From the miscellaneous drawer

Special - By Susan Pernia, Anne's niece from San Diego

When an elderly parent becomes ill, there is nothing as wonderful as an attentive son and caring daughter-in-law, as I witnessed last week.
Especially if it’s not a simple medical issue threatening the life of your mother, who has worked and lived independently into her eighties. One day she is maneuvering through her life, and the next day she’s in dire medical straits. It’s a turning point, with the realization that the family’s life has now entered a new and unfamiliar phase. The matriarch will no longer be fully on her own at home, or fully capable of advocating for her health care. So, it’s left to adult children, the ones with compassion and empathy for aged parents, to fill this void and fight.
Our first priority is to figure out the root causes of her pain, weaknesses, and bad stats. Her priority is to avoid strangers in medical garb, and the hospital building itself. But determining root cause requires time, competent health care providers, and patient patience, which is at odds with the patient who is suffering physically and emotionally in a perceived prison away from home.
When hospital delays, medical neglect, and physical pain of 9 out of 10 are what dominate the day, the mother/grandmother/great grandmother is naturally angry and exhausted. It seems at first that we, as adult children, can do very little to rescue our aging mothers in these situations. We visit, we verify it’s the right medicine she is taking, and we go down the hall and get warm blankets when she gets cold. We make sure she is eating something and drinking fluids, while continually adjusting her pillows for comfort and mitigation of bed sores. But these care-taking gestures turn out to be a saving grace for our elderly mothers vulnerable to the common disregard of our health care system.
Health care providers cannot be relied on to always get to the bottom of complicated and nebulous health issues of the elderly. Some don’t have active listening skills; some are overworked. Some are not bright enough to tackle complex symptoms not readily diagnosed; some just don’t seem to care. Days pass in the hospital, one shift after another. Always a new doctor on the floor, nurses coming and going, with no single medical person gaining contiguous, consistent, and coherent knowledge of the elderly patient’s condition.
We adult children are the ones who stay day and night, and provide each new health care provider who walks into the room with our mother-patient’s history, current state, and expected treatment. The same questions are asked of mother and adult child, and we give the same answers in hope of better diagnoses and effective treatment. The hospital staff half-listen and enter the repeated information into the computer system, where the electronic data already exists. They don’t look at the elderly mother in the hospital bed, they look at their screens.
It feels like blackmail. If we complain, maybe she will be treated even worse. If we feign patience and acknowledge medical staff efforts, maybe she will be treated better. Neither strategy seems to make a significant difference.
I hope it’s the exception and not the norm for elderly patients to be released from the hospital far worse off than when they first entered. In our case, our elderly mother/aunt was approved to go home with extreme abdominal pain, low blood count, and missing medical supplies that had been promised. In addition to vascular disease, an ulcer, and a third-degree burn, she was released without the diagnosis of two new ailments - diverticulitis and pancreatitis. The doctor who signed her release orders knew of her abdominal pain, but never physically examined her, or expressed any concern.
This elderly mother, suffering pain and exhaustion over a big-city hospital stay of 12 days and three surgeries, was hustled into a wheel chair and carted off to the hospital doors to be taken home. The drive was to be two hours to get home. With each passing mile, her groans grew deeper and louder as the abdominal pain became more excruciating. In the end, we rolled into the ER of her small home town, going from one hospital to another. At least the home town ER staff knew her, shared their care and concern, then raced to mitigate her pain within minutes of arriving. Within hours, her abdominal pain had been diagnosed and treatment begun.
She felt safer being out of the big-city hospital where she was barely visible to the medical staff, and back in her home town hospital. We could see on her face a sense of relief to be out of enemy territory and gratitude to back in familiar territory. Her home doctors didn’t have to ask her adult children about her medical history and current state of pain. They already knew.
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In the Ely Echo for June 28, 1999, 20 years ago, the headlines were:
• Not just science: Soudan Mine project has $20 million local impact
• Housing project funded by IRRRB calls for 13 log homes on Miners Lake;
• World Press journalists to make annual Ely stop;
• Phrasing of ballot question questioned;
• Special election slated for August;
• Ely Relay for Life teams ready to connect and collect.