Monday, April 29, 2013

Care Coordinators

Care Partners

The first thing I asked was “is she safe?”  The elderly man on the phone called to tell me his wife fell and is now in the hospital.  They took her to the community hospital (all names are being changed for obvious reasons) and I waited at the general hospital, he said in a shaky voice.  No one told me where they were taking her.  He was very distraught and now felt even more vulnerable.
A loving couple in their 80’s and never significantly separated; he is her caretaker and just recently realized he may not be able to care for her any longer.  Her dementia, falls and incontinence are taking a toll on both of them.  “How can I help”  I asked.
He felt she was safe where she was but didn’t know what he needed.  In his long career, he was an expert at his work.  As a coach, he is an expert in that field, but when it comes to his need for healthcare services, he had no idea.  I went to his home and together we found his insurance policy, contact information and names.  I took their ID numbers, birth date, address and other information and started right away making the calls.
As a care coordinator or patient advocate, there are many roles we can play.  I couldn’t possibly tell him “This is what you need to do”.  He wasn’t in a position to do anything but visit his wife and hold her hand.  It took me a few hours but well worth the time starting a claim on their long term care insurance.  When I asked him about his policy he said “I just pay it each year” and knew nothing else about it.
I have been told that I should charge for the services we offer at the nonprofit organization PULSE of NY that advocates for safe care.  Helping to start a claim and having someone talk to the family about the available services, fixing the wife’s walker so when she gets home she is able to go to the bathroom with the help that is needed are all samples of patient’s safety.  How does one put a price on the peace of mind we are able to give to one another just by helping where it is needed?
Any small community group can do this for each other.  Care partners can all take a role whether its phone calls about insurance, equipment, medication or helping to manage doctor’s visits, one person can be the care coordinator and never has to leave their home.  From their phone they can just log on who will be coming to check on the patient, what they are able to do and at what time.
If more communities had care coordinators and care partners watching out for each other, we could all rest assured that our loved ones are being cared for and helped by people they know.  This won’t take the place of qualified nursing or medical care, but it is a way to make sure our loved ones are getting the best possible care.
Below is a sample care coordinators chart.
Start off by sending out an e-mail or make some phone calls that this person may (or will) be needing help.  Offer some choices of what people might do or ask them what they are willing to do.  Most people want to help but aren't sure how.  Are they a leader and can organize people?  Do they cook, are they able to deliver meals, visit?  Are they more assertive that they can help plan their doctors visit,  research medications or check on side effects?   All that needs to happen is someone decide the first step and you can plan a care team!

Monday, April 22, 2013

To Boston With Love

Following the Rush

In the days following the Boston bombing, we can carefully reflect on the hard work and heroism of the people of Boston.  No doubt the medical professionals outdid themselves over and over again.  Many training their entire adult life for the moments they can work long and hard to save lives and be prepared for the rush of people who depended on them last week.  Skills, expertise and compassion showed through in the reports of nurses and doctors who did their job under such duress only few of us could ever imagine.  May we never forget that this is the healthcare system we know and love and though this can never take away from the pain many have experienced because of its failings, we also must be grateful for the people behind those walls who are saving lives and putting people back together the best they can with the tools they are given.  God bless every one of them.

Saturday, April 13, 2013

Patient Support

Medical Injury and Trauma

I took a two day course in New York City called Pastoral Crisis Intervention.    I called ahead to find out that I didn’t need to be a pastor or religious leader to take the course.  Although most of the sixteen participants were clergy of some type, the skills I learned in those two days had very little to do with being a religious leader.
Tragedy and trauma that someone may encounter after an event can be obvious or subtle.  Learning the mental state of a person following a trauma, making an assessment and possibly a need for referral must be fast and accurate.
Patients or family members who have suffered a medical error or anything that causes them to distrust or question the healthcare system can be severely traumatic.  At our most vulnerable, due to illness, injury or just age, we need to trust those who are caring for us and often making life decisions.  Each time we are asked to sign a consent (which won’t happen in an emergency anyway) we are trusting the professionals to do the right thing.  When that trust is broken, then what?  It’s not like we can say let’s do this over. 
There is a cost to not receiving help that goes beyond the patient’s rights.  Patients or their family members may avoid care until an illness needs attention that costs more and takes more time.  Avoiding treatment because a patient is fearful of the healthcare system is a symptom of post traumatic stress.  Not being able to overcome their fear, anger or depression because someone they love was injured or killed by a medical error, medication error or hospital acquired infection can be deadly.
When there is an unplanned outcome with someone’s medical treatment, it is important that they are assessed for trauma.  It can make a big difference in their future medical care and that of the people close to them.