Tuesday, January 26, 2010

Taking care of family

It's one topic we can agree on — we should take care of our family. The sticking point is often, who does the work. If your parents are still together as a couple, the healthier parent takes on those care giving responsibilities.

With only one parent left, a child will step up and take on those responsibilities. If you are an only child, it's easier and more complicated at the same time. You have all the responsibilities. The whole process is a lot more complicated than the bumper stickers that advise: "Be nice to your kids. They'll choose your nursing home."

I was reading an article in Time titled "Who Takes Care of Mom?" by Francine Russo. The author shares her experience as being the "bad" sister, who lived far away as her mom's health failed. "She never asked me to do anything, and I didn't volunteer." That sums up what many experience when siblings become caregivers.

I experienced that myself last fall when my mother had surgery. Although I knew there was little I could do while she was hospitalized, I coordinated my visit so I was there before and immediately after the surgery. There was nothing I could really do and as my mom put it during a recent visit to my home, "I don't remember seeing you in August."

I wasn't there when my sister and brother and their families tried to help Mom and help Dad help Mom during those weeks post-surgery. I called. I asked questions. I contributed little to the recover process.

The good news is that my family knew this going into the process. My sister and I talked about this prior to Mom's surgery. We all knew my visit during the surgery would be during the easy phase of the recovery — doctors and nurses did the bulk of the work here. It was when Mom returned home with special medical equipment, home health visits, etc. that the real work began.

It's important for families — especially siblings to talk about these issues before the relationship gets strained. Caregiving is a stressful experience and there will be blowups, frustrations and hard feelings. I don't see a way to avoid it altogether, but there are a few ways to ease the tension.

Families should talk about how they plan to proceed when a parent needs assistance. Is there money for in-home care? Will someone move in? Will a parent move in with a child? Will your parents needs to live in a nursing home or other-type of assisted care facility?

It's a good idea to discuss medical directives, guardians and wills at this time, too.

It's an uncomfortable subject, but it's one that is well worth it. Discuss what your parents want and don't want. Discuss what each of the adult children in the family can do. Then, you can hopefully develop a plan that makes everyone feel good and not like a "bad" sibling.

Wednesday, January 20, 2010

We still need to fix the health care system

With the election last night of Scott Brown in Massachusetts , a lot of people think health care reform is dead. Many people hate the reform on the table so much, they were downright giddy.

Brown's election may very well be the death of health care reform, but it's death doesn't resolve the problems we have in the system.

This new change doesn't help that there are a lot of people using our medical system, who have no way to pay for it. The change doesn't help the people, who need medications but can't afford them. The change doesn't help create a more cost-effective way of delivering health care to those in need.

I hope once all the happy dancing and finger pointing is over both constituents and elected officials in Washington will take another look at reform.

Just yesterday I was sitting in a program on pregnancy. The nurse conducting the class mentioned that a simple tape measure was once used to determine the baby's growth throughout a pregnancy.

Today, doctors rely on ultrasounds to track a baby's development. Most insurance and government programs pay for ultrasounds, so most patients aren't directly footing the increased medical bill.

Are they really necessary? The nurse presenting the program didn't seem to think so. One can debate the medical and cost merits of each method. Mothers-to-be might have some strong input on the issue. Ultrasounds give them an opportunity to see their growing baby on a regular basis. A tape measure couldn't compare on an emotional level, but it would save money.

This is just one random idea of how health care expenses could be turned into savings. I hope the momentum for change whether it began in the 2008 election or began in Massachusetts in 2010 will move in a positive direction for health care reform. We still need to fix our health care system.