Years ago, I had a family physician that I really respected because he was always so honest and direct with me. He was a very capable man whom I enjoyed having many candid conversations with. On one such occasion the topic of physician competence came up and he said something to me that I have never forgotten. “Most people think doctors are some kind of God, when, in reality, we’re right about 90% of the time.” I have no idea where he got this number but it certainly gave me pause. Ok, during which one of my visits will he be wrong?
I’d like to tell you that all of those in the medical field that deal with Alzheimer’s type dementia know what they’re doing but they don’t. My intentions are not to throw Doctors, Nurses and Aides “under the proverbial bus” or to deliberately shake your confidence in those that may be currently providing care to your loved one. My advice is often a confession and my own personal observations and experiences have proven to me time and time again how important it is that you are paying attention to how experienced your loved ones caregivers are.
For nearly 20 years I have worked around individuals with Alzheimer’s and other dementias in a professional capacity and I have also had personal experience dealing with this disease in my own family. Not surprisingly, you could say I’ve seen and heard it all; the good, the bad and the unbelievable. There was the elderly demented gentleman that was taken to his local hospital for a routine procedure that the Doctor refused to do because the patient “wasn’t cooperative.” If the patient can’t sequence well and you can’t talk to them in lists, what would you expect? A 92 year old gentleman with Alzheimer’s was admitted to a nursing home after a fall at home. He was a serious fall risk so the well meaning staff gave him an “alert” button to push when he needed to go to and from the bathroom or wanted to ambulate to a chair. He could remember what he did 20 years ago but how did the staff not know that, 90 seconds after they left him, he would forget to press that red button around his neck if he needed help. Not surprisingly, he fell in their bathroom and broke his hip, again. And finally, there’s the Emergency Room Physician that was so frustrated with a resident we had sent to him one night that he called my Charge Nurse and asked, “What am I supposed to do with him? You know, treating your patients is like treating animals.” My Charge Nurse was so appalled by the Doctors comments that she called the Nurse Manager at home, who called me. I was on the phone with the Hospital’s CEO the next morning and he had this Doctor call me directly. I asked him for an explanation for his comment and he explained that he felt treating our patients was “like being a Veterinarian and treating a Golden Retriever; they can’t tell you where it hurts.” I reminded him that, as an ER physician, he would rarely have the luxury of every patient being alert and oriented. I also told him he should be ashamed of himself.
In all fairness, I’m sure we’ve all experienced some wonderful care and services. Recently, when I needed X-rays, I put myself in the shoes of one with dementia. The technician was patient, respectful, gave me instructions one step at a time and I commended her.
Remember, you are their advocate and as such you can never assume that those involved in their care know things like their favorite activities, behavior triggers and favorite foods or understands their strengths and limitations as well as you do.
If you have any questions please email me at repe@careforcare.yabanjin.com and remember, Join the Journey.