Sunday, January 16, 2011

Communicating with Spouse Before Care giving is an Issue

Weddings are so pretty and such a great excuse for a party.  

In terms of medical planning, the most important words are "in sickness and in health."  If only married couples would take those words seriously, there would be no need for Obama's reimbursable yearly "end of life talks" with grandma and grandpa.

My dad preferred to go to his physician by himself (read: without my mom).  Seems reasonable. Dad was a private man.  Mom does not trust physicians.  I had been struggling with orthopedic issues and then cancer.  My oldest brother dies in a tragic accident.   

In our home, the problem arose when my dad (medicinal scientist, organic and medicinal chemist) "worked with" his Duke Medical endocrinologist John Guyton, MD on some blood result issues over the course of several years.  

My dad was very intelligent in the effect of medications on the body.  This apparently led to negotiations between my dad and Dr. Guyton on whether dad should have certain follow-up tests.  

My mom (dad's wife of over 50 years) had no idea that any of this was transpiring.

Dr. John Guyton is a phenomenal physician and man.  If my dad had signed an authorization for Dr. Guyton to communicate with my mom, the tests would have been done in a timely fashion.

Why should the spouse get involved?  My dad did not want to scare my mom and did not know how to broach the subject of a possible medical problem with her.

Dad was trying to protect my mom.  Ironically, in that attempt, dad suffered unnecessarily and mom knew "something" was wrong with dad.  Mom just figured that she did something wrong to upset him.  What a waste of precious time.


Communicating with Spouse Before Care giving is an Issue

1.  Many physicians offices now ask on initial paperwork whether the patient authorizes any other person to communicate with the physician about the patient's care.  Spouses should add each other on those forms to avoid potential problems if someone has a real health problem.  

2.  If there is no authorization and a spouse is currently sick, then the caregiver spouse must have a heart-to-heart with the sick spouse.  

The caregiver spouse is at an extreme disadvantage in terms of being able to provide loving and appropriate care and advice if he or she does not have complete information about the medical situation. 

I took my dad to every appointment.  I was with my dad during every hospitalization.  I knew all of his doctors.  My mom owns her small business.  Mom kept the house and food moving forward while I kept dad moving forward.

In retrospect, mom and dad should have talked about mom having permission to speak over the phone to dad's physicians.  Dad should have signed authorizations to allow mom to speak with Dr. Guyton, the oncologist, the surgeons.  


Physicians should encourage the patients to involve their spouses by signing authorizations.
 
No one knew dad was going to die on January 15, 2010.  Mom never even spoke with his oncologist or his orthopedic surgeon (treating the osteomyelitis).  

A large part of mom's grieving has been the void of answers.  If mom had been an actual working part of the care giving treatment team, she would have known how to best provide care and assistance for dad. 

But as in life, communication is the key.  The patient spouses try to protect loved ones from reality or sadness.  


The healthy spouses are probably stronger than even they know!

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