I am always surprised at the disconnect between our stated intentions in elder care, and what we actually get for outcomes. I am particularly intrigued by the "It wasn't me officer" approach of folks, who are often the loudest critics of outcomes ... and the worst offenders.
Lets start with treating aging, elderly, older, frail, persons as deaf children. I see it every day. Doctor, Adult child or spouse accompanying Elderly Parent - all in the doctors office or hospital room. The adult child is having a conversation about the elderly parent, referring to them in the third person. The older person is mute. Are they really mute. NO WAY! They are actually disappeared, outraged and withdrawn and feeling powerless, then they are shouted at - as if they were deaf, and spoken to in patronizing, condescending baby talk.
I know the feeling. I have recently been on the receiving end of that kind of conversation between a nurse and a doctor in a hospital room or in an emergency room where it is assumed that because I am almost 66, that I am retired, deaf, stupid and inarticulate .. and my name is always "Honey". It's excruciating - like being trapped in a $64,000 Question isolation booth. Except that I know the answer, understand the question, and could be an active participant/partner in the plan of care ... if asked But no one asks, invites or considered me a participant. Until I ask a very focused core question? My, what an interesting response....
This is the same problem Kubler-Ross discovered when terminally ill patients - whose minds were working just fine, but several major organs were caught up in metastasized cancer.
HELLO, I'm here, brain is working just fine ... and so is the isolation booth Same excruciating problem was discovered by Dr Jill Bolte Taylor, who had a stroke, and could not speak - but could certainly hear perfectly. trapped in an isolation booth and treated like fertilizer.
We must look at our own assumptions and intentions when we engage our parents or patients, and look at our unconscious behaviors driven by our own discomfort, our own anxiety, our need to control, our need to take control (even when no one has actually given up control - and if asked might reasonably - and rationally be able to respond - even with an eye movement or blink).
Our (misdirected and misinformed) good intentions (the road to hell is paved with them) absolutely drive our parents and our patients outcomes. If we want better outcomes, better compliance and responsiveness - then we ought to treat folks like real people - with dignity and respect.
If the tables were turned - "Would he like to be treated like that", said the Adult family member to the Doctor?"As you sat there screaming silently no...
"Why don't you ask me ...I'm sitting right here."
NOW WOULD YOU! ...Honey?
Comments