Monday, January 15, 2007

Getting old ain't for sissies

Patty here…

Bette Davis was right. Just ask my mother. She ended up in the hospital again last Monday. I say “again” because this is the fourth time she’s been hospitalized in the past twelve months. Ailments that send the young and healthy to bed for a day, send gray berets to the ER.

This time she was in the middle of a conversation when she passed out. It happened once before while I was visiting her in rehab after a previous hospital stay. I called a nurse who gave her oxygen, and she was fine. But it was scary.

I wasn’t with her when it happened again on Monday, but it frightened her caregiver enough to call 911. Instead of taking her to UCLA hospital where her saintly doctor heads the Geriatrics Department, and where she is fast becoming what the nurses there call a “frequent flyer,” paramedics took her to an upscale boutique hospital where the $18.00 valet parking fees and the pre-nups of its A-list neighbors are not negotiable.

When I came to visit her on Tuesday, at least forty-seven uniformed valets lined up to take my car. When I left, only one guy was retrieving them, some yoyo who seemed to think he was competing in the Indy 500. I can still smell the burning rubber from my tires.



The hospital had security, too, a burly guy in uniform who stopped me at the elevator.

“You gotta sign in,” he barked. “What’s your name?”

“Patty.”

That was apparently good enough for him. He wrote ‘Patty’ on a sticky nametag and handed it to me. So much for security. I could have been at a Chamber of Commerce mixer.

I found my mother in a chichi private room with a spectacular view. A nutritionist was there, taking her lunch order. My mother passed on the grilled tofu and opted for yogurt and fresh fruit. She waited for the nutritionist to leave before unleashing her frustration.

“Five firemen brought me here.” Her tone was laced with incredulity. “Five!”

“Were they hot?”



She rolled her eyes to let me know she wouldn't be answering that question.

“This place doesn't have any of the TV channels I like to watch," she went on. "And I ring the call button again and again, but nobody comes.”

After listening to her complain for a while, I detected the mother of all problems. She had no telephone in her room. This was very bad news, because she knew I had a cold and she was worried. At home she would have called to check on me. Here she was dependent on the kindness of strangers, some of whom were hardly the Florence Nightingale archetype. Still, she tried. She made her nurse promise to call me. When the nurse reneged on the deal, my mother began to wonder if she was in a hospital at all. Maybe the CIA was holding her in an undisclosed country that ended in “istan.”

She was cranky, so I knew she was going to live.

When I picked her up at the hospital on Thursday, the nurse who checked her out had never read my mother’s chart. She couldn’t tell me what medications she’d taken that day or what tests she’d had while in custody. She told me I’d have to call the doctor. Later I called the doctor listed on the release form. I was told that he didn’t have my mother’s records. I’d have to call the hospital. I called the hospital. (Wasn’t I just there?) I got a machine. I left my number. No one called back. The whole experience made me want to scream.



In the car on the way home, my mother said, “I never want to go back to that place again. They don’t know me there.” Her words were the ultimate indictment.

Navigating the healthcare bureaucracy in this country is daunting. I know because I’ve been doing it for her for the past four years, ever since my father died. I understand how she feels. If you have to be hooked up to machines, it’s better to be in a place where you’re a “frequent flyer,” a place where everybody knows your name.

Cheers!

16 comments:

  1. Hi Patty,

    Glad your mum is feeling better and out of that stupid place. If unprofessionalism makes her as cranky as it makes me, then I'm glad she's well enough to know the difference. Gad, that place sounds like a country private hospital that my own mother has stayed in a couple of times. The first two stays were great: she was treated like royalty and got the most attentive care ever. On the third stay, not only were the nurses disgruntled, nowhere around when you needed them, and trying to push expensive extras on her. The difference between stays? The previously locally owned private hospital was bought out by an American company, and the new American owners laid down very explicit orders about just what the staff was able to do before asking for more money to cover it. I'd be very surprised if any of the medical staff are working at there anymore.

    My own experiences of this country's medical system have been thankfully small, but five weeks after my wedding, when my father-in-law died, I got a good hard look at 'passing the buck', 'blaming someone else' and 'not responsible' about the medical staff, and I still want to strangle, and generally kick butt regarding the 'social worker who represented the Medical Insurer'. She also failed miserably in her care of her client, my poor father-in-law.

    It's late. I should go and find more chocolate...

    Cheers
    Marianne

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  2. Marianne, your experience is an apt example of why people in hospitals need an advocate on the "outside." Things change when family members are around asking questions.

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  3. The sad fact, Patty, is that we WERE there asking questions. At the totally inadequate nursing home that my father-in-law was dumped into two days after having a cancerous lump and half of a lung removed, Pauline, my mother in law, was there everyday feeding him and taking care of him. The Doctor was non-existant, the nursing staff unhelpful, and the unqualified rehab staff told us that they had to put Richard through physical therapy or they wouldn't get paid. It didn't matter that he wasn't scheduled for that kind of therapy at all. Also, Bob and I were at the hospital (all three stays)every second day, and we asked questions, sat with him and fed him when needed. Apparently we were unusual for doing that. In this area a lot of elderly get 'dumped'. It disgusts me. Oh, and the nursing home called at the end of seven days to politely tell us that Richard had slipped into a coma and would we like them to call an ambulance to take him to hospital. Totally stupid question! Of course we would. 'nuff ranting. Sorry.

    So, did your mum finally fess up? WERE the firemen 'hot'? :-D

    I can see a Tucker situation in there somewhere. :-)

    Glad your mum's home.
    Hugs
    Marianne

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  4. Patty, how many presales orders for your upcoming novel was Mum able to elicit??
    But seriously, I'm glad that she is back home and hopefully back to feeling like her old, uh,excuse me, young self.
    Jon

    PS: who'd ever think YOUR Mom was a sissie??

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  5. Valet parkers and spectacular views, but no one answering the call button? Like you, I would have been livid.

    I have a young paramedic/firefighter friend (yes, he's hot, but he's also my adopted son, so we don't go there) who gave me a list to memorize last year.

    "If's it's a gunshot, car accident or general trauma, tell the paramedics to take you to Hospital X. If it's a heart attack, tell them to take you to Hospital Y. Broken bones go to F. Disease of unknown origin, go to W."

    And here I thought I'd be reciting The Lord's Prayer in the ambulance.

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  6. Marianne, how horrible about your father-in-law. I had a similar situation with my father but will save that for another post. My mum is still keeping mum about the hot firefighters. Rats! Louise, maybe you could post a picture of your hot fireguy?

    Jon, I'm not sure how many pre-sales she made, but I did notice her surrepticiously dropping bookmarks as she was wheeled down the hall toward valet parking.

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  7. Patty,
    Reading your entry made me think of my own experiences with dying parents (All of mine are gone now --stepdad and goddad included.)

    So many things appalled me about the callousness of many workers. And, then, just when I'd be the most furious, a health care worker would turn it around with a kind word or compassionate expression.

    The stress of handling our parents' failing health is unlike anything else we'll ever experience. The lack of control we feel comes from both the hospital context and the fact that we can't control our parents' experiences.

    In Albuquerque, thank goodness, we don't have anything resembling boutique hospitals -- so at least that's not an issue.

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  8. Pari, as Our Jacqueline would say, how lovely of you to stop by. What you said is both true and eloquently stated. The most difficult part for me is watching my mum deal with the loss of her independence, something that awaits all of us to some degree. Ugh!

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  9. Oh, Patty. Sorry to be a day late in wishing you and your mom better health, and in pointing out that no discussion of hospital care can be complete without those two little words: staph infection. Or is it staff infection?

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  10. Good to hear from you, Mims! And, as usual, you're correct. The antibiotic-resistant staphylococcus aureus bacteria going around L.A. is the best reason to stay out of a hospital.

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  11. Patty,

    Sending good thoughts to you and your mom....

    ;-)

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  12. Thanks, Rae. It's always good to hear from you. I'll send your good wishes on to me mum.

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  13. "In the car on the way home, my mother said, “I never want to go back to that place again. They don’t know me there.” Her words were the ultimate indictment."

    It seems to me as if that is very much their loss.

    Good grief, I know I'd enjoy sitting and talking with your mum. We'd have some enjoyable topics to cover--books among them, I'm sure. :)

    And I promise that I wouldn't ask her about hot firefighters.

    I hope that she continues to recover.

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  14. Jeff, my mother called me this morning, all excited. The Talking Books version of False Profits had just arrived in her mailbox compliments of the Braille Institute. She was getting ready to rev up her machine and listen away.

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  15. That's wonderful, Patty. And I'm not sure whether it would have put a bigger smle on her face--or yours. :)

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  16. Dear Patty,

    Every story of careless medical care is a tragedy. Your mother, you, the other patients and their loved ones in that hospital deserve full service that meets their needs. I fear that expectation is no longer realistic.

    My mother's final years included disappointing care in different hospitals, too. Looking back, what I feel was most hurtful to us was that no one ever took the time to talk to us about advance healthcare decisions. When an elderly person with multiple chronic diseases becomes a frequent flyer it indicates a biological breakdown and is an alert to review and revise the plan of care, discuss at what point hospitalization would be a burden not a benefit and how to support your loved one through the end of life.

    Making these decisions in a crisis is not productive and it often results in unnecessary suffering for everyone, especially the patient. I’ve heard adult many children say, “Dad always got better. I can’t believe he’s not getting better this time,” while an elderly and frail Dad has had another surgery, chemo treatment, dialysis, intubation, it goes on and on. That is why the median stay in hospice today is 20 days. It’s not enough time.

    It is, after all, our duty and privilege as offspring to help our parents die with dignity and in peace. We cannot succeed if we are not prepared. Accepting the inevitable transition ahead, we can then hold hands and spend the time remaining smelling the flowers.

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