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2013-11-16 16.25.51The recent hospitalization of my 63 year old brother was a sudden reminder of how overwhelming it can be for any  visitor who steps inside the hospital doors. Many of us have aging parents or other elderly relatives.

Some are living independently and some have help. What they all have in common is health risks.  Their chances of having to go to a hospital at some point are high.
My brother  had a stroke and was in ICU.   I am now a  hospital visitor too.  He has moved on to the rehab section, and as I write this, he is still in need of a lot of therapy.
A hospital is often an intimidating and somewhat mysterious place. They speak a different language of medical words the average Joe or Jill doesn’t understand.  People in various kinds of uniforms bustle by and you don’t know what role they play.  Although I spent a fair amount of time in hospitals in my early nursing career, I had forgotten how strange this must feel for anyone who is not in the medical field.
My brother is in a good hospital, a fairly large regional facility with competent staff. I have an advantage of being able to speak “medicalese”.  Most people don’t.  There is no sign posted to tell the regular person visiting the hospital how to find out what’s happening and whom to approach for information.  So, based on this recent crisis, I’ve tried to put myself in the shoes of all the non-medical folks, like my other family members who really want to know what is going on and who feel really out of place in a hospital.  The overwhelming feeling of strangeness, of being on foreign territory is common to the ordinary visitor.  Most people are uncomfortable even as they approach the entrance.
Taking that into account, I have gathered some tips that could be useful if you have to visit a hospital to see someone you love there.  These come from my  own past nursing experience, and from my efforts to translate what was happening in the hospital most recently to my siblings and friends, none of whom have a medical background.  I would describe us as a disjointed family with less than perfect communication.  What we had in common was a desire to keep up with what was going on with our brother. Was he going to make it? What changes were happening?

Tip One:  Understand The Terminology Of Who’s In Charge
 Hospitals are bureaucracies with layers of authority.  Teaching hospitals have even more layers with interns, residents and other students.   Small hospitals have less of this.

The person in charge of ICU at this hospital is called a “criticalist”. That is the doctor who oversees the health care team in ICU or any other critical care unit.
Contrast that with the “hospitalist”, the doctor who oversees the care of the other physicians who are attending to the needs of your loved one outside critical care.    There may also be neurologists, cardiologists, and other specialty physicians in the picture.  A case manager, who is a nurse, may be assigned.  Family has a right to know what treatment is planned and you need to know the right person to ask.  Start at the top.
Tip Two:  If You Want To Know What’s Going On Daily With Your Loved One, Ask The Nurse

I was happy to interface with the various physicians when I visited, but the appearance of the MD was unpredictable and it can be impossible to plan to see her at a given time. The nurses, on the other hand are there for the entire shift. They use electronic medical records (now mandated by the Affordable Care Act), so any one of them can get into the digital notes from the prior shift, or from anyone on the healthcare team, and update you as to your loved one’s status.  I live at a distance from this hospital.  When I called in every day, I asked to speak with the nurse who was caring for my brother. I got a full update and my questions answered every time.  That was a relief. 
Tip Three: As For Explanations Of Terms You Don’t Understand

Hospital staff may speak to you quickly, and may use medical terms you don’t understand without realizing it.  Many people are intimidated by doctors. Most people don’t want to feel dumb and some may be afraid to ask “what does that mean?”  I’m just encouraging you to get over that and ask for the MD or other reporting person to please explain in simpler terms.  You deserve to understand what is going on.  They owe you the courtesy of letting you know what you want to know.
Tip Four:  Pick A Spokesperson For Your Family
Busy staff in a hospital are very willing to update you about your loved one, but they shouldn’t have to tell the same information over and over again to everyone who wants to know. If there are siblings and other relatives, it works best if one person in the family is chosen to be the point person for communications with doctors, nurses and therapists.  In my family, I’m the only nurse, so that job defaults to me. If no one has a relevant background, elect one of you who is willing to get updates and to call, email, or text to update the others about what is going on.
Tip Five:  Find Your Loved One’s Important Paperwork 
If the situation is critical, as it was for us, you need to know if your aging parent or other relative has a health care directive (proxy or healthcare power of attorney).  You also may need to help with your loved one’s home, bills, pets, etc.  If you go through a situation like this with an aging parent, and you have another elderly parent still at home it may be easier. But if your elderly relative or other loved one is alone, as my brother is, it can be quite a challenge to find the bills, tend to their ordinary expenses and make sure the utilities are not turned off while the person is hospitalized.  My brother’s car registration, for example, was due during the hospital stay.  I was able to get his mail and pay the bill. Tasks like that must be kept in mind, which is hard to do when shock, fear and grief are on your mind.
Tip Six:  Be Conscious Of How You Manage Your Own Emotions
The experience of having someone dear in the hospital is stressful and can cause other relatives to react in unpleasant ways.  My own family has a few nasty characters in it who are relentlessly critical and prefer complaining to cooperating.  If you can step back for a bit from it all, and just detach from their negativity, it can make it easier to cope with the situation.  I’m working on this one.  One good trick:  my wonderful husband, Mikol, offered to pre-screen the worst one’s negative emails and to delete them if they contain no useful information. I won’t have to read them at all. Bless him!  If you have a good partner or friend in your life, that’s something they can do for you too: help you avoid engaging with the offensive people so you can concentrate on being there for your loved one.
This task of being a hospital visitor is one most of us will face or have already faced. As we get older, we will find ourselves at the entrance to hospitals more often.  I hope in sharing my experience with you that it may make your next visit there a bit easier.
Until next time,
Carolyn Rosenblatt

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