Archive for January, 2010

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