I’m on hold, again. After a few minutes, the receptionist cuts through the elevator music and says, “Janet is still on the other line. Would you like her voicemail?”
“I’ve actually left her three voicemails this week and haven’t heard back yet so I’d like to hold for her.”
Eventually, a flustered-sounding Janet picks up the phone, apologizes for the delay in getting back to me and asks, “You’re a friend of Miss Helen* in room 226?”
I explain that, yes, I’m a friend of Helen’s and that I have a few concerns. I tell her that I started volunteering with Helen through Lori’s Hands three years ago and have stayed in touch with her since graduating. I tell her that I’ve been stopping in occasionally over the last month since Helen fell, broke her arm, and ended up in a rehab facility. On my most recent visit, I found her to be unhappy, uncomfortable, and confused about her care plan.”
“Oh… well now… I was told that Miss Helen would be moving into our Assisted Living Facility when she was discharged.”
“That’s one of my concerns. Helen has been very adamant that she’d like to go home, but she’s been told that’s not an option.”
“Well it’s always a consideration and I certainly want to make every effort if that’s what the patient wants, but I have a note here from the admissions folks stating that Helen’s sister-in-law set her up to go right into Assisted Living.”
“That’s one of the problems,” I explain. “Helen’s sister-in-law means well but she lives halfway across the country and isn’t very involved in Helen’s care. Besides, Helen is competent to make her own decisions. Any conversation that important should have been with Helen herself.”
“Oh, well you know that Helen is coming down with some dementia, right? I think that’s why folks are talking to her Power of Attorney instead of her.”
“I was just in to see her yesterday and she was perfectly fine. She is extremely hard of hearing and that can sometimes be misconstrued as confusion, but Helen is very bright and competent. She has no memory issues.”
“Oh but I’m reading in her chart here that on June 22nd, there was an episode with a nurse…” I hear Janet flipping through pages and then she says, “Helen stated ‘I don’t even know why I’m here! And I don’t know why I keep getting shifted around!’”
“I was there visiting when that conversation took place: Helen was upset because she’d been moved rooms on the floor four times that day and didn’t feel like she was getting any explanations. She had requested pain medication twice before I arrived and didn’t get it until I went up to the desk and asked for it. She couldn’t get an answer on how long she’d be staying in rehab, or what needed to be accomplished before discharge, until I went and got a nurse to come in and talk to her. So yes she was confused – but I would have been too.”
“Oh wow that is a totally different story than what’s written here. Now it also says that she changed her code status three times in one conversation. Do you know anything about that?”
“I sure do,” I say, “and Helen could tell you about it too, if you asked her. Someone came in and asked her to sign a piece of paper. The person said ‘This will determine your code status,’ and Helen couldn’t hear what she said and just nodded. One of our Lori’s Hands volunteers who knows Helen well was in the room visiting her at the time and moved in front of Helen because she hears better when someone is in front of her, and explained what the person had said. Helen said ‘oh yes I want that’ and the person checked the DNR box. Our volunteer said he didn’t think the conversation had been thorough enough and asked the person to explain what DNR meant. The person then went into more detail, which our volunteer also had to repeat in a loud voice so Helen could hear, and Helen then said, ‘Oh I thought you meant do I want CPR – I do! I want everything! I don’t want to be a DNR!’ so the person changed the form back again. Helen never changed her mind, she just couldn’t hear the person because she was standing to the side and talking in a quiet voice.”
“I’ll make a note of that in her chart. I’m really glad you called. It sounds like we do need to meet to clear some things up. It’s really important that someone who knows the client can be there to have conversations like this with me, because sometimes our staff doesn’t have time to get to know every patient really well and really figure out what’s going on. And, to be honest, our Admissions department just want to get everyone to buy into the facility, so they were probably thrilled to talk to the sister-in-law instead of Helen, who wants to go back to her own apartment. Let’s schedule a time for me to talk to Helen, and hopefully you can be there to make sure she’s getting it all.”
Every week for the last 3 years, Helen, a homebound older adult with cardiac issues, has given her grocery list over the phone to a Lori’s Hands volunteer. Later in the week, the volunteer comes by and drops off the groceries, and visits with Helen for about an hour. The tangible benefits of our volunteer services are clear in this relationship: Helen, who would otherwise have no consistent means for getting groceries, depends on Lori’s Hands to fill this void. I believe that Helen’s friendships with our volunteers, though, are as important benefits of the organization as the practical concerns that we assist with.
Our friendships were put to a dramatic test in the weeks after she fell, but we eventually resolved the issues with the nursing home and made sure that Helen’s needs were taken care of. She’s now working the facility to make plans to go home and they have a much better understanding of how to best work with and serve her, especially by accommodating her hearing loss.
Because of Lori’s Hands, our clients don’t slip through the cracks in the healthcare system, just as they wouldn’t if they had a big, caring family. And we, as volunteers, learn skills along the way that we’ll use the rest of our lives.
We don’t have to be experts in aging or medicine to fill the voids we fill. We just have to be there, listen, pay attention, and care. And those are things that Lori’s Hands volunteers are great at!
*Name has been changed to preserve client confidentiality
Written by: Sarah LaFave
Part of the Lori’s Hands family visiting a client’s home during the 2012 holiday season.