Issue 2.47 – Assessing Assessment

Catherine was grateful for her mother’s new doctor, Dr. Villeneuve. After Dr. Sheppard had transferred the file yet again, Dr. Villeneuve had taken the time to rectify many of the concerns both Catherine and Charlie had with regards to Hazel’s care plan.

After several medication changes, different treatment options, and more attentiveness by the hospital staff, Hazel started showing signs of improvement. It was the most progress Catherine and Charlie had seen over two months, which was significant considering the many ordeals Hazel had faced while in hospital. It had been exhausting, and Catherine had not done much else but be at her mother’s side to advocate for her care. Seeing her mother now sitting upright taking sips of ginger ale, with a bit of colour in her cheeks, made it worthwhile.

The Transitions Coordinator was still working on next steps for Hazel. While Catherine and Charlie had submitted their long term care preferences to the Coordinator, they were hearing that this had been done too prematurely. “You see,” the Transitions Coordinator explained. “We are no longer doing assessments in hospital. We can’t measure appropriate benchmarks or accurately assess Hazel’s needs while she is here.” Catherine shook her head. “A month ago you were trying to convince me that there was no other option but long term care for my mother and that you had all her care needs figured out. Now you are trying to tell me that the decisions you arrived at were based on inaccurate assessments of her condition?” The Transition Coordinator just smiled. “Not an inaccurate assessment of her condition…but of her situation.” Catherine rolled her eyes. “Her situation is that she is sitting in a hospital bed and we all just want to get her out of here.” The Coordinator nodded. “Yes, that is the plan. We’re going to get her out of here and assess her needs then.”

Catherine was very confused. “So, you agree she can’t be in hospital for much longer. She’s on a waiting list for long term care…meaning she can’t go to long term care yet. You have already told me…convinced me even…that she can’t return home because her care needs cannot be met there. I’m a little curious as to where you are going to place her.” The lady continued to smile. It was disingenuous. “We are looking at sending her home to assess her there. It will give us a more accurate picture.” Catherine nearly laughed out loud. It was not that she found the situation funny…but more that she found it absolutely ridiculous. “You’re going to send her…home?” “She’s showing great improvement,” the Coordinator offered. “Only in the past 48 hours! Mom can finally drink from a straw and stay awake for more than ten minutes and suddenly she’s ready for discharge? This is insane.”

“Well, we’re not discharging her right away,” the Coordinator said, trying to reassure Catherine. “Well I should hope not!” Catherine retorted. The Transitions Coordinator collected some papers and her bag and made her way out of the room. Catherine remained seated in the room, in complete disbelief.

“Uh oh, you’ve got that look on your face that’s telling me you just fought with someone else in here today.” Charlie entered the room just in time, coffee in hand. Catherine took one of the cups from him, and let out a long sigh. “The Transitions Coordinator just informed me that they are actually considering sending mom home…so that they can properly assess her.” “WHAT?!!!” Charlie exclaimed, in complete shock. “I know dad. If it didn’t come straight out of her mouth I never would have believed it myself. I just finished the nonsensical conversation.” Catherine took a long sip of coffee. It was too hot and tasted awful, but she didn’t care. It numbed her tongue and the sensation mirrored her entire body at the moment.

“You know what honey? I think you need a break. Mom is comfy and in good hands. Why don’t you take this time to go home, get some rest. Take a few days off. I’ll make sure I come by to visit…I’ll take over from here. You’ve done an excellent job.” Charlie gave his daughter a warm hug. Catherine felt her shoulders drop and the tension in her neck release ever so slightly.

“You promise you’ll call me if anything changes?” Catherine asked with red rimmed eyes. “Yes, if your mother does anything different, from breaking out into ‘Sweet Caroline’ or doing jumping jacks, I will call you. Now go home and get some rest,” Charlie laughed. Catherine laughed too.

Catherine found her coat and bag and made her way down the hallway. She wasn’t even sure where she had parked her car, she was so tired.
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Being an advocate for your parents’ wellbeing can be very trying. Constantly changing care plans, staff turnover, and new directives are hard to keep track of, especially if you have little knowledge of the intricacies of your parent’s condition or how the entire system works. You feel obligated to make decisions not only as a daughter/son, but also as part of your parent’s care team. It can be challenging and frustrating.

If you’ve had this experience, what was it like? What advice would you have for others? Healthcare teams? Decision makers? Share your ideas with us!

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