A to Z Challenge: Letter I for Investigator

There may be some things in the world of health that remain the same over time, but a whole lot more things change. It can be hard to keep up with the latest knowledge. Caretakers should not be afraid to investigate on behalf of the person they care for. Be curious and be a problem solver.

One of my favorite clients was always asking me to solve problems and invent ways to keep her comfortable. Curiosity and investigation would usually lead me to a solution of some kind. She named me Shirley McGyver. (I’m very proud of that.)

The husband and I have both had to investigate his diagnosis and care. Most of the time when we tell people he has Lewy Body Dementia they say “Lewy who?“ In fact, many people in health care have not heard about LBD, even though it is the second most common dementia behind Alzheimer’s. It has largely been up to family caretakers to know the ins and outs of their loved ones condition and make sure that they are treated appropriately. I belong to two online support groups for LBD and they have given a wealth of information about the difficult and unpredictable course of this disease.

It is important to investigate for others when they cannot do it for themselves. As a caregiver, you don’t have the same limitations that your person has. Often you can see what they cannot, go where they cannot go, and use resources that they cannot access.

Investigative caregiving has led me to:

-research drug interactions when I notice a new skin rash appearing

-check vital signs when my person says they “feel” a heart arrhythmia

-notice hypertension and bring it to the doctor’s attention

-determine that a person’s allergy symptoms are caused by her cat!

-avoid serious problems for my patient by listening carefully to their complaints

Investigative caretaking takes observation skills. It also takes the persistence to follow up on things that just don’t seem “right”.

My “closest to home” example of timely investigation happened years ago when I was still in nursing school. I would visit my grandmother when I was home on weekends. She was an intelligent, sociable lady who was alert, oriented and mentally competent. She was also on a daily diuretic medication for congestive heart failure. I was very surprised one week at school to get a phone call saying that she was disoriented, frantic, and acting very strange. Knowing this was not her usual behavior, I looked up adverse effects of her medication and was able to tell the caregiver that Grandma needed to be taken to the ER to have her potassium level checked. I was so thankful when they were able to reverse her condition quickly and easily by giving her potassium.

It’s helpful to me to think of myself, my person or client, and their medical professionals as an investigative team. Giving frequent, sometimes daily, care means that I have eyes on situations that the doctors never see. My job on the team is to report, as accurately as possible. For that reason I go to all doctor appointments, and all procedures. I also have proxy access to the online health charts of all those I care for. I am well acquainted with all the ladies at the registration desk since I sometimes see them several times a week, with a different patient each time.

I am a private eye (always wanted to be one…).

I am an investigator.

I am a caregiver.

Your Best Advocate

Of course I’d like to be a better writer. For a while, as I try to be better, I’m going to at least try to be prolific. They say that if you write a lot, you have a much better chance that some of it will be good. If you write seldom (or not at all), none of it will be, so be writing. That’s my goal.

 

You have to be your own health care advocate. If you find that impossible, make one good choice – someone you trust to advocate for you. This is not a new revelation to me, but newly reinforced by my recent wellness checkup with my primary care office.

I’m somewhat of a rebel, offspring of a family that believed that 99% of what’s wrong with us heals itself if not aggravated by medicine. This mindset was pretty well in place in my high school years so I don’t know what made me choose nursing as a career. It was mostly that I was fascinated by how complex human anatomy, biology and physiology were, and because someone gave me “Cherry Ames, Student Nurse” for Christmas one year. Cherry was the medical world’s answer to Nancy Drew.

Nursing has given me an inside look into the strange reasons why some things are done the way they are. The reasons are many and complex. You can’t always figure them out. What’s more, sooner or later, what’s good for you is going to come into conflict with what’s good for someone else. It’s nice to know at that point if you have options and what they are.

The husband and I are at the age where we have more time to devote to our physical condition, and it’s a good thing being that it’s also the age where there’s some new thing going wrong every week. We are still moving around under our own steam and able to read so we are researching. I read to him in the evenings, after we walk, and we discuss health issues and diets, sleep, exercise, medicines – all of that.

Without going into too much detail in this post, suffice it to say that we see a lot of new research that flies in the face of traditional thought about these issues. It seems that what we’ve been doing traditionally for the last half century or so has created an epidemic of obesity, diabetes, heart disease and depression. Oh, and Alzheimer’s dementia. Oh, and autism. Oh, and autoimmune disorders. And cancer. At some fundamental level, we are a very sick country.

Having decided to get smarter about simple things we could do to help ourselves avoid as much sickness as possible, we are starting with eating differently.

I was sitting with the PA who was doing my wellness questionnaire and telling him some of these things. I told him how I was limiting carbohydrates by cutting out most bread and sources of sugar. I mentioned ketogenic diet and how I’d lost ten pounds on it.  I told how it was a high fat, moderate protein, lo-carb diet, and that I was feeling pretty good overall. He nodded and appeared to be listening (how do I know what he’s thinking…). We talked about stress relief and I told him that I dispelled it by writing for my blog. Then he wrapped up the interview with “Okay, just keep doing what you’re doing and keep on that low fat diet.” Sigh.

Traditional advice is not always for everyone. Sometimes, it’s not even true or based on real evidence. I’m going to end this post in the same way I started it. You have to be your own health care advocate because no one doctor or health professional can concentrate on what’s good for you. You are it.

More to come on this and related subjects.

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Blood pressure gradually creeping up – that’s what first caught my attention. Just sayin’…