Tuesday, July 20, 2010

Helping Aging Parents Find The Best Hospitals

When there's a serious medical emergency it's probably safe to say few aging parents live near a hospital specializing in whatever caused the emergency. Most of us--even those who live near and help aging parents--don't know the particular specialties at hospitals located nearby. A sudden emergency may leave little time to do the homework.

Three no doubt common scenarios follow, involving different situations and actions taken. All happened in my family; all caused great concern; all turned out well.
All present strategies to help parents age well.

#1--Mother's stroke experience: initially memorable for the emotional stress; equally memorable for the relief and sense of some control we felt, once we found out--and got her to a place-- where she could obtain appropriate treatment.

It began with phone call. Parents in California for the winter. Mother's speech sounded "funny." Phoned my brother with concerns and a plea to fly to California immediately if possible (he was moving into a new home that day). He got there quickly, phoned saying Mother was on her way to the hospital. I should fly out asap.

When I arrived at Mother's bedside her speech was still garbled. Dinner was on a tray. She was eating the food with her hands. I've forgotten other details. A terrific nurse updated me and said Mother's physician would be in early the next morning with test results. We learned they had limited the "damage;" there was nothing more they could do. Mother could go home later that day or the next with a caregiver, or go to a nursing home. Dad would be unable to manage her care alone... a nursing home would be in inevitable at some point.

I knew I needed time to think. Decided I wouldn't get a caregiver for that day. Knew Mother was safe spending another night in the hospital. I called a NY friend knowledgeable about medicine. After some research, he phoned back. He said to get her out of that hospital, which lacked neurology expertise, and to a neurologist at UCLA asap, and gave me a phone number. With great difficulty I got an out-patient appointment for the next day.

The next morning we picked Mother up at the hospital and drove to UCLA with films and reports. UCLA had newer technology. New films were taken. The extent of the damage was clearly pin-pointed and Mother was given different medications, a prescription for physical therapy, and an appointment to return in a month.

There have been many advances in stroke treatment since. I know Mother benefited from some because the neurologist said some were not widely used yet. I also know: a month later the improvement was so dramatic most people wouldn't have known she'd had a stroke. Nor did she have any further strokes.
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#2. A family member, also living in the west, was diagnosed with colon cancer there... advanced: stage 3--maybe close to 4. Treatment was about to begin. "Not there," said my husband, who wanted to check Sloan-Kettering and knew we could be supportive if the family member came back. Indeed Sloan-Kettering had top colon cancer people. Convincing someone to come all the way to NY, however, isn't easy. It's easier when offered as "leaving no stone unturned"--making the trip to get a second opinion. That works.

While chronic health issues complicated things, Sloan-Kettering took charge: a top oncologist; an 8+ hour surgery performed by a top surgeon (who had done this countless times); a while to recuperate in NY. Instructions for additional "whatever" were given to the doctors in the west. Routine check-up visits show the surgery was a success.....and we think insurance covered everything.

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#3. Then there was Dad's "heart event" in California shortly after his 76th birthday. At the movies he began feeling dizzy. He went to the theater lobby and sat down on the floor. One of the personnel came over to see if he was alright. He wasn't; his blood pressure was low. Paramedics were called. He was taken to the hospital where his internist practiced. While it wasn't the right hospital for my mother, it had a first-rate heart team whose surgeon did heart surgery on a former president a few years later. Dad had 5 bypasses on a Friday and went home the next Wednesday. He aged well, lived to be 94, and his death was not heart-related.

So how do we generalize? When helping aging parents is a part of our life and our parents live long enough, the odds of serious medical problems necessitating hospitalization are great. Getting parents to a hospital with the appropriate highly experienced specialists, can up the odds for a successful result that helps parents continue to age well...and medical insurance may make it more affordable than one might think.




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