Trust

Parents need to know their adult children will, to the best of their ability, ensure they receive appropriate care in a hospital, assisted living, or skilled nursing residence. They hope their kids will look out for their safety without diminishing their autonomy and independence, but enough to keep them safe.

Transparency

Adult children cannot advocate effectively without knowing, their parents’ health care goals and values and are aware of their parents state of health. They should have copies of their parents’ general power of attorney (POA), advance directive, and are named as ‘attorneys-in-fact’ (or proxies) for health-related decision making. This means parents and their adult children have had “The Conversation” about these matters. They grasp that “The Conversation” is a process in which adult children understand and agree to carry out their parent’s wishes, especially their end-of-life expectations. And Mom and Dad are confident that they will do so.

Reliability

Parents need assurance that if they call their children from a hospital emergency room at 2 AM informing them that Dad had a stroke or Mom broke her hip, they will engage with hospital’s medical staff and inform them of their POA status and that they want to be kept informed every step of the way. If they live out of town, they may have to travel to be at their parents’ side to make sure their parents receive the best possible care, both in the hospital and after discharge.

Knowledge

Adult children, for example, know the difference between being admitted into a hospital and entered for observation.  They know who their parents’  doctors are and how to contact them. They know the results of their parents’ annual physicals and their medication regimen. They are aware of senior resources in their parents’ community and whether their parents know about them and utilize them.

Attitude

Parents hope their adult children WILLINGLY accept their advocacy roles. That they aren’t being dragged “kicking and screaming” into their roles. That they will communicate with their parents and with their siblings not just when it hits the fan, but on a regular, predictable basis, be it weekly or even daily. 

A friend recently had spine surgery that took 5+ hours. After regaining consciousness, she found herself in the recovery unit…for the next 26 hours! Groggy from the anesthetic and not knowing whom to talk to, she languished there until a friend arrived and raised hell. She subsequently learned that private rooms were available throughout the 26 hours, but somehow the Recovery Unit staff wasn’t aware of any. When they finally wheeled her to a private room, she waited another hour for the room to be cleaned.

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Like many of you, I have an Advanced Care Directive comprising a Living Will and Health Care Proxy (or Power of Attorney) to make decisions for me if I lose my capacity to do so. I live in a jurisdiction (the District of Columbia) that permits physician-assisted death. My family and I have discussed my health care values and preferences. If I ever have a mind crippling illness and had earlier told my family and physician my preference not to continue living in that situation, my family and doctor know what to do. Right? Wrong!

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My last blog listed types of listeners. From the ‘pouncer’ to the ‘monopolizer.’ Now, on a more positive note, this post suggests ways to enhance conversation. The first (and for me) most challenging step calls on us to become empathic listeners. I came across this term in an article by Dr. Tammy Lenski* who attributed it to author Steven Covey. For Covey “empathic listening is listening from the other person’s frame of reference. Only empathic listening comes from a desire and commitment to listen without an agenda (emphasis added).”

Developing the “mental muscle” to listen empathically takes practice. Give it a shot the next time you’re engaged in dialogue. In addition, consider these techniques to enrich your exchanges:

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One of the topics Carolyn and I discuss in our presentations about our new book Love’s Way involves Listening.  Most of us don’t listen well. And even when we think we are listening, we sometimes fall into one of the following categories:

The Pouncer: This non-listener is waiting for the other speaker to pause just long enough to inject his point into the conversation.   The speaker may be in the middle of conveying a thought, but hesitated to take a breath or sip some water. That’s the moment the pouncer has been waiting for: to take charge of the conversation.

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Talking with your doctor (provider) is not just about what ails you. It’s more.  Lot’s more. Let us count the ways:

First, a patient should know his or her health goals, or seek help in defining them, especially as she or he advances in years.  For example, if you became severely ill, even mortally ill, how much ‘heroic effort’ would you want your doctor to provide?  You should understand your medical options in case a health crisis occurs.  Bottom line: What quality of life would you want were you severely ill with questionable chances of recovery?  

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