Archive for March, 2009
Don’t Go Home Without It
Wednesday, March 18th, 2009
Going home is supposed to be the easy part. You put on your clothes. They roll in the wheelchair, and you’re home free. Not exactly.
My 84-year-old mother traveled from the kitchen floor to the emergency room to the intensive care unit. Her heart cycled in and out of atrial fibrillation. The cardiac surgeon inserted a pacemaker. Eight days later, mom was ready to head home to the comfort of her recliner where she could yell at "her Lakers."
The day started off well. According to the cardiologist, "all systems were go" for her release. They were just waiting for the internist to discharge her. He should be in shortly. Almost 12 hours later, at 7:30 p.m., the internist rushed in. After a cursory look at my mother, the doctor sequestered himself to write the discharge orders. We never saw him again. At 8:30 p.m., a nurse who had just begun his shift delivered the discharge orders to my mother whom he had met less than an hour earlier.
As we reviewed the instructions, I inquired about the six prescriptions. Did these orders supersede any previous meds she had been taking? They did. Should she cease and desist taking any prior prescriptions not on this current discharge order? She should. Did this new medication replace the old one she had been taking? It did. We packed mom up and escaped into the dark of night.
Back home in her bed, my mother’s heart began to race. Her blood pressure monitor malfunctioned. We considered calling the paramedics who would have taken us back to the ER. We weighed the impact of stress and the risk of infection for this already fragile being. We did some deep breathing and decided to ride it out.
The next morning, I raced to the pharmacy to have the new prescriptions filled STAT. It was not until several days later, when our own physician went ballistic, that we learned that the new medication on the discharge order was a second blood pressure medication, not a heart medication. After multiple tests, procedures and surgery, the hospital team discharged my mother without her heart medication.
To Prevent Your Own Discharge Disaster:
- Avoid going home at 8:30 at night.
- Don’t skip meals. Stay lucid and advocate for your loved one.
- Avoid going home immediately following a shift change.
- Clarify the discharge orders with the doctor.
- Ask specific questions about any new or discontinued medications. Don’t assume that the "new" drug replaces any deleted "old" drug. Ask what each drug is prescribed for. Inquire about generic versus brand names.
Conditions may be beyond your control, but do your best to stay on top of things. Don’t go home without a clear understanding of the discharge orders. It really can be a matter of life or death.
February Newsletter
Monday, March 9th, 2009If you missed our February newsletter, you can read the archived version by clicking here.
Hospital Hiatus
Friday, March 6th, 2009
One minute she was sitting in a chair talking on the phone. The next thing she knew, my 84-year-old mother was lying on the floor staring at the refrigerator with bent glasses in her hand and a giant lump on her head. Thus began a calamitous chain of events that included stops along the way to the emergency room, the intensive care unit and the operating room for the insertion of a pacemaker.
It’s been said that we make plans and God laughs. If so, He must have been laughing at my previous post about creating the perfect plan for balancing work and caregiving. I’ve been on a hospital hiatus, camped out at my mother’s bedside, then living out of suitcases at her home.
As a baby boomer caring for an aging parent, vulnerability and unpredictability are two of my constant companions. Caring for my mother is my first priority and posting on my blog is not even on my radar. Still I hope to share what I’ve learned to spare others the anguish we experienced.
I’m grateful to report that my mother is recovering well. We appreciate all your kind comments and words of concern. I’ll be posting again soon about some of the additional lessons we learned along the way. In the meantime, we welcome your comments about your own emergency room dramas.