This post is a
bit of a departure from previous themes and reflects a very current and ongoing
preoccupation of mine – eldercare. My 90 year old father (we’ll call him Tom
Walker here but that’s not his real name) was until a month ago, living at home
on his own. My mother died nearly 5 years ago and none of us could have
predicted Dad’s adaptability in the face of the loss of his partner of nearly
60 years. Whoever said you can’t teach an old dog new tricks hadn’t met my Dad.
Whether it was learning to use the microwave (yes, really...) or making new
friends in a community he had only moved to three years earlier, Dad has
consistently demonstrated that aging and adaptability can live comfortably
together, and indeed can complement each other well.
In recent
months, however, his physical health and capacities have declined, in the face
of robust cognitive skills, an observant wit and a remarkably intact sense of
humour. His physical mobility is limited, he has severe macular degeneration
and a range of medical problems. About a month ago, he became acutely unwell
and needed to be hospitalised, always a reminder to me of how fortunate we are
in Australia, in spite of the many legitimate criticisms that can be levelled against
our health system. At 90, he was taken by ambulance to the Emergency Department
of our local hospital, where he received first class attention and responded
well to the care he received there. He was subsequently transferred to another
facility, (a happy “perk” of his veteran status) and remains there now awaiting
longterm placement, as he has exercised his good judgement that going home
is not a wise move. So far so good, and I reiterate that we are very
fortunate in many respects – we live in a first-world country and his medical
care has been of a very high standard (bear in mind this is a man who has
survived several heart attacks, two lots of quadruple bypass surgery 20 years
apart, and is on his 7th pace-maker).
There is one
aspect, though, of his care that has consistently jarred with me (and, it has
to be said, with him) and that is the condescending manner in which many
nursing staff speak to him. I am sorry to single out nurses here, but after a
month’s observation, at different times and on different days, this is not a
behaviour I have observed in medical or allied health staff. That’s not to say those
staff are not sometimes also “guilty” and nor is it to say that all nurses
interact in this way.
However, my
father’s name is not “darling”. And it’s not “sweetheart” either.
His name is
Tom – or failing that, “Mr. Walker”. It’s written on a whiteboard next to his
bed, so even a busy or distracted clinician needs only to glance at this on the
way in.
At what age do
patients lose the right to be referred to by their name in hospital?
It’s perhaps a
small thing, but the use of people’s names (seems to me at least) to signal
respect, and is a small nod to the idea that the person in the bed or the chair
is indeed an adult person, not just another elderly, grey haired patient whose birth
date is suggestive of a pre-historic era. And nor is this person a young child.
And while I’m on
the topic of respectful communication, why do (some) nurses address their
questions to Tom via me? For example, the other day when he was lying in bed and I was
sitting nearby, a nurse entered his room, turned to me and asked “Does he use
his footstool”? I was both irritated and bemused by this – irritated because Dad
is more than capable of answering the question and bemused because I was the least qualified person in the room to
answer it – I spend about an hour a day there, but have no idea what goes on
for the other 15 or so hours that he is awake. The nurse in question was
visibly surprised when I politely suggested that she should ask Tom.
I’ve also
noticed that there’s a default assumption with elderly patients that they must
be hard-of-hearing, so staff come up very close to Tom and shout. The only problem here of course is that he isn’t hard of
hearing at all. I’ve lost count of the number of times I have interjected and
politely pointed out that he is not deaf – often to be met with a blank look
and something along the lines of “Oh, most of the oldies here are deaf, so we
just assume we need to raise our voices”. Or “I’m 32 and I’ve had a loud voice all my
life, so I’ll always have a loud voice” Really?!
Most of the
little communication touches that patients of all ages appreciate probably come
back to something as simple as respect, and the capacity to consider an
interaction from the perspective of another person – in this case, a physically
frail, but mentally able older person. I
could recount several other examples of missed opportunities to communicate
respectfully, but I don’t want to labour the point. Dad and I both notice not
only the ones whose manner is condescending, but also those who are genuinely warm
and show a personal interest in him. Happily there are many in the latter
category
I do find it ironic
though, that because of his poor eye-sight, Dad can’t read nurses’ name badges,
but he always asks them their name, and goes to great lengths to mentally
rehearse, and then to use their
names, e.g. when he is thanking them for assistance.
I guess we can
only hope that his light-touch role modeling will rub off on some. I need to believe that things will be better for the aging baby boomers.
© Pamela Snow
2014
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