs. Not that smaller hospitals do not carry heart issue equipment, but its nothing like the big Trauma Centers.

Heart issues are always brought to the larger hospital centers that have special heart teams on staff, at all times. So, you know if you have a senior with any heart, stroke or related issues with blood thinning medications…you have a clear path to that large Trauma Hospital. When you get all of this in your mind ahead of time…when the emergency hits…you are prepared.

Share your choices with anyone that will be caring for your senior …so this is all figured out and runs smooth. Every emergency is stressful…so to know the direction to go for help is really a step toward faster care.

Now if your senior is having small elective surgery…you want to once again take on that smaller hospital. But here is where that changes. If your senior is in a questionable situation…or diagnosed with something complicated…you want to find a “teaching or specialty hospital”. Yes, this could mean a drive to a larger city…but the specialty hospitals are simply a godsend when you have a complicated diagnosis from a doctor. When you face a long-term battle like cancer…having a full service cancer center to go to is a super smart way to treat the issue.

So the example would be this. Your senior goes to the smaller local hospital ER and is treated for a blocked prostate. They come back and say that the prostate is showing cancer, what to do?

There are a lot of decisions to be made in case of a complicated diagnosis. Prostate has many different treatment options. My young niece was just diagnosed with leukemia. That was a two-week ride of trying to figure out what kind of leukemia she had, so they could treat it well. If she was in a small town, with a small hospital – I would have asked them to transfer her to a children’s hospital in a larger city. That specialty hospital is trained in children issues, has specialists that deal with leukemia on a daily basis..not every once in a while. She was lucky because she had a children’s hospital close. She is safe and getting a complicated treatment schedule that the “Hospitalists” are well-trained for and she is getting stronger.

Something to know: Hospitality are now the treating physicians in the hospitals. You   will be using a general Hospital, not your own regular doctor  when your senior goes into the hospital. This is what I found for meaning: A Hospitality is a doctor who basically does nothing except take care of in-hospital patients. They do not have private    practices, they strictly do hospital work.

A senior with the prostate blockage and possible cancer would be best at a large hospital with a specialty of cancer or a teaching hospital. That way all the newer treatments are available for the senior and they can give you a full understanding of your choices in treatments. What I have found is that town doctors may be specialists, but in emergencies they stick to what they have done for years. They stay close to treatments and drugs that are comfortable within their experience. I do not want a complicated situation to be handled in an out of date or common way. I want a complicated issue to be handled with a group of specialists that are on the cutting edge and will use different services to make you and the senior informed of the options of care. I also like the idea that a “group” of doctors will be reviewing the situation and debating treatment for your senior patient.

If you are reading this and say…WOW, my dad is older and does not want to have fancy extended care. He wants to pass naturally and easily.

 That is called Palliative Care. Here is what I found on the meaning: With palliative  care, there is a focus on relieving pain and other troubling  symptoms and meeting your emotional, spiritual, and practical needs. In short, this new medical specialty aims  to improve your senior's quality of life -- however you define that for yourself.

What I feel is that the word Palliative Care is an important word for you and your elder/senior in care need to talk about. That is why everyone needs a Living Will/Medical Care Directive. As you make out this form, you will go through the different options of care giving with the senior. You will then know how to make a decision in the middle of a medical emergency. Do they want to be on long-term care? Do they want to have CPR…there are many different questions on the form and the senior will be able to design their own life care. If those decisions mean that they do not want to extend their lives you need to talk to a doctor and get a special paper that says “NO MEDICAL LIFE SAVING SERVICES”. This paper will be signed by the doctor and the senior. So when you call for help and the EMT team arrives they know the rule and the paper is posted and they then do not have to do “any or all to save a life”. This is important to have when your senior is in the last journey of their life. Lots of families do not understand this rule and do not take that extra step. When the EMT or ER people respond to the senior’s needs they can not…just let the senior go…they are legally bound to treat the senior. But if you have the paper that the doctor and senior have signed (its different – in different states) you can show it and the medical team can relax and make the passing comfortable.

Inform yourself on the forms to keep your senior from extreme life saving treatments. Its a form here is what I have found on it: What are “Medical Orders for Life-Sustaining Treatment” (MOLST)?
The MOLST form is a standardized document containing valid medical orders about life-sustaining treatment. It stays with the patient and is honored by health professionals across all health care settings.

My mother had the MOLST paper posted…but when she started to bleed from her mouth..I still took her into the hospital and they found she had an ulcer from her medications. They did a small procedure to stop the bleeding and changed her meds. I did not think we should have let her life go, under the situation. It was a small mend and she lived on another two years. You see I knew how to make that decision because we had talked about her care when we did her care directive and I got my name on the paper as her Power of Attorney for Medical issues. I know it sounds complicated…but I assure you…during the care process for a senior these issues will come up. Life is not always “passing away in your sleep”. It can get very complicated. So with my mother…she did not want any fancy testing or complicated or major procedures to extend her life. I knew that and my choices for her care were easier for me because of our talking over her wishes.

To download your state’s health care directive forms FREE click here. 

I have put the hospital phone numbers of my city on my cell phone. I have also thought about when I drive or when I call 911 for help. When my husband George had pneumonia I called a friend to come and help me drive him to the hospital. When he had symptoms of a heart attack I called 911 for immediate help. If you take a few minutes to think over the idea of when to call for help or when to do take action on your own…you will find that you are prepared in your mind…when and if an emergency pops up.

I also have just done a review of how to make sure that you are prepared for the ER hospital trip and possible stay. Here is a link to that blog so you can pack and have your Emergency Kit all ready to go.

George on a rare out and about with me ;)

George on a rare out and about with me 😉

I want to take time to thank you for the care giving you are doing for your senior. I know what a struggle it is to be a care giver and I appreciate all you are doing. Would you do me a favor and click on the “sign up” button on the right side of your screen. I am so busy with care giving for my Georgie (with Alzheimer’s and Parkinson’s) that my blogs are random…this way you will get an email with my new blog info. Blessings, francy

PS Thank you to all of you that are constantly supporting me during my care giving for George. He is getting much weaker with his Parkinson’s issues. So the care giving is more complicated and extended. But we did get out for dinner on Good Friday…to celebrate Easter. We met George’s son and his wife at a local restaurant and had a nice dinner. I picked a place that I could park and walk in on one level. George just wheeled up to the table and I did the running around the buffet to fill his plate. He had such a good time, but it took about three days for him to recover from the extended activity from the out and about. I think of our journey as “creative problem solving’ on a daily basis. I want George’s life to be as joy filled as possible. So, we make most quiet days into little celebrations of current events. He is happy and the care giving needed, is still within my range. Thanks again, francy

Are You Ready to Take Your Senior to ER?

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How to be ready for emergencies so you and your senior can get to the hospital and be comfortable while you deal with the Emergency Room or extended stay. by francy Dickinson

GrabnGo ER Kit 4 You!

Grab n Go Ready ER Kit – Just 4 You!

Dear Francy; I live in a small community and my dad lives with us. He had issues last week, his heart was in a race and he was fainting…on the floor…I was in a panic. I called the doctor, because dad was on a lot of heart meds and they said take him to hospital. A neighbor helped me get him in the car and off we went for a 28 minute drive to the hospital. Once there…they took over…but I just lost my head. I had none of his information with me, we start in ER and then were there for two more days while his drugs were adjusted and watched.  I was exhausted, worried and still dressed for work. It was an all around horrible situation. I remembered you talking about being prepared…I failed on that end…would you review the ideas for stress and emergency room trips. Thanks..Cindy, New Mexico

Thank you Cindy…don’t feel bad…I’ve been there too. You sit in that hospital and are uncomfortable…and can not just race home to change or get your things….so what I suggest is that if you are caring for a senior….YOU NEED A BAG FOR THE ER!

I have heard the stories for years…a spouse, family member or dear friend goes into a serious backward spiral and you know that you have to call 911 or take them to the hospital yourself. You are caught up in the moment of panic, worry and actual action of caring for the senior. Out the door you fly…to drive behind the ambulance or drive to the emergency care place yourself. The last thing on your mind is comfort..your mind is racing and your heart is in a high state of worry. But once at the hospital…everyone starts to ask you questions…social security numbers, health card information, does the senior have allergies, what are the medications that they are taking…you stand there in stunned silence…just wanting to be in the ER with your spouse or parent…and there you are – stuck with answering questions that you are not prepared to answer. After that nasty 15-20 minutes…you try to find your senior and they have started treatments. They are telling you things and you wish you could write them down…new ideas for treatment, interactions of medications and you are just trying to breath and tell your senior that they are OK…just hang in there. Then the ER puts the senior in a side area and they have to wait…wait for tests, wait for doctors to arrive, wait for ER or CAT scans…and the minutes stretch into hours and hours…then they say they will put the senior in a room for a couple of days…they want to keep them on close watch. Close watch? That means you don’t leave your senior’s side.

You are tired…your phone is on the last few minutes of energy…you have no phone numbers with you to use the hospital room line. You need to drink some water, have a snack but its the middle of the night and the cafeteria is not open yet and no change for the snack machines. You have now been at the hospital for 4-6 hours and you are looking at an over-night stay…sitting in a chair in the room. Nasty….and all of us…have gone through all of this and there is no reason to do that to ourselves….we do enough just loving and caring for our seniors. We need to be prepared for these fast, unscheduled emergencies….so we all need to put a kit together for our own use.

“ER Grab n Go Bag” 

If you have not experienced this yet, please believe me…it happens…your senior can fall or become unwell in an instant…and you will be faced with all this drama…and wind up feeling like a fool that you did not plan ahead to make the trip so much easier for your self. REMEMBER: the hospital is going to give full care to the senior in the emergency…YOU are the one that is not going to be cared for…you are simply in their way…so you stay quiet and try to stay close to your senior so you can give them calm and love. BE PREPARED!

ER Info Kit for your Senior

ER Info Kit for your Senior

START WITH ER INFO KIT FOR YOUR SENIOR

I keep an ER info Kit for George in my handbag…and one in the kitchen. I have given one to my sister and his kids know where I keep another copy. I have all the info that the ER entry office person is going to ask me. There is a good copy of all his cards, front and back. There is a review of what he is allergic to and his personal needs for check-in. There is a very detailed medical prescription and doctor listing and there is Power Of Attorney or a letter signed…that allows you to give and get medical information. I also tuck in the driving instructions so if I get too nervous or stressed…I can still get to the hospital. This is a must…and you have to take time to type it up and make copies…and then you are set to go. I update my medication listing…and you will find a whole blog on the details on April 21, 2010 called “If your senior goes to ER, are you ready” Please put that in the search bar on the top of the page and read over that blog…it has all the details for the paperwork to get you in the out of the check-in process of hospital or doctor visits. I can not tell you how many health care professionals tell me how they love my kit…you will too.

Just remember this information is all of the personal ID on the senior and it has to be kept private and safe…so keep it protected...I use a plastic envelope and I also have a whole booklet that I use for his medical information. If you do put together the “Grab n Go Ready Kit” you will also have a spiral notebook n pen to take notes. Trust me…I have given care to my mum and my husband for over 10 years now…you need these items when you go to the doctor and the hospital. I know you may think they have all the patient’s information in their computer system…but you are wrong…info is rarely updated and they often lose the patient in the computer files. Be ready to give them any thing they need to help the senior get well in the middle of a crisis. Do not count on your mind…even ss# can be forgotten or mis-stated when you see someone you love in peril! (NOTE: What I remember is wasting time at the check-in window when I wanted so badly to be with my frightened 95 yr old mother in the ER room…to keep her calm. I did all of this so I would never have to repeat that.) The next time we were at the ER…the check in lady…just took my paperwork and told me she would enter it all and bring it to me in the ER…it was perfect. I have been thanked by nurses, doctors and admin-people for having the information so well-organized and it only took the time for me to enter it into the computer the first time. I update the info every six months or on medication changes. Easy -peasy for no stress check-in’s.

 NOW LETS TALK YOU…HOW ARE YOU GOING TO COPE WITH HOURS IN THE ER– IF NOT DAYS IN THE HOSPITAL? JUST LIKE SCOUTS….”BE PREPARED”

hospital sleeping chair

Well this is the chair you get to live in for a couple of days. As you can see it is not pretty, but it does recline and you can stay in the senior’s room…by their side and be part of their healing team. Even a First lady, does not get anything better than a sleeping chair in most hospitals. But trust me…its a lonely place if you don’t have anything with you.

So, out comes your ER GRAB n GO READY BAG…and you have a few things to make yourself feel comforted and rest as you help your senior do the same.

  1. Comfort and Warmth; I put an old pair of sweats and a warm top in the bag…with cozy warm slipper socks…that way my clothes are presentable to the public…but totally comfortable for me to sit and sleep. I also have a throw…or you could put in a hoodie so at night you can be extra warm…the hospital rooms are always cold to me. They often give you a blanket…but its never enough for me. As you see the chair it does have a lift so your feet will be up and the back will tilt. I have a pillow collar that I can tuck under my head or put on my lower back to ease the comfort level. You can get blow up neck pillows in the travel department. They are honestly the best gift to yourself in this situation. (I would rather use my things instead of hospital things…its a germ thing with me…my things make me feel safe, not worried about catching something)
  2. A small water bottle is in my bag…you can refill it in the hall with the drinking fountains. This is just a must…I don’t want to be buying soda all day…and swell up…the hospital can have dry air…so stay hydrated. I also have a couple of snack bars…to get me through. Usually the emergency is through the night and when I am able to take a few minutes to eat…the cafeteria is not open and you are faced with only snack machines. So, I have my snack bars and I tuck a few dollars in an envelope and keep in my bag. Often times, I am out of cash in my purse so this makes it easy to get anything I want out of the machines…and then I can also go to the cafeteria for a sandwich or soup during the day. I also tuck in a few tea bags and sweeteners…you can always get hot water from the nurse’s station…and it tastes so good to relax and calm yourself with tea. You can also ask them if there is a snack fridge for family….the VA has a nice area for us to go and get hot coffee, yogurt, or pudding etc – any time, when we are with our loved ones. Don’t be afraid to ask…it maybe there for you, just steps away from the room.
  3.  Keep clean…wash your hands until you drop when you are in the hospital…and I have a small hand cleaner in my bag with Kleenex if I get snuffy. Plus…you will never find me wo/ my Advil. I have a bad back and I tend to get pressure headaches…so my little package of Advil that I got at the Dollar Store is heaven-sent when I’m in need. If I was taking medications…I would have a couple of ziplock baggies with a couple of days of those in my Ready Bag too. Nothing worse than going without your bladder or blood pressure med for a day or two…add in the stress and your body will really complain.
  4. Bored? Remember…people that are unwell…sleep. The hospital will give them drugs to keep them calm…but what about you? I bring a book to read. I use a Kindle but you don’t want to depend on remembering that….as you run out the door. A good old fashion paperback book and a pair of readers can be tucked in and ready for you to dive into and remove your stress in a good story. An older Mp3 player is also a great tuck in…yes, TV’s are in the rooms…but often they are on a channel that you don’t like or you can not hear them…so I make sure I have my own things to keep me calm. If you are a knitter…just tuck in an old project you have never finished…in a zip lock bag and its there for you. Think what it is that you enjoy…and make that happen in your Ready Kit.
  5. Calling the family? You need to have a re-charger in your bag…buy one that will recharge all your devises and if you tuck in your reader or tablet as you run out the door…you will be able to keep them going with your charger. Your mobile phone is your lifeline to the family…but many times the hospitals…block the cell phone signals. What then? You have to walk all the way to the front of the building and make your calls…not an easy thing to do. I had that happen to me and it was exhausting. So, write down a few of the key family phone numbers to keep posted. You can always ask them to send the information out to others. This way you can use the in-room telephone for local calling. I have my number in the front of my spiral notebook and I’m ready to go.
  6. Pets left behind…what about the mail? After a long stay in the ER and then you find out you maybe in the hospital for a day or two longer….have a neighbor or friend that has a key to your home and will take care of your pets. They can also pick up the mail and put it in the kitchen for you and just keep the lights out and everything in order while you are gone. I always put a key ring with my name on it…so the neighbor can keep it and knows who it belongs to — it could be a couple of years before the call could come for them to help….once you have this info in place…you can relax and know that all is well without you leaving your loved one to run home.
  7. A Ziplock baggie with little things that mean something to you…to keep you calm. Maybe you need cough drops…or lip balm. A new toothbrush and small toothpaste. Hand cream and face cream…Glasses and a glass cleaning cloth. Maybe you are a person that needs a few peanuts to keep you going or hand wipes to feel clean. If you are in need…you can tuck in a few Poise/Depend pads. Think comfort. NO the bag does not have to be a huge case…its just a big tote…but keep it full of things that bring you comfort…so when you are stressed and worried…you can keep yourself calm.
  8. If you forget your tote…then you call a friend to retrieve it from your hall closet and everything is in the tote..instead of the friend wandering around your home for a “few things”.

I suppose you read this and think…Oh, I will get on this pretty soon….please do not do that. Go right now and just put a few things in a bag and tuck it in the hall closet. You can make it fancy or expanded later..but get the ER senior’s information kit, in order and a few things in your own Ready Kit–RIGHT NOW. Its like giving yourself a gift…and you will rejoice in it if and when the day comes that an emergency hits your home…and you can just open a door grab your Ready Kit and walk out the door caring for your senior in need.

I always want to thank you for caring for your senior. Would you do me a favor and “sign up” up for the blog. That way it will come to you via the email and you will not miss any of the tips…and if you know someone that is a care giver…please share my blog with them…thank you.

As a spouse of a Alzheimer’s/Parkinson’s senior…I find the care giving can be so overwhelming and it represents such love. The gift of care is the dearest thing you can give to a person that has become unwell, unsteady or confused.

My Georgie has been declining a great deal lately. Falls and safety issues are a daily challenge for me to handle now. I am not blogging as much as I would like…but know I’m here for you to send me a message if you have a question or need help.

I am pleased to say I have a dear friend that helps me with my care giving….and I want to thank you for just “being there” for me in this journey I am taking with George….Friends are the best. I hope you feel I am on your friend list and you will feel free to ask questions that you may have at any time….Blessings…francy

Me with my friend Cheryl who is always helping me with George and supporting me as a loving friend...Thank you Cheryl!

Me with my friend Cheryl who is always helping me with George and supporting me as a loving friend…Thank you Cheryl!

10 Tips for Great Doctor Appointments 4 Your Senior

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Info on how to prepare for doctor appointments for you or your senior. by francy Dickinson

George on his weekly out and about.

George on his weekly out and about.

Dear Francy: Mother was complaining for two weeks on how she was having bowel problems and a soreness in her rib cage…I made the doctor appointment. We go…then she says nothing! He asks her how she is and she says; “FINE”  I am so frustrated and mad that I wasted a day off work for an empty doctor appointment. HELP!

Hello!  Are you sure you are not living my life? I have been there and done that so many times that I sat down and went over all the steps that would give me quality time with busy doctors. We all can get scattered and forget, or not really ‘think’ about our body and what to ask the doctor. So here is a listing to help you never again feel cheated at a doctor’s office.

George is going to his memory clinic on Friday. We have had three appointments that have had to be cancelled, due to all sorts of things, so this time…we need to really go and hit the nail on the head. I am taking time to do all of these steps this week with George. I know this will help you. It has made my time at doctor’s offices go smooth and easy.I have even had doctors “thank me” for being so informative.

10 TIPS TO HELP YOU MAKE THAT DOCTOR APPOINTMENT INFORMATIVE:

  1. Quiet yourself and think about you/or your senior’s body. What has changed since the last time you were at the doctor’s office? Even if the doctor you are seeing is a foot specialist…write down your whole body changes. Doctors diagnose with detailed information. They are best when they know the most. Give them a list: slightly dizzy when I get up to go to the bathroom at night – gained 10 pounds and feel like candy is my best friend – allergy headaches that really bother me – my mouth is dry all the time, lately – my nails are breaking a lot – my hair is getting thinner. Go ahead. Sit and think about this, talk it over with your senior or spouse and write it down. Do not be afraid or embarrassed to share the information…this list could save a life.
  2. Write a letter to the doctor about your care giving elder. Just let the doctor know. I have written my letter for my husband’s friday memory clinic appointment. I have taken time to be quiet with myself and just write down his changes with his Alzheimer’s. I have had to insist on him getting out of bed, he only feels safe there. I have forced him to walk 10 min. in the hall – twice a day. His shuffling is so bad that I am very worried over him not walking at all and I would lose the ability to care for him. I even did a short video to show him on our tablet. I am not sleeping (see I talk about me too) I find my temper is getting short over the silly things he does. Now you go ahead do your letter and let it all flow out. Let the doctor know the things your senior has told you during the last couple of months. Write it down and give it to the check-in desk and ask the doctor to read it before he comes into the appointment. The doctor will be so grateful.
  3. Keep a list of things you hear on the radio, from friends or read online about the special medical problems you or your senior may have at this time. Maybe you heard a tip on supplements to help diabetes, or a special test on a new drug, or a place to go and join an experimental test. Write it down, so you can remember to ask the opinion of your own doctor before you proceed. Use his opinion to help you make your “own informed decision”  about treatment.
  4. Walk in the doctor’s office with an updated list of your medications. Keep this list on the computer or ask the doctor to print if off for you. You need to know each name of the medication, the amount, the time to take it, if it is taken with or without food, and what the medication is doing in your body. If you don’t know those things take a trip to the pharmacy and talk to them. You need to take pills that make sense to you and understand the reason you take them. That way you will be taking them on time, in a a daily manner. Many medications simply stop working if you take them 2 -5 times a week. So you may “pay” for a medication and then not take them properly or not understand that one medication may assist another. This is serious stuff. If you do not take your medications…then open your mouth and tell your doctor. He is assuming that you are taking it. So each time you walk in the door, he is trying to diagnosis you and if you do not have his prescriptions in your body chemistry…he is unknowingly making a mistake.
    This is important. KNOW YOUR MEDICATIONS AND TAKE THEM PROPERLY. If you forget to take them…find a way to remind yourself. There are cell phone apps that will do just that, or ask your care giver or family to call you…but take your medications!
  5. Be informed. I often go to the doctor with my sister because she tends to blank out when she is faced with the doctor’s answers to her questions or diagnosis.  I go and take notes. But now, we all have cell phones with recording buttons. When the doctor is starting to tell you what is wrong with you or how to treat it…have your record button ready…let the doctor know you are taping and push the button. Then you can play the information back for yourself or your family to review.
  6. Dress for success. OK you are going to the doctor, wear something that is easy to remove and put back on. Wear shoes that are not the heaviest you own because you will be weighted-in. Take off your coat before you get weighed and take note of your weight at the doctor’s office so you can go home and adjust your own scale. Also write down your blood pressure, if it is high you can then take it a few times at home to make sure that it does not stay in a high range. Blood pressure is best taken at lunch time…relaxed and repeated so the doctor can see the time frame of the numbers. Same with weight…weigh in the morning, twice a week and write it down in a notebook. When you go to the doctor you can show him your progress up or down over a time period so he can look for glues.
  7. Seasonal issues. Keep a green marker for your calendar journal to mark seasonal problems. Maybe you gain weight around the holidays…write it down. Maybe you have spring or fall allergies, write it down. So the next year…you can look at it and know that it is repeated and needs to be talked about with your doctor. Allergy medications have changed a lot in the last few years. Ask for help, runny noses may not be life threats, but they do keep you from going on walks for your health. Medications change and update…always ‘ask’ the doctor about new medications and if you can drop some that you are taking. All medications are changed just one at a time…so the doctor and you actually know what the reactions are for that one drug. Then you can make another change…so be patient. Maybe your weight has gone down and your diabetes pills or water pills are no longer needed. Do not marry your medications…think of them as fluid and up-datable. There is always a doctor that will give out medications just to keep you quiet…so make sure you “ask” why you are getting a medication and then do a little homework online to make sure it is something that you need and you are prepared for the side effects if they show.
  8. Can you relate to your doctor? If you are going to a doctor that does not talk to you, or you do not understand. Tell him, or change doctors. Your own, or your senior’s health is what life is about. You need to understand..that exercise is needed to help your knee or maybe you need to stay off of it…or cold not hot must be used. If you do not understand then you are not healing and it could effect the way you walk for the rest of your life. Its a big deal! Do not be afraid to make a change of a doctor, or to speak up!
  9. Use a calendar on the wall to remind you of all medical appointments. I like to cluster them. I have George do his appointments in the spring and the fall. So, in one month we see all his specialist doctors. Then the rest of the time…we only go to the doctor if he is unwell and needs extra help. This way I am not trying to take him around to appointments every month…or twice a week. My mother got too weak for doctor appointments…so I found a local doctor that would come and visit her at home. Working with a nurse practitioner is also a wonderful way to check-in quick with questions and not have to wait for appointments with a busy doctor.
    REMEMBER: ER visits are to be avoided. You can catch germs, get overly tired and they are expensive.  Make appointments and keep them. That way the flow of your life will be calmer.
  10. If you have come to a point in your life, or your senior’s life — that fighting a physical or extreme dementia condition- is simply too overwhelming. Then you need to tell your doctor that too. The doctor will discuss palliative care. That is where you are treated to keep you pain free and comfortable. You will be assigned a Hospice Care Team that will come to you and allow you to relax and adjust to the end of life journey. There is no reason to drag elders around to doctor appointments if they have issues that are beyond a medical cure. No matter what your income..Hospice is there for you. You or your senior deserves to have a wonderful team of caring nurses and helpers come to you…to keep your needs met and the pain or worry level down. It is always hard to make that decision, but once made the Hospice team really knows how to take over and keep the elder in-care…comforted and given good palliative care.
    NOTE: Medicare and insurance bill either your regular doctor or Hospice. So you do have to make an appointment and have a good truthful decision with your doctor for this change of care situation. You need to also remember to ask for a disability sticker for your car and understand the doctor needs to sign a ‘Do Not Resuscitate’ agreement. I always try to remind you to get a Health Care Directive Form, signed and agreed on right away while the senior understands the issues.

I hope this will all be of help to you. Since I have kept my medication listing and added in the allergies that George has and his needs if he is put into the hospital on that same page….the doctor visits have been great. I express myself before the appointment and then the information is turned into the nurse at the check-in desk to attach to the file. The doctor then walks in the door, knowing what is going on and directs his attention and knowledge to help me and George make changes for the good in our daily lives. Some times there is no change, some times there is a medication change — other times there is just advice in how to make changes in our daily life to keep George as strong as he can be. Maybe we go to the Physical Therapist to help him get strong, maybe we have a respite to give me a break. All of the information that I share with the doctor, helps him make sound decisions that are based on our reality of life. I once told the doctor that a medication he prescribed was to hard for me to give four times a day. George has no memory and I can do morning and evening meds…but to add a few more during the day…means I have to remember things for me and for him. It was too much. The doctor said that was fine, he would change the medication to one that had a time release. You see how being honest helps everyone?

REVIEW:
*  Take time to review the body functions of yourself or your senior
*  Write down the information or changes
*  Be prepared with a list of medications that is complied from all the different doctors that prescribe to you
*  Be honest with yourself and the doctor

Thank you again for giving your time and love to your senior. Its a lonely world out there for care-givers. I appreciate you taking your time to share with me. I am here for you. Send me your questions and I will do my best to help. OH, I would really appreciate you signing up for this blog post…it will email it to you. I am doing less blogging because George’s Alzheimer’s is getting in advance stages and he needs more care. So the ups and down of my writing is easier for you if you just recieve the update in your email. Please add your email to the side bar and you will hear from me each time I write a posting….Thank you…and Blessings, francy

If Your Senior Goes to ER – Are YOU Ready?

by francy Dickinson

Mother in Hospital visit by her Pup

There I was standing in mother’s room in our home and she was not doing well. It was time to take her to the hospital. I had been through this before and I was running around her room trying to pack a bag. All of her meds in a plastic ziplock, slippers, her hearing aid case, her eye-glass case, her robe, on and on as I am zipping from one side of the room – pulling open drawers and grabbing what ever my mind said to grab, then darting back to check on her. My husband is coming in the room, getting her up and into her wheelchair and I am covering her with blankets so we can wrap her warm for the drive to the hospital.

Once there she is taken into the ER and I’m asked to fill out papers. I can hear her calling my name. Mother could not hear and she was frightened and needed me but I was filling out paperwork. It was horrible. I vowed not to repeat this mess again with any of us.
I put together a small plastic envelop filled with information that would answer all the questions that the hospital needed and allow me a quick in and out of the check-in with really just a signature. So I could be by the side of my loved one, not answering questions and pushing a pen around. Check and done…I know you will find this helpful. My mother passed at 100 yrs of age. But now my self, my friend Cheryl and my husband Georgie all have info packets that stay in the small desk in our kitchen. We are all ready for the ER and no matter how upset or scattered we are when we leave the house for the Emergency Room…we will now have all the required information in our hip pockets or in our purse.
YOUR EMERGENCY ROOM INFORMATION PACKET:
  1. First, I sat down with the bag of mother’s daily medications and read them over and divided them into morning, noon and night. I wrote down the name of the medication, the dose, the amount of daily dose pills, the time to take them and why she was taking them. If I did not know, I called the pharmacy and had them explain it for me. I would ask if it should be taken with food, or before food. Most medications absorb better on a stomach with at least a yogurt or apple sauce taken first, now it was on the paper for me to see and remember.
  2. Once they were all written down, I bought a new pill container that fit her schedule and was large enough for all of her meds and supplements. Yes, Mom took supplements. I studied what would help her, then asked the pharmacy person to make sure it would be OK with her prescriptions. Then I separated the supplements to compliment her medications throughout the day. I added the supplements to my listing of pills and the amount in the supplement.
    Example for you:  
    Vit D3 – 500 units -1 pill- morning – w/food  – (energy and emotional support)
  3. OK, I was now ready. I brought the paper to my computer and started to enter her list of pills and supplements. The top of the page had mothers full name and our phone number. The computer would put down the update date so I could keep it current and correct. I used the outline I had started and did the full listing. As we added or removed medications in times to come, I would just enter the new info into the computer and update the listing. It made the entry easy and fast from that point forward. Trust me so worth the effort when you consider you have to bring the big bag of pills to every doctor appt and now the listing on the paper is updated and easy for the doctor’s staff and you to read and understand. It’s a great thing. Not to mention perfect for travel even if the travel is to visit a close relative for an over night or weekend. 
  4. Now I started to think of the questions they asked at ER check in. Does she have allergies to medications? So I typed in the title and put down a list of medication and food allergies. She had no medication allergies, but she did have allergies to peanuts and rose oil. Believe me, even if it seems pointless to state this, you never know what is in medications, or lotions used for back rubs or veggie stir fry in peanut oil…this is big deal.
  5. They will ask about history: I put down a short history, 4 children, no miscarriages, eye operation to uncross her eyes, and cataract removal, no other medical history of hospital stays. No history of diabetes, blood pressure or confusion. Then I added the medical history of her family: Mother and dad passed with heart ailments, brother with cancer, brother with stroke, sister with Alzheimer’s. There you go – a quick and easy review for any new doctor to take a glance and see that there was clear relationship to her own heart problems.
  6. Now the emotional: Mother is clear of thought, reads even at her advanced age, watches TV and interacts with the news of the day. She does get very upset with her own frail abilities and can get angry in the late afternoons. See? It is stated matter of fact but you get the issues easy and so will the attending physician.
  7. Now her abilities: Mother does not hear well and her left ear is her best and has a hearing aid. Right ear is lost with no hearing aid. Her teeth are false and she has uppers and lower bridge. She walks with a walker at all times or she will fall. She has limited strength in her legs. NOTE: In order for mother to live with us she has to be mobile so she works hard to get around with her walker. She uses a bath chair and commode by her bed at night. She rings for me to come and assist her in transitions during the nite. But does them on her own in the day time.
  8. Food and Drink; Mother is not on any special diet, she eats well and prefers light food. She drinks one coffee per day and is not able to drink water, so juice mixed with water is her liquid for the day.
  9. Her TV habits are easy to understand news with captions or food shows that she can lightly watch and understand.

    Can you see the idea?  All the information that the ER needs, the nurse stations need, the new doctors that are assigned to her called “Hospitalists” need to know……in one place. Easy to read and understand

When I first presented this to the ER hospital check in person she took in a breath and said. “Wow, this is great, thanks I will make a copy and I think everything seems to be here.” KAZZZAMMMM – It worked!

NEXT PAGE: The next page is a listing of doctor and insurance information. I started by going to the copy shop and making a one page filed with mom’s driver lic, her social security, her medicare card and AARP supplement card. It was all there on one page. She could keep her ID in her wallet and I had it in my trusty ER Info Kit.

I then listed her doctors, their speciality, their office phone and fax numbers. I had a small explanation under them:

Dr Anna Kline, General Practice  o/555-222-1234  f/555-233-5678
Mother has been with Dr. Kline for three years and Dr. over sees and does all mother’s prescriptions. We use 90 day Rx and generics when ever possible. Dr. Kline works well with mother and is easy for her to hear and understand.  (Last seen June of 2009)

AT the end of the page: I put a — 

NOTE: I placed my name, relationship and emergency cell phone and stated my place as her Power of Attorney. Her medical information is to be discussed with me before any major change in medication or procedure given.

All of this is in my computer under Mother’s name. I updated it each doctor appointment and it’s printed and ready to go in a clear plastic envelop that I keep in the kitchen. I put a copy of the Power of Attorney in with the above information. That needs to always be presented at the check in for the doctor appointment or the hospital check in.

PLEASE NOTE: Power of Attorney can be done on your own computer. You can buy a great program called Family Lawyer or do a search and the information will be on the Internet. You can buy the paperwork at an office supply store. But the software is really nice to use. Then you sit next to your senior and together answer all the questions that will walk you through the Power of Attorney for Health. (You can also do full Power of Attorney) But the hospital needs this to include you in the informational and decision process for your senior or family member or close friend. By the way the Power of Attorney has to be notary stamped. You can do that free at most banks or real estate offices. This will also require two witnesses. So, I have done it and had mom sign and I wait for two people “unrelated” to come to the house or ask a neighbor. This is a no nothing thing that takes very little time and will pay off as your senior ages and their health diminishes and you are really needed to make decisions in their name. Just as you will need it for a spouse, friend or child. This is an important step in your family health, so taking the time to get this done will rest your mind and be appreciated greatly in times of crisis.

There you go…how cool is that…your packet is done:

 

Emergency Info Kit:

  • List of medications and the details of each and supplements
  • List of the person information
  • List of insurance and ID cards with contact  numbers
  • List of doctors and their contact information and how you use the doctors
  • Your Power of attorney (copy only needed)
  • Name of patient on each page and current date on material that could be unusable if out dated

All of the above are gathered folded and put into your plastic envelop. I used one that had come with an old insurance plan. It worked so handy I looked and found others like it. I slipped in business cards of the hospitals so I would have the call in phone numbers of the nurse’s station. That is it….Gold in an envelop.

OK… so it takes a little while to do the project, but once done you are in order and planned for any emergency. No matter what their age your family members will sooner or later need to go to the doctor or have an emergency. So, do this project and be prepared.You have the information for trips, and everyday crisis that do arise. Your Packet will relieve all the running around when you are in a state of high stress.

Would you like to have other tips to keep your life flowing a little easier? I have a step by step practical home care work book that is perfect for any family. It goes over all the things you ask yourself and wonder about when you’re caring for those that are unwell or elders that need assistance at their home or in yours. I have had such great feed back with my “Senior Care Workbook 101”  that I can say with confidence you will use it with ease.

Thanks for all you do for others…francy