Communication

“Transition” is open ended in both concept and definition. Letting go has been surprisingly difficult. I thought (even dreamed <grin>) it would be easy. When you do EVERYTHING all the time it’s strange to learn to let others start doing it.

Over time, home caregiving skills evolve as you adapt to progression and other times are simply intuitive. That isn’t exactly an ideal merger with the bureaucracy of institutional care. Three shifts of people replacing just you have an entirely different ‘approach’ from communication to consistency.

It’s been almost 2 months since Patti was admitted to her care facility and I find myself still NEEDING to monitor.

A perfect example happened just this week. I received a notice from Patti’s medical insurance notifying us they would not pay for a thyroid level test that had been submitted two weeks after she was admitted. (????)

To make a long story short for background, Patti had ‘Graves Disease’ prior to MS and her Thyroid was removed. She takes Snythroid daily as a replacement.

Some shift staff member when distributing meds had double checked Patti’s records and couldn’t figure out why she should be getting Synthroid and, if so, were levels even correct. That ‘flag’ triggered a blood test which confirmed levels and accuracy of prescription. That was basically a GOOD call by the shift staff.

What was WRONG was that I was not called or notified. I only became aware a full month later because payment was rejected because Patti had just had a physical and full blood work just before admittance.

I discovered what had happened is that her care facility had misfiled her medical records in the wrong section of her file. Shift staff had only looked where they were ‘supposed’ to be. This problem REMAINED uncorrected until I followed up on the insurance charge.

Fortunately this was minor and had a positive result. However it does not require a great imagination to see how an urgent dilemma could have spun out of control because of misplaced medical records. Or because no one thought to call Patti’s spouse caregiver.

Institutional bureaucracy by its nature has a tendency to want to think that everyone operates as they do. As a spouse caregiver I’m only used to doing it my way.

I know we NEED three shifts of people to properly and safely care for Patti. It will take time to make it succeed. “Transition” is not a door that opens and closes on home caregiving. It has been two months and I am still discovering and learning.