Everything you need to know about admitting your elderly parents into hospital
My friend Jenny recently experienced what it is like to navigate the hospital system after her mother had a major stroke, and she had some great tips. In addition to writing everything down in The Notebook, here are some essential rules.
1. Bring your elders things they need
Remember how women close to giving birth are advised to have a bag packed for the hospital? Same, same. If not a bag packed, make sure you have a bag handy, and a list of things you need to pack for your loved one.
After Dad was admitted to hospital following a major fall, I rushed to see him with flowers, grapes, and grief, but I should have included pyjamas, a toothbrush, a list of medications, batteries for his hearing aids, reading glasses, a book to read (or a talking book), socks (because you can get really cold in hospital), money and civilian clothes (in case he wanted to do a runner. Also, one hospital discharged him in his PJs after a hip replacement, presumably to hitch home).
2. Be a ray of sunshine
Be nice to everyone when you visit: nurses, therapists, cleaners, caterers, casuals, the people visiting the patient in the next bed. Engage. You are all there for the same reason. Know their names, introduce yourself and your extended family if they are crowding in also. Having said that, nominate a family contact so staff can call one person, not four. Anyone in the hospital can provide useful intelligence to tell you how your elder is really being treated, how they are coping, are they distressed. This was helpful with Mum, who is almost wholly blind and deaf. She doesn’t know what is going on around her, which is intimidating, and the button for the nurses is often out of reach. She was tortured by a rogue nurse who insisted on heaving her upright by her broken shoulder, who refused to help her get to the toilet because the nurse’s back hurt, and who wandered off to leave Mum to soil herself. Mum said ‘That nurse destroyed me.’ Mum’s account was backed up by another woman in the room. It led to a polite but bloody pissed-off letter.
3. Introduce your parent, the patient
Talk about your loved one; even put a sign up with hearts on it and a description of them. Make sure everyone knows if they are vision-impaired or have dementia. Or if they are hard of hearing, so the staff will understand why they are nodding politely to an enquiry about whether they would like an egg sandwich or curried chicken with mashed potato.
In my experience, staff are likely to engage more fully with your parent if they are encouraged to see them as a valued and loved person. Most staff are amazing but there will be the occasional arsehole with a secret sorrow. And there is very little you can do about them.
4. Identify who’s who in the zoo
Find out who the key people are and build a rapport with them. They may help you just to make you go away, nicely. The nurse unit manager is a good person to ask any questions about the treatment and keep up to date.
Find out who everyone else is, their place in the hierarchy and their responsibilities. Who are the decision-makers in your loved one’s ‘care circle’ (as Jenny puts it)? Learn to distinguish between the uniforms, just as you would on any battlefield. (No good asking the orderly about an MRI; no good pouring out all your concerns and complaints to the tea lady. Actually, in some hospitals, she is probably as good a person as anyone.)
5. Be polite
Do not be arrogant or pushy, but don’t be brushed off either. Always be courteous. Your parent may be stressed or medicated or deaf and not pick up the finer medical points, especially the ones in Latin. The very best time to meet the doctor, I discovered, is when the doctor arrives with an entourage of medical students. The doctor did not go ‘Hmm. Ah . . .’ and move on. He explained, loudly and in well-expressed detail, for the benefit of his students, what was happening. Diagnosis, prognosis, the lot.
6. Call at the right time
Jenny says that trying to catch a doctor on his rounds was like Pokémon Go in hospitals. Especially on weekends and night shifts. Concerned families wander the corridors, trying to find the right person with the right information.
Find out when the decision makers’ shifts are on. Jenny found herself making calls to the hospital and not being able to get in touch with anybody who knew the latest on her mother. She says, ‘Find out when the physician/surgeon/nursing unit manager will be working. Because there is no point ringing at 4pm to speak to a nursing unit manager when their shift finishes at 3.30. And don’t call them when they start at 7.30 in the morning because they are looking at all of their notes. Or at 8am because they are doing all their rounds. If you call them at 10 or 11 you are more likely to be put through.’
7. Make up a care roster
If you are fortunate enough to have other family members close by, draw up a roster. Make sure everyone has a copy.
8. Tell care providers and My Aged Care
If your elder is receiving a Home Care Package, contact the provider to let them know your elder is in hospital. They will suspend the package while care is being supplied by the hospital. Arrange a reassessment for your loved one by ACAT every time there is a new ‘health/medical event’. (For example, when Mum had a stroke, she went from a level 2 Home Care Package to a level 3, which meant that a nurse was now a part of her package. This was all good and nice. But it also meant the lovely community nurse who had been coming in regularly to dress a wound on Mum’s foot was given the old heave-ho. Sheesh!)
9. Trust the experts
Once you know your elder’s hospital or rehab care team, stand back and let the experts do their jobs. Your role is to keep up morale, hold your loved one’s hand, surround them with golden glows, or good vibes, or prayers, or any other spiritual and emotional strength you can convey. Tell a few jokes. Peel grapes. You know their favourite treats. Bring some in. Custard tarts are good, maybe hash browns. Do not bring in the Hibachi and a bag of prawns.
10. Look after yourself
You’re no use to anyone stressed out of your mind and too tired to think straight. Take care of yourself, too. With wine and chocolate. Do not lie awake fretting, or doze fitfully, waking every two hours and worrying. That’s the patient’s job.
Image by Rob Palmer featuring Jean Kittson, Elaine Kittson and Roy Kittson.
We Need to Talk About Mum and Dad by Jean Kittson. Published by Macmillan Australia, RRP $34.99.