Friday, March 05, 2010

pulling your hair out and smiling at the same time

Recently Patti was observed by staff intermittently cursing over pain in her right hip and thigh during assisted dressing and Depend changing.

In the care facility era, pain intermittent or otherwise is approached differently than in homecare or self-care. Multiple staff over multiple shifts equals numerous eyes to not only document but set in motion addressing the problem. This is especially beneficial when Multiple Sclerosis memory loss and cognitive impairment clouds a patient’s ability to self direct.

Care in a care facility is governed by a protocol, more importantly a protocol that is not subject to the timetables of the real world.

Technology comes to you. X-ray ruled out a fracture. Ultrasonic testing ruled out a blood clot. Often ruling out problems is actually working forward.

A “house call” is the norm in the care facility era. Unfortunately Patti’s MS prevents her from sharing much credible information or history, if any, to help her physician during room visits.

I prepared and left a “precise and concise” one page note for Patti’s physician on Patti’s family and physical activity history and my own observations on the different lifts in use since recent room change. Could the change in slings be affecting Patti’s hip and thigh?

As I have said before, as an advocate you must do more than monitor a ‘whatdunit’. You must inject yourself IN the mystery.

Many problems yield a diagnosis only after treatment begins, sometimes the response to therapy leads to the diagnosis.

Currently physical therapy (just down the hall) is treating Patti with ultrasound massage, analgesics are used for complaints of acute pain, and staff is working on the challenges of varying lifts.

OK, so people and machines are working around the clock. So what does Patti have to say about all this? Patti’s Mom asked her that question when visiting the other day. … Patti’s response: “What pain?”

Welcome to pulling your hair out and smiling at the same time?

Caregivingly Yours, Patrick Leer
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1 comment:

  1. so sometimes having memory problems could be a good thing; its good that the pain is not a persistent problem that is there every single minute but I'm sure it would be nice to be able to pinpoint it to be able to fix it or avoid whatever the trigger is. but the care at Patti's facility sounds really good and on top of it (with a little help from her advocate of course :) so that is a good thing.

    keeps you on your toes, though

    (I was thinking of pictures, LOL, with son's birthday entry but that would go against my policy on privacy so I thought I humiliated him enough for this year; honestly I am just glad he got to 21 and is still alive and not in jail, so thanking God for that)



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