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PATIENCE, PLANNING AND SUPPORT: REFLECTIONS ON DEALING WITH AGING FAMILY MEMBERS
Unprepared. Even though you know it’s coming, your parent (or your loved one) tries to assure you they’re ok...so you don’t prepare, and you put it off. You put it off because you are afraid. You put it off because you think they will be angry and resist. You put it off because you don’t know how to solve the problem. In hindsight, I genuinely believe that preparing can be done with dignity and respect out in the open with participation or maybe in secret because of denial. You need to do it. If you first try to do it out in the open with participation and involve your parent or your loved one, they may resist, argue, or deny and try to convince you that they are OK. This may cause you to feel like you need to back off or wait to make decisions or have further discussions. In reality, you need to move forward with what you know and what you think is best, in the open or behind the scenes, based on your knowledge and some outside research. At first, it may be painful, and there may be hurt feelings. In the end, it will be the right thing, and you will be more prepared.
My father is 75 years old. He was largely healthy and active his whole adult life. He did sports, went to the gym, ate well, and drank minimally. He was no stranger to surgery but could avoid or reasonably manage many of the chronic illnesses common for his age group. Last year, he began
to have disabling back pain and right foot weakness. It reached the point of needing surgery. The telltale sign for me, although I would not have recognized it at the time, was his belief and expectation that the surgery and recovery would be like the prior surgeries years before, including
a quick recovery with minimal pain. He underestimated both his age and his resilience following an intensive L2-S1 fusion. My mom and I did, too. We learned a lot from this experience, and there are many things we would have done differently or better. We can now share those with you in the hopes that you will be more prepared when your parent or loved one falls ill or has a long hospitalization.
Lesson 1: Expectations and Pre-Planning following a hospital stay/surgery
Although you cannot always manage the expectations
of your loved one, reasonable or unreasonable, you can work towards planning for success and managing your expectations. My father was a Medicare patient with
Part A and Part B. Medicare does not begin to cover hospitalization until day 3. Had we known this ahead of time, we may have spoken to his physician about keeping him in the hospital longer to help manage his post-operative pain, rehabilitation, and chronic medications. Instead, we were surprised when he was discharged on day two home instead of to a rehabilitation facility. We could have checked
this coverage ahead of time and then weighed the cost of a 2-day hospitalization versus a 3-day hospitalization covered by Medicare. For you, it may be best to determine the approximate amount of these costs ahead of time to prepare for amounts that may not be covered and speak with your loved one’s physician to determine a more manageable length of stay.
Once you know the discharge date and plan (you may need to check with the attending physician many times along the way, so be prepared to do so), help prepare for the event by asking yourself the following questions:
1. Can I care for my loved one at home during this period largely uninterrupted? Although you may think that you can take breaks between conference calls, a working spouse or child cannot care for an aging loved one after major surgery or hospitalization, where recovery requires 24-hour care and monitoring. You will find that trips to the bathroom take upwards of 30-45 minutes. This sometimes relates to the physical act of getting to the bathroom but may also relate to
an accident that happens along the way, the need to go back to the bathroom after a failed first attempt, and the time needed to “clean up” after bathroom use. Sleeping is disrupted constantly with medication management
for pain, and cooking and preparing food and snacks sometimes need to be coordinated with taking medications and providing assistance with eating and drinking. This means that a 15-30 minute time period for preparing food becomes a 1-hour commitment multiple times per day.
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