Preparing To Care

An “Advocate” in the hospital is a family member or friend or professional sitter/caregiver who stays with the patient all day, all night, or around the clock. With family or friends, it is usually in shifts. Good professional caregivers are accustomed to “sitting” on a 24-hour basis with clients in facilities and may stay for several days in a row.

Why is it important? Frankly, no matter what my age or condition, if I were hospitalized, I would want someone “on guard” with me around the clock. I just posed that issue to a friend who has years of experience as a hospital RN and she heartily agreed.

On guard for what? In today’s hospital environments, people come and go all day and night, taking vitals, giving bed baths, changing sheets, giving meds, changing IVs, taking blood, administering breathing treatments or physical therapies, performing transfers (helping to bathroom), doing exams, changing a dressing, delivering food, and so on. My nurse friend recently served as an Advocate for a young-adult in a first-class, big-city hospital. She told me it seemed to her that care is delegated in so many directions, that one nurse is not able to concentrate on “her” (or his) patients as much as they used to.

Advocates, says the nurse, whether family, professional or “just a friend,” should be respectful and nice with staff, but should not be shy about asking each and everyone who comes in the door, “Now, what is it that needs to be done?” or “What med are you giving now?” and just paying attention to what is going on — or what should be going on.

Does everyone remember to wash their hands properly? Are they in a big hurry? Do they forget something? Do they get distracted? (They are only human.) Does the room stay wiped down to help avoid today’s hospital “super-bugs”? Has there been a med change that hasn’t been properly communicated? Is the patient getting any kind of food or med they shouldn’t? Does the Advocate see or detect a subtle change in the patient that the “comers and goers” might miss? Is the patient getting checked on enough, or too much? Does a different doctor need to be called? Is there a mechanical malfunction? Someone comes to take the patient somewhere — do they have the right patient? (It happens.) Are they sterile in handling IVs, colostomies, catheters, or dressings?

What if the patient tries to climb out of bed? (They can do it, no matter what age, even with the bed rails up.) What if they fall? If it is someone who is fighting to get up consistently, the hospital will usually request (or require) a sitter around the clock. Hospitals — and facilities in general — are overworked and understaffed. They just can’t be everywhere at once. The patient may need something and the staff just can’t get there right away, especially at shift changes, or at nights or on weekends.

What if the patient has an unexpected — even rare — drug reaction? The staff have left the room. The door may even be closed. Who would know? Years ago, my aunt (an RN) happened to stop by her brother-in-law’s hospital room to check on him and saved his life. His ulcer had started bleeding. No one was in the room.

The Advocate might need to encourage eating or drinking, rolling over, and coughing, or discourage visitors when rest is needed. “Lobby for that patient when necessary,” says my nurse friend. “Too often, the squeaky wheel gets the grease.”

The really good, experienced, professional caregivers know a lot. Most have been Certified Nurse’s Aides (CNA) in a facility or have done care giving so long, they’ve seen it all. They are excellent, objective listeners and observers. Their instincts are to advocate for their clients and their mission is to relieve stress for the family. They are genuine lifesavers.

No matter what our age, we can end up as a patient in a hospital, and then possibly a rehabilitation facility. The elderly are the more likely among us to experience an assisted living or skilled nursing facility.

It’s a sad and telling truth that when we are the most vulnerable physically, we are fed the worst diet. Some facilities are better than others, and there may be some exclusive, high-priced ones out there serving high-quality fresh food, but, from what I’ve seen and heard in the caregiving business, the facility food situation is not good.

Why? Let’s face the hard facts. Most facilities are under terrific pressure to cut expenses and boost profits — sometimes just to make a profit. Even if the budget wasn’t an issue, there is a lot of confusion and even ignorance among care professionals concerning what is truly healthy and nutritious and what isn’t. And often the healthy and nutritious is more expensive. [See our Health Around Your Corner and More Than Gluten websites.]

Recently, one of our caregivers had a knee replacement and spent several weeks in one of our local rehabilitation facilities (skilled nursing and rehab). This woman is an excellent cook, and knows a surprising amount about healthy food. She fed one 90-something male client “churries and pruins” for his arthritis and bowels with beneficial effect. For those who are not “well-seasoned veterans” from rural Pennsylvania, the translation is “cherries and prunes.” Not long after she told me, I received an article in a health newsletter about the proven benefits of cherries (that good ol’ dark red color) for arthritis and joint pain. She was tickled to get a copy of the article.

But, back to the facility food, she said that everything she received was processed, canned, and “no good.” Accustomed to cooking from a garden or with fresh meat and produce from the store, this was particularly hard on her. Of course, it’s hard on everyone. When we need good nutrition the most, we get it the least. If you or a loved one has to spend time in a facility, do everything you can to bring in good, healthy food. Juice veggies and fruits at home and bring it to the room. Be creative. Seek out a truly knowledgeable nutritionist or naturopath.

At some point in your life, you are most likely going to be dealing with the issue of caregiving. Your parents or someone else in your family may need a caregiver. It may be you. It’s better to gather information in advance, because, when the need arises, you will probably be under stress and pressed for time.

Four years ago, we started a sitting and caregiving business in an area of small towns and rural counties. Prior to that, we knew nothing about the subject. Guided by two wonderful ladies with nine years’ experience, we jumped into the “deep water.” For us, it was a whole new world. It is rewarding. It is fascinating. It is sometimes frightening. It is stressful. It is greatly necessary. It knows no holidays and no “regular hours.”

The purpose of Preparing to Care is to share our ongoing experience and research into the subject of caregiving, from the nitty-gritty details of daily care at home or in a facility, to the broader issues of the industry at large — an industry that should be preparing for the “arrival” of the aging of the baby boomers.

In addition, as we combine our caregiving knowledge with our years of nutritional research and our experience publishing a regional alternative medicine and health magazine, we believe we can provide some unique and powerful information regarding quality of life — remaining as healthy and active and mentally sharp as possible. As the saying goes, we want to add life to our years, not merely years to our life.

We will add information as fast as we are able. We hope you find it helpful. If you have a question, leave a comment and we will address it the best we can.

Preparing to Care is part of the family of Health Around Your Corner Publications.