Don’t go to the hospital in July – It could be dangerous to your health

I was talking to legal nurse expert, Patricia Coonan, and she was telling me that there is a definite increase in medical errors in July. I have heard this joked about in the world of medicine, but it is not a joke. Errors increase every year at this time because this is when doctors in training shift to a new level of responsibility. The newly graduated doctor becomes an intern, the intern becomes a resident and the resident becomes a fellow. With this increase in responsibilities practically overnight, the doctor needs to be ever more vigilant about asking for help when they get into an overwhelming situation. It is normal for them to need help occasionally and they need to speak up at those times. Patricia says that medical negligence is usually not because the patient has the negative side effect, but is when the doctors or nurses don’t notice and fix the problem. Medical errors are normal because humans are taking care of us. And the younger doctors are still learning.

I am not telling you this to scare you but to make sure you are educated. You should always have a patient advocate at the hospital with you. You should ask what medicine is being given to you and what dose you are getting. If it is not on your list of medicines, ask why you are getting this new drug. You should make sure people are washing their hands before they touch you. You should make sure you have all of your questions answered before you sign a consent form. If you can, ask questions and make sure you are getting a consistent message from your doctors. If you are too ill to watch out for yourself, then get a love one to protect you and ask questions.

The only way you get new doctors is to train them. And they get trained by learning on all of us. These are real doctors and they have been well trained. I have had all of these levels of doctors take care of me when I was in the hospital and I was just fine. So, I am not saying you should be afraid of interns, residents or fellows. This is just a reminder to be your own patient advocate.

Have a kind and respectful day.

Patient’s Rights – Where do they start and where to they end?

What are our obligations to the patient? Keep in mind that autonomy only works with people who have the capacity to make their own decisions.

Here are some of the patients’ rights that come with using autonomy:
• Patients have the right to receive all the information they need to make a good decision.
• Patients have the right to make their own decisions.
• Patients have the right to refuse treatments they do not want.
• Patients do not have the right to demand treatments that will be medically ineffective or are medically inappropriate for their condition.

It is important to realize that there are limits to a patient’s rights. A patient is limited to asking only for treatments that will benefit her. This limitation makes sense. It would be pointless, and potentially harmful, to provide a treatment or medication that would not improve the patient’s condition. So, as a physician, you are able to say no to practicing bad medicine. If what the patient or decision maker is requesting would be inappropriate or non-beneficial you can say no and protect the patient. But if it is a medically valid option, even when you disagree with what the person wants because you think they are being foolish or it isn’t the best option to choose, we have to respect that it is the patient’s body and life.

I know this can be difficult as you watch people making foolish choices. But that is autonomy. All of us, including you, are allowed to make the decisions that make sense in the context of one’s own life. (Of course, there are different boundaries in pediatrics.)

One technique I use with patients is to say, “Here is the ideal plan. Now let’s talk about your plan.” That allows the two of you to partner together to build a plan, although it might not be ideal, it is something the patient is willing to consider and to try. And then perhaps in the future, the patient will be willing to consider the other options you would like him or her to try.

Have a kind and respectful day.

Autonomy and Patient’s Rights

Autonomy means that a person makes his own decisions, so it only works with people who have the capacity to make their own decisions. If you have determined that your loved one still has capacity, then this is the correct decision making option. With Autonomy, the person gets to say what should be done to his body.

When I went to my doctor to talk about my injured back, my doctor told me what options were available to help me get better. He said I could try physical therapy, have a cortisone injection in my back, or just wait and see if it got better over time. Because I had the ability to think for myself and to make my own decisions, I was able to choose what I wanted to do. I got to think about the different options I was given and then make my own decision. I had Autonomy.

Here are some of the patients’ rights that come with using autonomy:
• Patients have the right to receive all the information they need to make a good decision.
• Patients have the right to make their own decisions.
• Patients have the right to refuse treatments they do not want.
• Patients do not have the right to demand treatments that will be medically ineffective or are medically inappropriate for their condition.

It is important to realize that there are limits to a patient’s rights. A patient is limited to asking only for treatments that will benefit her. This limitation makes sense. It would be pointless, and potentially harmful, to provide a treatment or medication that would not improve the patient’s condition.

Keep in mind that autonomy only works with people who have the capacity to make their own decisions. If you have determined that your loved one does not have decisional capacity, you will have to use different tools such as Substituted Judgment or the Best Interest Standard. (I will cover these two later this month.)

Have a kind and respectful day.

Caregiver Yoga – Right in your home while you raise money for your school

Interview with Laura Colvin-Brown about Caregiver Yoga and raising money for your school. June 10 at 10AM pacific. www.blogtalkradio.com/kindethics

Take care of your self AND your school! Finally… a way for busy parents and educators to get in a little TLC for themselves, while helping out their favorite school…aaaahhh!

If you are like all the other parents and educators that I know, you don’t have time to visit your local yoga studio: who would watch the kids?! …..but you WISH there were a way. Well, now there is!

How about THIS…. we will send you eight new yoga classes every month… that you can watch and do right from your home computer or laptop ANYTIME… and you can do them as many times as you like! 8 all new gentle flow yoga classes will be sent right to your inbox every month when you subscribe to our service. This is like having a private yoga studio right from your screen… for only $15/ month! ….and the best part? Half of that goes directly to the school or group who sent you here.

Compare this to a yoga studio near you: some charge $15 PER CLASS! This is the easiest, most reasonable way to get your yoga in and help your school out at the same time.

Sign up today to receive 8 full video classes every single month!
www.OnlineYogaFundraiser.com
www.FlagstaffYogaFestival.com

Have a kind and respectful day.

Why is he suffering? Why is the doctor waiting to give him pain meds?

Dear Viki,

My nephew had surgery a few days ago and he is still in a lot of pain. He told the doctor that he has a pain level of 8 and the doctor told him that he would come in in the morning and address his pain level. I don’t think this is right. How can the doctor just leave him suffering all night? What can I do?

Answer:

I can’t believe this still happens. Patients are not supposed to be in pain and should not be left in pain until it is convenient for someone to deal with it. Hopefully by now your nephew has been taken care of but the next time, you can ask the nurse to call the doctor who is on call that evening and ask him to order the right pain medication.

The question you might want to ask the doctor when he or she comes in the next morning is, “How would you like to suffer all night with a pain level of 8? Would you leave your own kid in that kind of pain?” I would love to hear his or her answer. As caregivers/family members, we have to advocate and sometimes get loud in order to make sure our loved ones get what they need.

I do have compassion for healthcare professionals because they see so much suffering, like those in the military. The only way they can cope is to distance themselves from what they are seeing. This doesn’t excuse not taking care of your nephew but I just want you to understand that usually, it isn’t that doctors don’t care—it is because they care too much.

Have a kind and respectful day.

Join Viki as she talks about “Empowering Caregivers to Make Better End-of-Life Decisions” at Circle of Care Leeza’s Place, June 16th in Sherman Oaks.

Empowering Caregiver’s to Make Better End-of-Life Decisions at Circle of Care – Leeza’s Place on June 16 from 12-1:30.
Everyone is welcome!

Being empowered and educated about the dying process brings peace of mind knowing that you will be able to handle what may come your way. Attendees will learn about the needs of the dying, how to make good end-of-life decisions and hospice services can benefit your entire family. Viki Kind joins with Circle of Care Leeza’s Place to create a safe haven ot ask yoru questions and to talk about your fears.

Circle of Care Leeza’s Place
5000 Van Nuys Suite 110, Sherman Oaks, CA 91403
818-817-3259 F 818-817-3263

Circle of Care Leeza’s Place is an intimate and safe setting where caregivers and loved ones recently diagnosed with any memory disorder can gather for education and support, and to prepare themselves for the challenging journey ahead. Developed in response to the challenges Leeza Gibbons and her family encountered while seeking specific and needed support, and funded in full by the generosity of our community through the Circle of Care Foundation, Circle of Care Leeza’s Place offers new supportive settings for the purpose of
Educating, Empowering & Energizing.

All programs are FREE OF CHARGE & held on site unless otherwise noted.
Please feel free to contact Stefanie Elkins at 818-817-3259 or selkins@leezasplace.org.

Have a kind and respectful day.

Great new guide for when you leave the hospital

Too often we spend a lot of time thinking about going into the hospital but no time thinking about coming home. The hospital discharge process is when patients are vulnerable to misunderstandings and errors. The patient is feeling sick and not able to listen to the instructions, the loved one may or may not be there, and the nurse rushes through the crucial information. If you can, make sure you have a loved one beside you when the nurse goes over the discharge instructions. If you have questions, ask until you get the answers you need. You can even ask the doctor to tell you what you will need to be prepared for when you go home when you are talking about the upcoming surgery or procedure.

Here is a guide to review and use before you think about going to the hospital.

http://www.medicare.gov/publications/pubs/pdf/11376.pdf

Have a kind and respectful day.

Empowering Caregivers to Make Good Decisions Event in Thousand Oaks – June 12

Grand Oaks Senior Living Proudly Presents – Viki Kind, MA

Author of The Caregiver’s Path to Compassionate Decision Making: Making Choices for Those Who Can’t

A Free Educational Seminar for Families and Caregivers
“Empowering Caregivers to Make Good Decisions”

When:
Saturday, June 12, 2010, from 1:30PM to 3:30 PM
Where:
Grand Oaks Senior Living
2177 E. Thousand Oaks Blvd., Thousand Oaks, CA 91362
(Note: Please park on Thousand Oaks Blvd.)

Viki’s book will be available for purchase and she will be on hand to sign your copy!
A percentage of proceeds will be donated to the Hospice of the Conejo

Refreshments will be Served
RSVP by June 10, 2010 to 805-370-5400

Have a kind and respectful day.

Helping our patients get the help they need when their senses fail

The American Speech-Language-Hearing Association (ASHA) http://www.asha.org

It is so important to make sure that your senior patients get check ups for both hearing and seeing. Don’t assume that the mental changes you are seeing mean there is a brain or psychological issue. Sometimes it is a senses issue. And your patient may or may not know it is happening since it changes happen slowly over time. I didn’t realize that my dad had such poor vision until I sat with him during his eye appointment. Then I understood how much he was missing and how I needed to make sure we modified his space to help him with his visual limitations. I wish the doctor had taken a more proactive approach to helping me with my dad. Instead, he just documented what was happening and moved on to the next patient. I sure could have used his advice and guidance about what this vision loss meant to my dad and how I could help.

Language barriers also create an obstacle to getting what one needs. Unfortunately, I see healthcare professionals discount or ignore someone with speech limitations and turn to the family member instead. I know we are all rushed in medicine but we have to take a stand and say no, I am not going to rush this person through because my patient needs me. It also happens in our day-to-day life when we want someone in front of us in line to hurry up but they can’t because it takes them longer to speak.

Just because people can’t speak well or speak fast, doesn’t mean they shouldn’t have a voice in their lives. There are other ways to communicate. People can write, type, point to words or pictures on a board or sign. Many times it is just about having patience. Having the patience to sit still while the other person finds the words. And what I have found with my hospice work is that people communicate even when they can’t say a word. So, sit still and listen. You make a difference when you do.

Have a kind and respectful day.

National Nursing Home Week – This Year’s Theme – “Enriching Every Day”

Thank you American Health Care Association for these wonderful ideas about making this week special at your local nursing home and making sure we don’t stop there but work to enrich every day. http://www.ahcancal.org/events/national_nursing_home_week/Pages/Activities.aspx#specialservices

Enrichment through Words…

Grab a Pen and Make a Friend! Do you like to write and receive notes? Then Grab a Pen and Make a Friend! Having a pen pal club is a great way to learn about others and start an enriching relationship through the sharing of stories and interests. All you need for this activity is a pen, paper and “pal.” Of course, pen pal writing could also occur on the internet with e-mail. The activity could be small, with residents writing to other residents or staff. Take it a step further by partnering with another facility, local high school, volunteer group etc. At the end of the week, encourage residents and other participants to reflect on what they learned (or hope to learn) about others. Consider Grab a Pen and Make a Friend a part of every week throughout the year and watch relationships blossom and grow! Don’t forget to order the official 2010 National Nursing Home Week® pens!

Poetry Reading A literary art, poetry can bring deep reflection and comfort, inspire a conversation and enlighten the mind. With a focus on enriching, the act of poetry reading can illuminate the atmosphere of a nursing home through spoken words. Consider hosting a poetry reading at your facility. Have an “open mic” where anyone is welcome to read a poem they select or share their own poem! Family members, friends and others from the community can also listen and share their poetry too. Make it a memorable event with tea and cookies and invite everyone to attend and participate. Afterwards, have a question and answer session or an open discussion.

Don’t forget to advertise this event in the community section of you local newspaper. See the PR Tips for more information.

“Thank You” Note Scavenger Hunt Thank you notes not only show gratitude, but also add a personal touch that can be cherished and remembered for years. This week, encourage residents to write a note of thanks to their favorite staff person or fellow resident. Have them reflect on a characteristic that makes that person unique and put it into words. During the week, ask residents to post or tape the notes all over the facility and have staff members find them and read them out loud to share with everyone during a Staff Appreciation Lunch. Staff can even write a thank you note back!

Share Stories with the Veterans History Project Do you have a veteran in your facility? Consider honoring him or her during NNHW by sharing their story with the rest of the world. The Veterans History Project of the American Folklife Center collects, preserves, and makes accessible the personal accounts of American veterans. Stories can be told through personal narratives, letters, photos and other ways. Stories and materials submitted to The Veterans History Project will be archived and housed within the Library of Congress online database and available to Congress and researchers who visit the Library of Congress. Visit the Library of Congress for more information, registration and tips for hosting a community event in honor of your veteran. To share your veteran’s story online, consider uploading a video on YouTube and sharing it on Facebook!

Enrichment through Music…

American Senior Idol Do you think your residents have what it takes to be the next American Senior Idol? You don’t have to turn on the television to watch stars be born, just look to the talent at your facility! This week, invite residents (and staff too) to sing songs that enrich the heart and the mind. A little healthy competition is always a good way to generate interest and participation in an activity. Everyone can earn a reward for participating (see pages 11-14 for NNHW themed products). Make your American Senior Idol a fun competition by getting other residents and staff involved as judges and inviting the community at large to attend. You can ramp up the excitement by inviting your local high school glee club or show choir to “open” the competition with a performance. Many high schools have a community service requirement in their student curriculum. Check with your local school system for details.

“Senior Prom” A good way to keep up the momentum during NNHW is to have a “Senior Prom.” Bring back those treasured high school memories or create new ones. Try partnering with local high schools to participate in their Prom or host one right in the facility. Allowing young and old to mix and mingle gives new meaning to the phrase “Senior Prom.” This event can create long lasting memories that will be talked about well after graduation!

Don’t forget to advertise this event in the community section of you local newspaper. See the PR Tips page for more information.

Enrichment through Images…

Take Pictures As the activities and fun continue throughout the week encourage residents and staff to make these memories last by taking pictures. Equip them with disposable cameras and encourage all to take a snapshot of their favorite moments. Once you develop the pictures put your creative thinking cap on. There are several ways to use the photos.

You can:

* Post photos in resident rooms and throughout the facility;
* Put together and display a facility-wide collage of all the pictures for all to see;
* Make a slide show and display it in the cafeteria or activity room for as long as you like;
* Encourage residents to share their favorite photo during a group activity; or
* Have a contest to turn the best pictures into a 12 month calendar.

Don’t forget to post your pictures on the NNHW Facebook Fan Page!

Enrichment through Crafts…

Quilt A timeless activity for residents and staff is quilting. This popular pastime allows all participants to chat and learn more about each other while unleashing their creative ability through fabric. Most likely, you already have a quilting superstar in your facility who can help everyone get started. If not, check your local newspaper to contact your nearest quilting club for assistance or get started on your own by visiting How to Make a Quilt. The quilt can be donated to a local library, a homeless shelter, or it could be kept in the facility as a token from the week. A lap quilt is another great idea! Don’t have time to make enough for everyone? Have everyone help to make a smaller number of lap quilts and raffle them off to residents during the “Senior Prom.”

Birthday Boxes Everybody has a birthday, and NNHW is a great time to remember them. Birthday Boxes are a simple idea that can bring tons of cheer throughout the year. During NNHW week, ask residents to decorate their own Birthday Box. These can be tissue boxes, shoe boxes, or any small box with a lid. After the decorating is done, have residents and staff write down special notes about everyone else and put them in the respective Birthday Box. As an alternative, write birthday notes during the birthday week. After all notes are collected in the Birthday Box, read them aloud. Residents can then put their notes in a scrapbook or on their own wall for all to see!

Enrichment through Special Services…

Staff Appreciation Day Make one day all about the staff. Honor staff that strive to make a positive difference in the lives of others. Plan a special lunch in honor of them, invite families and have volunteers from the community serve them. During the lunch have residents tell why their closest caregiver is so important to them. Encourage resident families that have a special bond with staff members to show their appreciation with flowers or gifts. You can even reach out to your local media contact and encourage them to profile an outstanding staff member in a local publication or news cast.

Prayer Service A prayer service can enrich the spirit as well as the heart. During this special week, invite all to attend a special service celebrating the members of the nursing home “family” and to remember those that have passed on. Consult with your facility’s spiritual advisor to arrange the details of the service. This serves as a perfect prelude to a Mothers and Fathers Brunch.

Mothers and Fathers Brunch This Mother’s Day, kick off NNHW by hosting a Mothers and Fathers Brunch. Show all mothers and fathers just how special they are by preparing and serving a delicious meal in their honor. Plan a three course brunch menu, complete with hearty breakfast foods, tasty cheeses and meats.

Complete the brunch with a savory dessert. Involve local boy or girl scouts by having them perform a special salute and then serving all mothers and fathers. It’s a great way to nourish the body while enriching the heart!

Memory Garden Springtime is a perfect time to commemorate the passing of loved ones or friends with a memory garden. Planting a memory garden is a beautiful exercise that can heal the heart. Engage residents and staff in this unique activity by involving them from the get-go. Choose a sunny spot where several people can gather. Personalize the flowers or plants that you select by reflecting on those individuals to be remembered. You may select their favorite flowers or favorite scents. You could also select a plant that symbolizes them in a unique way. For example, a chrysanthemum expresses wonderful friendship while magnolias represent dignity. Forget-me-nots are beautiful flowers that can be planted throughout the garden. You can also include small statues, objects or plaques that carry special meaning.

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