Recent Blogs
Hospital Quicksand: Words Are Not Enough
I was asked for suggestions on how to help seniors preserve control in a hospital setting where all control quickly vanishes. Interesting question I thought. What would make things better? And then I remembered David.
David is a friend of mine who suddenly fell into frightening rabbit’s hole when he was being worked up for cancer. What was supposed to be a routine out patient biopsy triggered a medical crisis that sent him directly to intensive care. Thankfully he clawed his way back out of this nightmare after weeks of doom, gloom, and what seemed like endless setbacks. But he said something to me during one of my visits that gave me a jolt of fear and insight. “I losing track of what is happening,” he said in a medicated monotone. “I am losing my ability to figure things out.”
This disorientation happened to a middle-aged, educated, no-nonsense adult. What happens if you wind up in the hospital at advanced age, wrestling chronic illness, and overwhelmed by the healthcare system? Now what?
It turns out, words are not enough. With so much information coming at hospitalized seniors from all sides and wrapped in medical jargon, seniors quickly get overwhelmed. They need a better way to manage information. Enter the lowly dry erase lapboard. This simple yet elegant white 9”X12” melamine hardboard turns out to be an ideal control preservation tool. Here’s how.
Ellen’s mother was admitted to the hospital for suspected congestive heart failure. Her mother was anxious and having a hard time understanding all the things that needed to get done for the medical work up. Sitting on the edge of her mother’s bed, Ellen used a dry erase lapboard to outline out what was going to happen and why. It looked liked this:
1. CXR > Lungs > Any Fluid?
2. Echo > Heart > How Strong?
3. Test > Blood > Any Problems?
As she outlined one item at a time, Ellen’s mother had questions. “Let’s find out,” Ellen told her. Knowing what is going to be done and in what order is the first step in regaining control. The dry erase lapboard provided a visual aid to decode the process and resulted in a fundamental shift in the balance of power for Ellen’s mother. The same approach was used throughout her hospital stay and at discharge.
Here is what the dry erase lapboard outline looked like on the day Ellen’s mother was discharged:
1. New Medication > Reduces Fluid Build Up >Take One Every Day
2. Walking > Strengthens Heart > 15 Min, Twice A Day
3. Follow Up > Family Doctor > Two Weeks
The board costs four dollars. The marker two dollars. The ability to understand and preserve control: priceless.
Here is a good place to get the boards: http://www.dryerase.com/blank.htm
Caregiver Stress? Try Inspirational Walking
Caregiver stress is well documented and extracts a heavy toll on both caregivers and their families. In the heat of trying to keep everything together, it is hard for caregivers to find effective strategies that offer some respite from the natural tendency to obsess and feel overwhelmed. Caregivers need a way to take their brains “offline,” to momentarily disengage for anxious, closed-loop thinking, catch their emotional breath, and come back renewed. But how?
Here is my solution: Inspirational Walking. This is a simple, effective strategy that combines walking with a personalized soundtrack. It combines two powerful strategies that change thought patterns: exercise and music.
Exercise clears the mind. Even when we start out feeling overwhelmed, a simple thirty minute walk makes our thoughts clearer, gives us new ideas that help us cope, and leaves us feeling physically and mentally energized.
Music inspires the heart. Music has been a part of lives from early childhood, and we all have personal sound tracks of our lives. We mark people, events and the passing of time with certain songs. In the end, music helps us give meaning to our experiences and, as important, helps us cope.
Inspirational Walking integrates both of these strategies into one simple strategy. Here’s how it works:
1. Using iTunes, create a playlist that is thirty minutes long. Begin with a song that captures the reality, mood, or irony of being in a difficult caregiver situation. I personally like Van Morrison’s song “Stranded” with the lyrics “everyday is puzzle time again.” I can’t explain it, but hearing these kinds of songs makes me feel better. Then add songs that that offer courage, inspiration, and motivation. I personally like Jack Johnson’s “Upside Down,” Indigo Girls’ “Love of Our Lives, and Coldplay’s “Yellow.” The key is to find songs that speak to your heart, that pick up your mood and step, and that remind you that you are not alone with your life struggles. Don’t obsess about the order or the exact length of the first playlist. As they say at Nike, just create it.
2. Give your playlist a test run. Put on your most comfortable walking clothes and shoes and take an thirty minute Inspirational Walk. This is your thirty minutes off line. If you can, walk outside; it will have the deepest impact on your thoughts and mood. If not, use a treadmill or an indoor mall. Put the world on pause; it will have to make due without you for thirty minutes. Find your own starting pace and just go with the music.
Remember:
Everyone is stiff and tight the first ten minutes and wonders if this is a good idea.
Everyone feels remarkably better at twenty minutes and are glad they took a walk.
Everyone feels better as they bring it home at end of thirty minutes and are sure it was good for their body, brain, and heart.
3. Modify your playlist and build new ones. Maybe you want to change the order of songs, or delete some songs and add new ones. Maybe you thought of a theme for another Inspirational Walk playlist. Create playlists for those days when nothing goes right. Create playlists for those days you are grateful for the lessons. Create playlists for those days you are on point and things are falling into place.
Our minds don’t do well sitting and stewing. We need movement and music to break us out of our mental quicksand. Try Inspirational Walking for thirty days, three to four times a week. See where the music takes you. See how your body feels with some new, consistent motion. See how your brain reacts to new input. Lastly, share your success and playlists with other caregivers who, like you, need a little time off line to regain their balance.
No Place Like Home for Aging Parents? Maybe, Maybe Not (Follow Up)
Leslie Peters was my guest on a recent blogtalk radio show I host (http://www.blogtalkradio.com/solie/2009/11/07/no-place-like-home-for-aging-parent-maybe-maybe-no). I asked her to provide me with a “list” of questions that would help aging parents and their adult children screen potential senior living accommodations. She was kind enough to send me a list of questions that “often go unanswered.” I think they are excellent. Here they are:
Parent company:
Who owns and operates the community?
How can you find out about the parent company’s fiscal health?
Are there documents such as annual reports or audits that you can have copies of?
Is the company for-profit or not-for-profit? What’s the difference?
How long has the company been in business?
Staffing:
How is the transfer to a higher level of care determined?
Is there someone on staff whose job is to manage transitions from one level of care to another and coordinate communication with the residents, their family members and the physicians?
Are there state and community regulations that determine who is appropriate for each level of care?
What medical and other support services are available on site?
Is there a way of checking to make sure that your Independent residents are up and around each day?
Miscellaneous:
Ask the Marketing person to set up a lunch or dinner with some residents so you can hear firsthand what it is like to live in the community.
Adult children might also consider talking to some of the children of residents to hear about their take on the community, staff and services.
How are new residents welcomed into the community?
Thank you Leslie…
A Blog Worth Repeating
Dr. Patrick Roden has a wonderful blog entitled “Aging in Place.” Below is the link to his latest post on September 14, 2009. It will do your heart good…
Successful Aging: A Man Named Pearl.
