My father fell in mid-June and fractured his pelvis. On Sunday, he fell and broke his hip. The good thing about this fall (is there a good thing?) is that I feel experienced. I know can draw on the experience I had dealing with the first fall, to navigate through the system on this fall. I say “system” because there is one. And it’s a very clear process to everyone who works in the health care biz. Unfortunately, those of us on the outside get blind sighted by it the first time we are confronted with it.
What happens is this:
1) you arrive at the hospital, assumably by ambulance. You get your parent checked in; give the all the necessary insurance cards and the like.
FIRST TIME THROUGH: They ask you for living will, advance directives, DNR documents (stands for “do not resuscitate”), You scramble to find them, and ultimately give the documents to the hospital on day 3.
SECOND TIME THROUGH: On the way to the hospital, you swing by the house to pick up the file you already have put together with all this documentation, so you are ready.
Next, a social worker comes into the room (before your parent even goes into surgery) to ask you where you would like your parent discharged to…as in which skilled nursing facility for rehab.
FIRST TIME THROUGH: You panic, as you have NO idea about skilled nursing, what it is, which one is good, what you want to be asking about a facility, NOTHING.
SECOND TIME THROUGH: You have already asked your sibling to go to www.medicare.gov and look at the nursing home compare tool to look at ratings for the nursing homes within a certain mile radius of where you live. He emails that to you, and you have it before the social worker even makes first contact. You are ready.
What you are never ready for is when the anesthesiologist asks you whether you want your father to be resuscitated should he go into cardiac arrest while on the operating table. That is the conversation everyone dreads, but it is necessary to have that conversation and to be ready for it. When it came, I was frozen. I knew my dad was very clear in his advance directives that he didn’t want anything done to prolong his life if there was no way to recover. Putting a breathing tube down his throat during surgery because he was fading, was, in fact life-prolonging, however I decided that in the controlled environment of the OR, if something unexpected happened, I did want them to do what they could to save him.
I also made it clear that OUTSIDE the controlled environment of the operating room, my dad’s advance directive was to be respected. So if, after surgery, for some reason my father could not breathe on his own, they were to remove it.
SIGH. Welcome to the club no one asks to join. If you are a member of this club, the more prepared you can become, the less stress you will have.