Advice for Relatives of an Ill Family Member

 

hospital-family-memberIn the last two weeks, while I’ve been taking care of my mom, first in the hospital, and now at a rehabilitation center, I’ve learned several important points about healthcare. Below are the most important:

  1. Don’t get sick.
  2. If you do get sick, and have to go to a hospital, have family or friends spend as much time with you as they possibly can.
  3. The family needs to check and double check everything that the hospital staff does.
  4. Family has to actively advocate for the patient, in a kind, respectful, patient, and persistent manner.

I am always impressed with how kind, caring, and competent the nurses and their aides are. They make everything happen in the hospital. They communicate with the doctors, they make sure the patient is comfortable, they share information with the family, and they provide emotional support to the patient and to the family. They rock! Be respectful to all of the staff, and they will be glad that you are there.

But, they frequently have too many patients to care for. They may have three or four patients that press the call button at the same time! So who gets taken care of first? The patient with a caring, loving family that gently goes out in the hall and connects with the nurse or nurse’s aide.

Now, here are some more important items:

  1. Bring pictures of family to your relative’s room.
  2. Learn the names of everyone who is taking care of your loved one.
  3. Make sure to introduce yourself to everyone, let them know your relationship with the patient, and find small ways of connecting with each staff member.
  4. Don’t ring the call button more than once.
  5. Anticipate a reasonable wait time for help.
  6. Do as much as you can to help the staff.

Today is Saturday at the Skilled Nursing Facility (SNF), where my mom will be working on her rehab for the next two weeks, before she is ready to go home. In the course of her 7 days in the hospital and due to her cardiac insufficiency, she is very weak. When I arrived at 9 a.m. with my niece, I introduced myself to the new staff at the nursing station. Joe, one of the nursing directors, commented on how rare it was for visitors to introduce themselves and ask their names!

I asked him if my Mom could have physical therapy (PT) early in the day, and he said “I will expedite that for you!” Thirty minutes later she was wheeling into the PT room for an hour of physical therapy! Take my word for it; if I hadn’t connected with the weekend staff, it would be up for grabs. Maybe she would get PT today, but it might be later in the day when she was tired out.

Don’t ask if you can participate in various activities, just join in. My niece functioned as my mother’s personal trainer during PT, counting for her and giving her encouragement when she felt tired. When my mother was having her breathing tube removed at the ICU, we didn’t ask if we could be by the bedside. We were there. It’s easier to ask for forgiveness then permission! If I had asked the respiratory therapist if we could hold her hand, I am sure he would have had us leave the room.

The biggest problem that I observed…there is a lack of standardized systems to make sure that everything is done. There are few checklists that insure that everything is completed. There are many opportunities for important details to fall through the cracks.

Finally—

  • Make a checklist of all the things that need to be done.
  • When you meet with your family member’s doctor, come with a list of questions.

This time with my mom is precious. I can’t think of anything I would rather be doing than to be by her bedside. Making her more comfortable and helping her feel safe and cared for is very important to me. She brought me into the world. I want to help her leave this life with love and grace.

6 Comments

  1. JPG

    Great blog Dr. Paul! And wonderful tips! From my experience with my grandmother I’d like to also suggest paying attention to how your loved one is feeling and what they are telling your that they are feeling/thinking. Then listen to what they are telling their nurses, doctors and staff. It’s not always the same, if they are sugar coating it for the staff or leaving something out, don’t hesistate to tell the staff what you observe or have heard them say.

  2. JPG

    Glad your mom is on the mend!

  3. longtime RN

    This is great advice! I would add a couple of things:
    1. Ask questions of staff – “How can I best help my mom today?” “What the one thing I can do that would make a difference in the long run?” You may get different answers from different staff members, but it’s all going to be important information.
    2. Designate one person in your family to be the “information” person – that way staff aren’t answering the same questions over and over. It will allow them to be more responsive to your other requests.
    3. Don’t bring in food, drinks or medicine until you clear it with the staff. Often, people are on special diets or need to have their fluids thickened; or staff have to keep track of exactly what they are eating or drinking. And even over the counter medication or supplements can cause problems some medications commonly given in the hospital setting.

    Hope this is helpful.

  4. Mark

    Some great advice here Paul! I also think some of these concepts extend to those who are actually patients as well. As someone who spent 2.5 weeks in the ICU and had 3 brain surgeries in that time, I can say without a doubt that being kind, patient, and respectful goes a very long way to getting the best care. Both my family and I tried to establish good relationships with my nurses, which resulted in being moved into a single room when one opened up as opposed to having to share one with someone else, which is absolutely invaluable. It also helped turn my nurses into my advocates when they spoke with the doctors. Even in some of the most trying circumstances, kindness and respect are the currency that helps buy you the best care that our excellent nurses provide!

  5. Debbie

    My 93 yr old Mom has been in the hospital for 3 weeks and rehab for 2 weeks now. I totally agree with what you are saying Dr Paul. Our family has been with mom around the clock and watching out for her. The staff does love it because it does help them with their work load for sure and we too have made many personal contacts with so many wonderful caring nurses and aids. BUT…I will say that in my mom’s case in some ways it has not helped. She is blind & has some deafness and now her 5th compressed vertibrate. With our family’s love & support, we have almost done too much for mom. After 2 wks in rehab she now is not trying as hard because we have “helped” too much! There is a fine line when you want to help, but what is truly needed is encouragement for them to do it instead of you doing it for them. It’s the hardest thing I’ve ever been through. My dad has done so much for her for several years due to her blindness and wants to still be her provider. The hard thing is for my brother and sisters too is that it’s almost like we have 2 patients. I hope your mom gets better. It is so great that we still have our Mom’s into their 90′s Dr Paul…thank you for sharing, it’s been helpful to me at this time too. Bless you and your mom.

  6. Dr. Paul

    Doing too much for an ill family member can backfire. The more the recovering person does for themselves, the stronger they get. Sometimes being helpful is encouraging your relative to do more for themselves!