Senior Advocacy cover
With much “practice” in the elder care world over the last few years, I’ve often had to intercede on my parents behalf when they have been unable to do so. Based on my own personal experience, Senior Advocacy: What Adult Children Can Do to Help Their Aging Parents offers some real life examples, where you as the adult child can help your aging parent receive the best care possible.
Real Life Example #1
A little over a week ago, my mother fell in her apartment at the assisted living facility where she resides. This fall was a bad one – she split her eyebrow and head open (requiring glue in the eyebrow and staples in the head), fractured her left wrist (she’s left-handed) and gashed her right knee open requiring 9 stitches. In addition, she fell so hard that she strained muscles in her chest making breathing difficult and coughing painful.
We spent two separate days in the emergency room – the first day of the fall, where she was treated and released after 10 hours in ER and the second day, when her assisted living facility sent her back out of grave concern for her condition.
Here’s the conundrum about my sweet mother: she’s always smiling. It’s rare that she doesn’t smile. She’s one of those blessed individuals who looks at life as full of wonder and possibility and it shows all over her face. When she is not smiling, we, as her family, know that something is wrong. But, even when she is in pain, she smiles. So, when she’s in ER, she smiles. Doctors interpret this to mean that she’s fine, when often she’s not!
During the first visit to ER, my mother complained to me over-and-over that her wrist hurt. Now my mother is not a complainer, so I took her complaint seriously. The ER orderly came and took her away for a CAT scan and when they brought her back, I asked the nurse what they had scanned, telling her that my mother was complaining of both chest pain and wrist pain. The nurse explained to me what the CAT covers, which does not include her wrist, so I asked if she was scheduled to have her wrist x-rayed. Minutes later the nurse came back to say “no”, but they had scheduled her now.
And, it turned out that her wrist was fractured.
But, that x-ray wouldn’t have happened if I had not (1) listened to my mother and (2) questioned the staff.
In addition, the ER doctor on duty that night was very nice, but not overly concerned about my mother’s condition and wanted to release her after attending to all of her wounds. They ran all the usual blood tests, which came back within normal parameters. I explained to this ER doctor that my mother had been on oral antibiotics for 4 days because of bronchitis and cellulitis and asked him to make sure she was well enough to release. He assured me she was and we left the hospital at 1:00 in the morning and I took her home to her assisted living facility.
The second visit to ER the next day was precipitated by the assisted living facility out of concern for her condition. She wasn’t eating, was in great pain, and not herself. Since they know what “herself” is, they were right to make the call. However, upon arrival at ER, the hospital wasn’t so convinced that she should have been brought back because my mother was lucid, smiling and answering questions.
But, she’s that way most of the time and as her children and her grand-children, we know when something is wrong. There were four of us in ER this time with my mother: me, my husband, Charlie, my sister, Gail and Tiffany (her granddaughter and Gail’s daughter). After expressing our concerns to the doctor, they decided to keep her and admitted her.
She was there for a week!
Not only did she have the issues from the fall, but she had a severe infection requiring IV antibiotics. For a week. This was not detected during the first ER visit because they neglected to run a urine test on her the first time. This second visit to ER could have been avoided if they had run a urine test. Despite all of my questions to the doctor the night before, they did not do this one test. How much did that second trip to ER, which could have been avoided, cost Medicare?
This is a classic example of “advocacy.” Often, in our toot sweet lives, seniors are ignored. While I don’t think this is intentional, it is a fact. All of us, including doctors, nurses and other hospital staff, are often overwhelmed and this particular day in the ER was particularly busy. Seniors often speak slowly, grasping to find the right words that no longer come easily and hospital staff want to get done and on to the next patient. This is not a criticism of hospitals and staff – my overall experience with hospitals and staff has been extremely positive. I credit them for saving my parents’ lives over-and-over-and-over again.
But, it is a fact. With aging parents, adult children need to take on the advocate role.
Real Life Example #2
When the hospital deemed she was ready for release yesterday, they were going to send her back to her assisted living facility. I knew, in my heart, this was not the right call for my mother. Left-handed, with an injured right knee with a deep and wide gash, she is not able to walk unassisted. And, she is currently walking with the assistance of two people – one on either side of her, supporting her. I knew that her assisted living facility, even at the highest level of care that they provide, could not meet her care needs.
A quick phone call to the RN at the assisted living facility confirmed my fears. My mother needed to go to skilled nursing for rehab. So, I called the hospital and discussed this with the charge nurse on duty, expressing my concerns. After consultation with the doctor, the hospital agreed that she should be transferred to skilled nursing and not sent home to her assisted living facility.
As her advocate, I knew the suggested course of treatment for her was not sufficient and I pushed the system to give her recovery the best possible chance.
Real Life Example #3
My father died this past January and I miss him terribly. But, this post isn’t about his illness or his death, but a real life example of advocacy on his behalf. A few years ago, he was in a skilled nursing facility recovering from a bad fall, where he, too, had cut open his head requiring stitches. That was his second severe fall within a four-month period and this second fall had caused him to have on-going dementia.
He was in an alarmed wheelchair in the hallway of this skilled nursing facility. He was in an alarmed wheelchair because he was a fall risk and alarms would go off, alerting the staff, if he got up. Well, he got up. And, staff wasn’t close enough to catch him as he fell to the floor and broke his neck!
I arrived a few minutes later for a scheduled visit to find my father on the floor surrounded by firefighters and paramedics, who were strapping him to a back board and had already placed a neck brace around his neck. I, of course, was shocked to find this situation happening, but grateful that response had been immediate.
I asked the paramedics where they were taking him (there are several hospitals in the vicinity) and he said the closest hospital, which was a few miles down the road. I asked why they weren’t taking him to another hospital with a trauma center, which was maybe a mile further. He said because it was probably just a head wound (my dad’s head was bleeding). I explained that this was now his third fall in five months and he said, okay, we’ll take him to the other hospital. I wanted him to go to this particular hospital because they had a trauma unit and I knew he would get the best possible care. And, once there, he was diagnosed with a broken neck.
This is an example of advocacy; advocacy of an adult child for their aging parent. No one in the skilled nursing facility had the “history” of my father’s recent falls in their minds with this drama unfolding. While it was in his patient file, it wasn’t in their “minds” like it is an adult child’s mind. As the adult child of your aging parent, who better knows what has happened to your parent than you? Who can communicate that concern when your aging parent can’t do it for themselves? You.
My father, with dementia, couldn’t communicate what had happened to him over the past several months. He was scared and crying and so glad to see me. And, I was so glad to arrive when I did because he would have ended up somewhere else. My mother’s angel was on my shoulder that day.
Real Life Example #4
Many years ago, my mother fell and broke her hip while visiting my father in a skilled nursing facility. My father was in skilled nursing at the time recovering from knee surgery. Anyway, that’s a long story for another day, but the bottom line is that my mother was in a separate skilled nursing facility recovering from her broken hip.
Both my sister, Gail, and I were visiting her after work one evening. The staff had served my mother dinner and she was eating, slowly as she often does, but having difficulty getting the food to her mouth. It ended up on her chest more than in her mouth. She was also slurring her words and having greater than normal difficulty in talking.
While we were there, a doctor came by to check on her. Gail and I both expressed our concerns, telling this doctor over-and-over that our mother was “not herself”. He thought she was progressing nicely. But, we kept pushing him, telling him to watch her eat and telling him to listen to her speech. He did and decided to order a blood test on her right then.
I left to go home and Gail stayed behind. This skilled nursing facility was about 20 minutes from my home. I had no sooner driven into my driveway than I got a call from Gail, in tears, crying that they were transporting our mother to ICU. She was in critical condition, suffering from low sodium. Normal sodium levels are 135. Hers was 108. The doctor wasn’t sure she was going to make it. I turned the car around and went back to the hospital.
Well, she did make it. But, to this day, I shudder what would have happened after we’d left if we had not been insistent with the doctor that something was wrong. I’m sure my mother’s angel was on her shoulder because it isn’t often that doctors visit their patients when family is present. More often than not, I miss the doctors and don’t get to talk to them directly about my mother (or my father when he was alive). So, my mother’s angel intervened that day and brought the doctor to her room during our visit.
I could give many more examples, but this post is now already exceedingly long. The bottom line is that most seniors need advocates and if you are the adult child of an aging parent, being their advocate is the number one thing you can do the help them. You know your parent better than most. You know their history better than most. You have their best interest at heart. You love them and want to help them. You. As respects senior advocacy, what can adult children do to help their aging parents? Give them the gift of you.
Until Next Time,
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Great post with good examples that are easy to understand. Well written.
Thanks, Dawn! I appreciate the “kudos” from the school principal!!