Reflections on Aging Well

Author, Living with Purpose in a Worn-out Body: Spiritual Encouragement for Older Adults (Upper Room) and Columnist, Aging Well, United Methodist Reporter

End-of-life issues: tone matters August 17, 2009

Filed under: Uncategorized — missybu @ 9:34 am

 Late last September, my 92-year old Mother fell in her senior residence and shattered her femur into over a hundred tiny pieces. The fall set into motion a series of health issues, culminating in her death in December.

For almost three years prior to my Mother’s fall, she’d had caregivers twice a day, one in the morning and another in the evening. Each day, I came mid-morning and stayed for three or four hours. Combining efforts, it was a network of care that seemed to be working pretty well.

 Our goal: to satisfy my Mother’s desire to be as independent as possible while also keeping her safe. But as grown children of elderly understand, it’s almost impossible to personally monitor older loved ones every moment of every day.

At the emergency room, I completed the forms with relative ease. I knew the drill. I’d even remembered to grab all her medications, putting them in a large zip-lock bag to take with me to the hospital. My Mother had made her wishes known regarding end-of-life and I had legal documentation. But as the ER doctor began her examination, I found myself becoming more and more uncomfortable as she took on an accusatory tone, quizzing me about the details of my Mother’s fall as if I could or should have prevented it.

Though my siblings and I had taken great precautions, installing grab bars and equipping her with a lifeline, my Mother had fallen while taking less than ten steps to the bathroom in the middle of the night. Now being in terrible pain, she was not able to effectively communicate for herself. I had no first-hand knowledge of precisely what had happened, but I provided information about my Mother’s severe arthritis and the details of her last physical, only two weeks prior.

Even so, the doctor peered over her glasses at me with a cold glare. I confess, I felt like an innocent child being called into the principal’s office for another’s misdeed. But it was the doctor’s tone that troubled me most. I was sure she thought I had somehow been negligent or even worse, abusive to my Mother.

I found myself desperately wanting to defend myself. I wanted her to know that I really had been a devoted daughter. I wanted to say, “Hey, wait a minute. I have dedicated the last three years to my Mother’s care. I’ve taken her to every medical appointment; I’ve ordered and picked up every prescription. I’ve organized each pill into its daily container. I’ve made sure that her hair has been washed and styled, that her clothes are clean, and that her rent is paid on-time. And on top of that, I’ve had lunch with my Mother and her elderly tablemates every day. Ask anybody at her senior residence, and they’ll tell you I’m a caring daughter!”

That was the litany of things I wanted to spout off.

Then came a moment of clarity, not just an emotional response. I realized that, even if I didn’t like her tone, the doctor was asking appropriate questions. She didn’t know me from Adam. I could have been an older adult’s nightmare— the negligent adult child, or even worse, the abusive daughter.

Still, it was an uncomfortable feeling. And it got me to thinking about health care and end-of-life concerns on the minds and lips of every American, particularly older adults.  I admit, I don’t know the answers to such complex issues. But there is one thing I know for sure.

Tone matters. It matters a lot.

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6 Responses to “End-of-life issues: tone matters”

  1. Thomas Says:

    The physician is a service provider. That is all they are. There are many such service providers. If a service provider can not speak to you with respect, fire them. Tell them precisely why you are firing them. Then fire them. Tell them their services are no longer required and select another service provider. Notify the hospital or clinic of why you fired the provider. You are the customer. As a paying customer, you have a right to be treated with respect and not as a supplicant or suspected abuser.

  2. the one at church Says:

    I disagree with Thomas. A doctor’s first priority should be the care of the patient, not to please the paying customer. If he or she suspects elderly abuse, they have an obligation to pursue that line of questioning so that they know how to best care for the patient.

  3. Thomas Says:

    Suspected elder abuse is one thing. A physician who has been watching to much House and CSI is another.

  4. missybu Says:

    I think you both raise valid points. For me, it was not the questions. It was the tone in which she asked them.

    • John B Says:

      I completely agree with Thomas. As one who has some major medical issues and has dealt with a number of hospitals and doctors, I’ve learned to have a consumer mentality. Some doctors tend to be high and mighty and forget who’s paying their salary.

  5. the one at church Says:

    I would rather that they be harsh to a loving family than passive to an abusive one.


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