Monthly Archives: May 2015

Life Intervened

Well, we’ve missed two of our weekly blogs. Life intervened. Two weeks ago on a Saturday morning I awoke with what felt like razor blades in my throat. Couldn’t talk; could barely swallow. Spent the weekend that way and then went to my doctor on Monday who said it was just the “viral crud” going around. I didn’t buy that since I know my body and I know that I’m prone to sinus and ear infections … but figured I’d let it run its course. Then, another life intervention, over the next 36 hours, I had fevers (which I almost NEVER get) and other (more gross) symptoms, so I placed a call to my doctor’s office and received a boatload dose of antibiotics for 10 days. I’m feeling much better now!

Life intervention two: This past Tuesday, Jim was involved in a motor vehicle accident when a young woman rear-ended him in the Subaru while he was waiting to make a left turn into his office parking lot. Fortunately he wasn’t seriously hurt (bruised back with some spasms – muscle relaxants are interesting!) Car has some damage, but it’s fixable. Just goes to prove – you never know what will happen to throw your life out of whack for a bit.

This week, I had the pleasure of providing two educational sessions for family and community members at work. The presentation was titled “Decision Making for a Loved One” and I was happy to see that 20 people attended since this is usually a daunting topic that keeps people away. Our family members at the nursing home where I work are awesome. They are actively involved and engaged in the care of their loved one (most typically a parent). We talked a lot about how life intervenes and throws changes at us that we’re not really prepared for.

We had some fruitful discussion about the legal powers that documents like a General Power of Attorney and Healthcare Power of Attorney bestow and how those legal powers don’t really help all that much when you’re standing around the bed of a loved one trying to figure out what to do. We spent a lot of time talking about talking. How having conversations, about our values and beliefs and the people we want around us when life intervenes, are so much more valuable to surrogate decision-makers than the possession of a piece of paper. Many were surprised to learn that documents are sometimes ignored in favor of people standing around the bed – whether they are the ones with the legal authority to make decisions or not.

There were some tears in the sessions when we talked about the guilt felt when placing mom or dad in a nursing home, or making some other decision with which adult children struggle. We talked about how difficult these conversations can be to start, but I assured everyone that once they get past the first conversation, the next ones seem to be easier. For some in the room, it seemed comforting to know that someone else (me, and the other family members) were going through similar things or have already walked the path of decision-making for a parent through the end of life.

Life intervenes in many ways. Sometimes good things happen (like putting me in my current job to help others my age deal with decision-making for their elderly parent); and sometimes bad (like a sinus infection, fender bender, or something much more traumatic).

Before life intervenes with a medical crisis, traumatic accident or terminal diagnosis, talk to people you love. Talk about what matters to you. What gives your life meaning and purpose? What kinds of symptoms are you willing to “live” with? What abilities can you not live without? Who do you want making decisions for you? Can they make the tough decisions? Can they advocate for you counter to physicians who may suggest a different path?

Caring Choices understands that these conversations are challenging, and making decisions for someone else can be difficult. But we also understand that fear and guilt from decision-making can be lessened when we’ve had conversations and prepared our loved ones with the knowledge and courage to do what we ask. We can help you start talking. It’s never too early, but it can be too late.

Dragged and Thrust

A few nights ago I was reminded how quickly a life can go off the rails. Someone I love is in the ICU after a relatively common and curable illness went on a rampage inside her. What was initially assumed to be a flare-up of a chronic issue became increasingly more problematic as additional symptoms followed. The symptoms compounded one another over a few weeks until a trip to the primary care doctor resulted in an unexpected trip to the ER, followed by several surgeries and now days in the ICU. She’s getting the best care, everything is being done to restore her, and we’re all praying that she recovers and recuperates fully.

Situations like this occur every day in our healthcare system. Patients undergo extensive surgeries, are attended in the ICU by teams of dedicated nurses and doctors who monitor every single bodily function for any change. In the meantime, adult children are scrambling. They are being dragged into the quagmire of complex healthcare decisions and procedures; some with very little understanding of the medical “lingo”. Some operate under the motto “Physician Knows Best” and don’t question anything. Others may consider the route of “do nothing” and elect hospice. Still others may be visited by palliative care personnel who will offer advice about pain management and symptom control. Some adult children may be afraid NOT to continue with surgeries/procedures; others may be afraid to agree to proceed with surgery.

While things are spinning out of control around them, they watch a loved one lying in an ICU bed surrounded by tubes and drains and machines and beeping. These adult children are being thrust into having to making decisions on behalf of their parents (or other loved ones) with little (if any) preparation to know what course of action is desired by the patient.

They’re thrust/dragged into this nightmare for many different reasons but typically for any combination of these three:

No healthcare power of attorney exists on paper or electronic record
They’re the next of kin
They’re the people standing around the bed or sleeping in the waiting room

Hearing my cousin’s exhaustion through the phone the other night after she spent the entire day in the hospital awaiting the outcome of another surgery, I wished I could save her from the anguish of the uncertainty of knowing what to do and when to do it.

Caring Choices intends to keep people from being dragged into healthcare quagmires or thrust into the service of a loved one without the knowledge, preparation and courage to make difficult decisions. We believe that talking with your family about healthcare choices can be a welcomed lifeline. Reach out and grab it.

Walk the Walk

I have been interested in music, poetry, and art the majority of my life. I have often paid close attention to detail and pondered the meaning behind many of the lyrics I heard over the years. On this occasion a spoken phrase from Jeff Beck’s “Guitar Shop” (released 10/1989) comes to mind: “Much is being said my lords, but nothing is being done.” The song’s lyrics seem to relate to the environment. The “Talk the Talk” companion to the title of this blog indicates that there is no follow through. There is no “action” (walk the walk) to complement the words.

Health care trends today suggest “having the talk”, conversation, discussion, and planning for the eventual changes life inevitably presents us. Sudden or chronic, we will face challenges to our health, independence, and stability. Yes, taking the time to have these meetings with family and friends, advocates, caregivers or attorneys is in our best interest. But it also takes Action beyond “talk”.

Words alone are easily misunderstood, and forgotten. The intentions behind them may change. The action I refer to is an on-going effort of the continued periodic review with whomever we have designated as our future healthcare advocate. Having a document that was drawn up 10, 20, or 30 years in the past is not truly a reflection of what may currently exist today. A friend recently mentioned how relieved he and his wife were when faced with difficult healthcare choices concerning the medical treatment of their failing family member. “I wasn’t going to go against Mom’s Living Will.” This was just one more example confirming for me the importance of taking action. “I didn’t want to talk about death and dying,” he said when describing his mother’s “action” during her research and application of planning for her future. The outcome was one of peaceful acceptance and gratitude that only afterwards could be most appreciated by him and his family. In my decade of hospice experiences, I have often witnessed the importance of action in addition to words.

Caring Choices can facilitate the “Talk” with the use of our Elephant in the Room. The next step (walk the walk) is yours.