A care­giver’s per­spec­tive: Do you see what I see?

Health-care pro­fes­sion­als must heed the ob­ser­va­tions of those clos­est to the pa­tient

The Hamilton Spectator - - COMMENT - VICKIE CAMMACK Vickie Cammack is a social in­no­va­tor who has es­tab­lished ground­break­ing or­ga­ni­za­tions ded­i­cated to strength­en­ing com­mu­nity and ad­dress­ing iso­la­tion, in­clud­ing Tyze Per­sonal Net­works, Planned Life­time Ad­vo­cacy Net­work (PLAN) and the Fam­ily

The term vi­sion­ary is rarely used to de­scribe nat­u­ral care­givers. Yet vi­sion is in­dis­pens­able when we take care. No pro­fes­sional care provider, no mat­ter how trained or pre­pared, can see what we see — what was, what is and what can be for our fam­ily mem­bers and friends.

Vi­sion­ar­ies make the truth vis­i­ble. Care­giv­ing re­quires us to share our knowl­edge with cer­tainty, our in­tu­itions with con­fi­dence and our stories with pride. When we do this, we not only pro­vide crit­i­cal care in­for­ma­tion, we help ev­ery­one in­volved to care and con­nect in more mean­ing­ful ways.

A few months ago at the start of a busy day, I gave my feisty 90-year-old mother a call. I was wor­ried. She had been nau­seous and a lit­tle fever­ish for the last few days. Alarm­ingly, she had lost her in­ter­est in cook­ing, her chief pas­sion, and didn’t even want to walk into the kitchen or con­sider eat­ing when I spoke with her the night be­fore. On the phone that morn­ing, she sounded con­fused and said she felt dizzy. She com­plained that her heart was pound­ing. I dropped ev­ery­thing, re­lieved that fi­nally she had agreed to go to the hos­pi­tal.

I pro­vided the in­take clerk with all my mother’s per­ti­nent in­for­ma­tion — med­i­cal num­ber, med­i­ca­tions, my contact in­for­ma­tion. I pro­vided most of her med­i­cal history. My mother de­scribed her symp­toms but was not as sharp as she usu­ally is. Her sen­tences were in­com­plete. Her words were slurred. I did my best to fill in the blanks. I em­pha­sized that my mom is usu­ally a bright, vi­brant, ar­tic­u­late woman. This is not like my mom, I say. I didn’t want any­one mak­ing as­sump­tions about her ca­pac­ity be­cause of her age.

My fears were not un­founded. Health­care pro­fes­sion­als of­ten mis­tak­enly as­sume that older peo­ple who seem con­fused and dis­ori­ented have pre-ex­ist­ing de­men­tia or men­tal ill­ness. A mis­di­ag­no­sis of delir­ium, a rel­a­tively com­mon ex­pe­ri­ence of hos­pi­tal­ized older adults, can be life-threat­en­ing.

The Cen­tre for Health Care of the El­derly re­ports that in a re­cent study, up to 67 per cent of delir­ium cases weren’t rec­og­nized by physi­cians and 43 per cent of cases weren’t rec­og­nized by nurses car­ing for the pa­tients. The cen­tre con­sid­ers the prob­lem preva­lent enough that it cre­ated the web­site This Is Not My Mom en­cour­ag­ing car­ers to talk about sud­den or rapid changes in the per­son they’re car­ing for even if no one asks.

Through­out our day at hos­pi­tal, many tests were con­ducted with my mother. Each time a new nurse, doc­tor or tech­ni­cian ap­peared we re­peated the con­text, the symp­toms and, just as im­por­tantly, how mom was be­fore she fell ill.

I de­scribed her pas­sion for bak­ing. I even slipped in a men­tion of the elab­o­rate birth­day cakes that she bakes and painstak­ingly dec­o­rates with her arthritic fin­gers for each of her great-grand­chil­dren. I did this be­cause I wanted them to see what I know. I wanted them to ap­pre­ci­ate what has been in my mother’s life and to spark for them what is pos­si­ble.

Hap­pily, the cause of my mother’s dis­tress was found to be sim­ple de­hy­dra­tion. A cou­ple of bags of in­tra­venous fluid and she was well on her way back to nor­mal. When she asked me to go down to the hos­pi­tal gift shop and pick up her favourite cook­ing mag­a­zine, I started to re­lax.

I could imagine her stand­ing in the kitchen, bak­ing up a storm once again. The doc­tor saw it, too. She gave my mother dis­charge in­struc­tions to drink plenty of flu­ids and said, with a twin­kle in her eye, “take it easy in the kitchen.”


Social in­no­va­tor Vickie Cammack writes: Care­giv­ing re­quires us to share our knowl­edge with cer­tainty, our in­tu­itions with con­fi­dence and our stories with pride.

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