September/October 2013 Print - Debra Levy Eldercare Associates

Avoiding surgery on the wrong body part

Surgical errors are alarmingly common. They can include the wrong procedure or the wrong person. Or surgery on the wrong body part, such as the left hip instead of the right! The government calls these errors “never events,” because they shouldn’t ever happen.

The good news? Communication is the best prevention. You can play a well-defined role in ensuring your loved one doesn’t become the wrong kind of statistic!

Use the following guide to support your relative on the day of surgery, in either an office or hospital setting.

Ask about surgical protocol. Inquire about the steps or checklist the doctor and his or her team use to prevent errors. The best answer is the “Universal Protocol” issued by the Joint Commission.
Read the consent form thoroughly. In addition to checking the name of the patient on the consent form, double-check the name of the proposed procedure. Make sure it’s the one you expect to be performed! If appropriate, note the specific site (right or left hip, for example). Ask questions about anything you don’t understand.
Verify your relative’s name and date of birth. Throughout the preoperative process, whenever a member of the staff comes in to do something, he or she should ask for identifying information and check the patient’s wrist ID bracelet. If they don’t, you can offer your loved one’s name and date of birth to double-check.
Request “site marking.” This step is crucial. Ideally, site marking occurs while the patient is still awake. Specifically, the surgeon should mark and initial the surgical site with a pen, literally on your relative’s body (that right hip!). If your loved one is already under anesthesia, insist on witnessing this step yourself.

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Choosing an elder law attorney

Elder law attorneys focus on issues concerning aging and illness. They provide expert advice so their clients are not caught unprepared. They also create legal documents to protect their clients’ wishes and rights. An elder law attorney can help with

planning for long-term care. This ensures one person’s need for care does not bankrupt the other family members.
review of contracts from long-term care facilities. Make sure your loved one fully understands the cost and what care is and isn’t provided. Also, it’s important to clarify the conditions for having to leave the facility.
eligibility for public benefits (Medicaid, Social Security, care and assistance for veterans). Elder law attorneys understand the programs and the laws. They may be able to offer advice that increases the likelihood that applications will be accepted with maximum benefits.
wills and estates. These legal documents spell out who inherits what. They help prevent costly court hearings after a death.
negotiating claims. An elder law attorney can represent your loved one in conflicts with long-term care facilities, Medicare, or long-term care plans.

To find an elder law attorney:

Seek referrals. Ask your friends, clergy, or tax accountant for recommendations.
Gather information. Contact the lawyer’s office. Ask about years in practice and typical cases. Those highly focused on elder law belong to the National Academy of Elder Law Attorneys. Or they may list themselves as a Certified Elder Law Attorney.
Request an initial interview. Describe your situation. Ask how often the attorney has handled something similar, and what is recommended. Ask about the cost. Does the lawyer seem to appreciate your concerns? Is the attorney talking in terms you can easily understand? Does it feel like a good fit?

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When Mom is really mean

Aging brings with it many losses. Some seniors feel enraged by these changes, and others are terrified by the lack of control. Sadly, when people feel backed into a corner, they often “let fly” with the safest person: the caregiving family member. If spending time with your relative leaves you feeling worthless, picked on, or controlled, that’s cause for concern. And action.

In the extreme, your relative’s angry or controlling behavior may constitute emotional abuse:

Threats and demands. “If you don’t spend the night, I won’t get out of bed. I’ll just lie here wet.”
Humiliation. “A 10-year-old could do it better.”
Dominance and isolation. “If you go to work, I’ll know you don’t really care about me.”
Blame. “Since you started giving me my pills, I haven’t felt good. You must not be doing it right.”

Whatever the cause, you don’t have to just “take it.” It’s not healthy for you, and it doesn’t really benefit your loved one either. Try these strategies instead:

State your concern. “Mom, I’m walking on eggshells around you these days. It seems the littlest thing sets you off. Is there something bothering you that I can help with?”
Respect yourself and set a limit. “From now on, Mom, whenever [xyz] happens, I’m going to stop what I’m doing and leave.” (Then follow through, each and every time!)
Protect yourself. For example, you might oversee your relative’s care but hire a geriatric care manager to handle tasks involving direct contact.
Get support. Take breaks. Get help maintaining perspective: Your family member’s behavior is not your fault. Attend a caregiver support group. Take respite breaks to refresh your spirit.

Is your relative’s demanding behavior new? If so, get him or her a full medical exam. Such symptoms can indicate depression or the onset of dementia. Medical treatment may help.

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