Why Elderly Patient Need Advocates
Warning I am going on a long rant about care for the elderly. My dad has been in the hospital four times, once for a planned procedure and the other three due to an emergency.
First trip to the ER was Valentine’s Day 2015, we discovered my dad has AFIB, at the time he was scared it was a stroke (something he really is afraid of) and he did not have his hearing amplifier. So, I ended up answering the doctor’s questions because my dad could not understand him (he had an accent and talked fast). Since 2015 I have been going to all of dad’s Cardio appointments but not his Annual Physicals.
Second trip was in July 2016, my dad had been feeling really bad, unfortunately I was working and did not just how bad he had gotten (we do not live together). In February, my dad’s Cardiologist suggested maybe he should have an angiogram Primary doctor in March. In March during his annual physical all his Primary said was that there was something off in my dad’s urine test and prescribed some pill for it but did not address how bad my dad was feeling.
Finally in July my dad decided to have the angiogram and did a pre-procedure blood test. The Cardiologist’s office called my dad and told him to get to the ER immediately. Due to the fact that it was 10 am the ER was packed and we sat their until about 1 pm before they even started the preliminary tests, turns out my dad had severe anemia, something I feel his Primary could have found if he did a little more investigation or at least did more extensive blood tests (apparently the blood tests did not include checking iron levels).
My dad ended up getting two bags of blood, two large bags of iron and several tests none of which could tell anyone the cause of his anemia. This is where having a person who knows your history helps, years before my dad had a bad reaction to Statins, knowing this I started to research all of his medication and discovered that Xarelto can block the red blood cells from regenerate which they do every 120 days. This was proven to be the case when his Cardiologist took him off of it and his iron levels remained high, now every time at least his Cardiologist tests his iron level, still not sure about his Primary.
Third trip to the hospital, this one was planned, it was his angiogram which he did well and showed that everything was good. But leading up to the procedure that was a little drama with his Primary’s office, my dad thought he might have a Urine infection and was advised not to get the angiogram, it turned out to be nothing and the procedure was done on time.
Fourth Trip, on Sunday July 3rd, 2022, my dad called me and said he was having a problem, turns out that his was fine earlier in the morning but now he could not move, I called 911, they took him to the ER and called in a possible stroke even though the EMT I talked to did not think that was the cause it was more of a precaution. My dad did not have his hearing amplifier and his eyes have worsened, so he apparently kept telling the ER staff to talk to me. I ended up filling out all of this paperwork then I was able to sit with him and get updates from the doctors. It turns out he had pneumonia. During his 5-day stay at the hospital, I filled out all of the paperwork and did the research for the Care Facilities that dad went to so he could get stronger. I also stayed with him as long as I could and ended up answering most of the questions. Again, once at the Care Facility, I filled out all of the paperwork, answered and stayed with him from about 10 am to after his dinner.
Now I know that staffing is an issue and that with COVID resources are strained but there seems to be a lack of empathy for older patients by some, there has definitely been some truly great Doctors, RNs and CNAs at both places but there have also been some who seem to be there for a paycheck only. This has been especially true at the Care Facility, some of the CNAs barely do the minimum (in fact in some cases I have done some of the things for my dad like empty out his urinal when it gets too full). One of the common complaints from a few of the patients is there being no schedule with anything especially Physical Therapy and the response time if any when the Call Button has been pushed. A few of the patients my dad included no longer wait until someone shows when they need to use the bathroom, they get up and go, in fact my dad’s first night there the Night CNA just turned on the light and then left the room even though my dad is there to build up his strength and is a Fall Risk.
Again, there are some CNAs that even when someone is not in the care, will always help, two of them have been Elaine and Martha they have been incredible with my dad and others.
It is not just CNAs who seem to forget how scared some of the patients can get, between being in a strange place but also the reason they ended up there, it is also the Administration. My dad has been there also most 2 weeks and he has only seen the doctor once and it wasn’t until his 4th day that he finally had a really good PT session but again there is no schedule, the patients don’t always know if they are going to one or two sessions each day.
Also, a lack of communication, last Tuesday my dad was told that they were going to keep him there and re-evaluate his case the following Tuesday (yesterday 7/19), by 3:30 we had not heard anything, so I went and asked what was going on. I was told that the meeting got delayed until today (Wednesday 7/20) which would have meant if he was given the OK to leave it would be at least Friday. I said my dad wanted to go home no later than Thursday (7/21) at which point the Discharge Manager said let her call the Insurance Case Manager to see what could be done. It was agreed that my dad can be discharged tomorrow (7/21) but what if I had not asked, what would have happened and what about those who do not have someone to ask or advocate for them?
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