One night several years ago, when my mother was in her fourth month of hospitalization and in critical condition, I noticed that she hadn't received her evening medications. It was getting late. The pills and open vials of medication had been sitting in the corridor outside her room for some time.
When the nurse finally arrived well after 10 p.m, I expressed concern about the medications that were left exposed in the hallway. She replied with a sneer, "You just want everything to be so perfect for your mother, don't you?" I gave the only response I could: "You bet I do." It's the same answer that any daughter or son would surely give in similar circumstances.
In many hospitals, it's not just that the care is less than perfect. It can be downright harmful. Medical errors in the hospital setting are the third leading cause of death in Canada and the United States. Some 15 million patients suffer some form of harm in U.S. hospitals every year. In Canada, one in every nine patients will acquire an infection while in the hospital. Thousands die from hospital acquired infections every year.
Being hospitalized today presents a serious dilemma to both patients and families. You need hospital care because of some condition or disease. But you may also need protection from the hospital and the harm that can occur as a result of everything from medication errors and pressure ulcers to sponges left inside the body after surgery . The elderly, as so many of our parents are fast becoming, are especially vulnerable to hospital harm.
What to do?
Since becoming involved in the patient safety movement in Canada and the United States, I have read thousands of pages of medical research and literature on the subject. I've talked with world renowned experts and listened to the tragedies of countless families looking to share their stories so that what happened to their mom or dad, daughter or son will not happen to others.
Here are three take-aways from my experience that can help patients and families successfully navigate a safer hospital journey.
A safe patient is an informed patient.
An informed family is often necessary when older parents are hospitalized.
Learn about the realities of medical errors in hospitals and how they can occur. Check out the facts about your hospital if they are available, such as infection rates and post-surgery death rates. Look around: does the hospital seem clean? Do healthcare workers constantly sanitize their hands or do they cut corners? Hand hygiene before and after patient contact is critical in preventing the spread of disease and infection. Google the hospital for any complaints or news items of interest.
There are good online sources from respected healthcare organizations that will help patients and family members understand their rights and what steps they need to take protect them while in the hospital. A starting point for these resources can be found here.
If you have any doubts about what you learn or see, you may need to become even more involved with the patient's care. You might need, as I did, to become virtually embedded as a member of your loved one's care team. That is your right as a close family member.
A safe patient is an engaged patient.
When patients cannot be fully engaged with their care and the decisions being made, that responsibility becomes the family's.
Document, document, document. Keep a comprehensive journal of your loved one's hospital stay from start to finish. Always have it with you while visiting. Make detailed notes about what is happening around you if you think it could impact the patient. Any significant interactions with doctors, nurses or other healthcare professionals need to be journalized. Always get their names and write them down, along with details about any conversation. Medical records don't always tell the whole story when it comes to hospital harm. Vital information may be left out. If you have your own accurate record, that can help in forcing proper disclosure and accountability.
A safe patient is a protected patient.
Families are key to the protection of loved ones. Look for warning signs. What is happening with mom or dad? Do they seem not quite right? Has something changed in their cognitive or physical functioning? You are the expert on what is normal for your family member. Trust your instincts. You may pick up early warnings of a loved one's deteriorating condition before it is noted by healthcare professionals. Make your concerns crystal clear. Find out if there is a rapid response protocol in the hospital that will allow patients or families to immediately summon help when it is urgently needed. Don't wait for the damage to become irreversible.
In my mother's case, I noticed a serious change in her demeanor and responsiveness. She was having trouble breathing. Her care team insisted she was fine and made it clear there were other patients in the ICU who needed more attention. Later than night, she suffered a cardiac arrest. She was revived, but was left permanently disabled and requiring 24/7 care. That is a life-changer for any family.
There is no more precious gift you can give your mom or dad than the gift of hospital safety. My mother's doctors repeatedly warned that her demise was imminent. Without a vigilant family, it would have been.
Even though she returned home a tiny shadow of her former self and had been left by the hospital in a malnourished state, she has become a towering beacon of the indomitable will to survive that has inspired others. This will be her fifth Mother's Day since her discharge from the hospital.
We call it Mother's Day. But the truth is her love and enjoyment of life are really a gift to me. Every day.
Happy Mother's Day, Mom.
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