Linda’s Insights

The Energizer bunny finally powered down. My 97-year-old mother-in-law, Helen, passed away Oct. 5.

People who read this and did not know Helen will say, “Ah, well, she lived a long life.” And she did. What they don’t know, however, is that up until the end, she was the Energizer bunny—always on the go, full of 97-year-old energy and pep, never wanting to quit. My former co-workers gave her that name, because it seemed that whenever she was down, she got up again.

It has been a tough summer for her. She thought she could undo the consequences of her age through surgery. Instead, the surgery to repair her bladder turned out badly and took a grave toll on her health. Determined, however, she exercised daily until she built up enough energy to return to “school” (the senior center). Then, one day, she announced she wanted to visit her brother and extended family in rural North Carolina. My husband took her there, and that is where she passed away—in the house where she grew up.

They say each of us goes through five stages of grief—anger being one of those stages. I admit that several days after Helen passed away, I began to feel an emotion unfamiliar to me. It was anger. I was angry because Helen had not given us the opportunity to say good-bye.

A few days before she died, her brother took her to the ER, where they diagnosed an inoperable problem. The doctors told her she was dying, and she said she understood. But she didn’t accept it. Instead, she kept fighting to live. Up until the end, the night before she passed away, as she complained about pain (her pain pills had not kicked in), she said, “Take me to the hospital. There has to be something the doctors can do to keep me living!”

But, there wasn’t. And by the next evening, she was gone. She missed the chance for us to say “we love you.” And she missed the chance to say good-bye.

Death is the one certainty we all are guaranteed to experience. I loved my mother-in-law, and I think I am over the anger I felt at her not accepting her finality. I hope, though, that when my time comes, I will have the opportunity to say good-bye to those who mean the most to me. As the “serenity prayer” goes, “accept the things you cannot change.”

Until next time,

Linda Segall
Segall Enterprises: Writing and Editing Solutions
www.segallenterprises.com

We wonder what is wrong with our healthcare system. We wonder why costs are so astronomical. It’s not difficult to understand. Just look at the inefficiencies—and the greed. They are everywhere.

The inefficiencies start with recordkeeping. Every time my husband has taken his 97-year-old mother to the hospital it is the same story: He has to provide the same information to the intake worker. An admission that should take no more than a few minutes and the click of a mouse, ends up taking at least 30 minutes, with the intake worker inputting the information anew. Doesn’t the hospital know that every time data is input, the opportunity to introduce errors (or omissions) increases? Duh.

Other inefficiencies also are due to recordkeeping and the inability of agencies to share information (with permission, of course). When my mother-in-law was discharged from rehab/nursing home last week, a home-healthcare nurse was supposed to visit. Once they finally came out, the nurse took down all of the information that was available from the nursing home (and the hospital). Could she have accessed records and merely updated information?

We had to fire that agency because they were unreliable. We hired another, which had come out to our home several times in the past—so it had the healthcare records. What was the first thing the nurse did? You guessed it: She took down, by hand, all of the information. Why didn’t she have the records with her? And why couldn’t there have been a sharing between agencies?

It’s actually worse than I describe: This nurse had a computer. I did not see what she was looking at. It could have been my mother-in-law’s records, or it could have been some government or agency forms. Whatever it was, she copied what she was reviewing on screen to a handwritten form!

And of course, there is greed. In my previous post, “Just because you can…” I commented on the ethics of the doctor who performed multiple surgeries on my mother-in-law and left her much worse off than she was before she went to him initially. I am convinced it was greed, allowed by the system, that encouraged him to do those things. And I find it extremely interesting that Medicare recipients get just enough rehab to take them through the end of Medicare coverage—whether they need it or not!

We need a complete overhaul of our medical system. I am disappointed that Mr. Obama has caved in to the pharmaceutical, medical, and insurance industries and abdicated the only thing that makes sense: a single-payer system. Sure, that would require a completely new paradigm of how we “do” healthcare. But, that is what we need. The system as it is “working” today costs us too much in too many ways.

It is time to change.

Just because you can, doesn’t mean you should. That piece of ethical sense seems to escape a lot of people—especially in the medical community.

How about the artificial insemination that resulted in octuplets being born to a single mother (with no means to support her children) who already had sextuplets from a previous artificial insemination? Wasn’t that a breach of medical ethics?

It can be argued that such cases of medical ethics are not mine to judge. I can, however, judge something much closer to home: The medical treatment of my 96-year-old mother-in-law.

For a person her age, she is in remarkably good health. She gets up early every morning; puts on makeup; and take a mini-bus to the senior center. Once a week she arranges a mini-bus ride to have her hair done. She exercises on the Gazelle every day. And when the weather cooperates, she takes a walk around the neighborhood, pushing her walker and resting when she needs to.

She is like the pink bunny in the battery commercial: She just keeps on going.

Although she looks at least 15 years young than her age, her body almost 97 years old. And inevitably, it is wearing down. She is unrealistic does not want to accept that fact. She believes that problems—such as her urinary incontinence—can be fixed the same as they were when she was 75. So she asked a urologist to fix the problem.

He tried some relatively noninvasive procedures, which did not work (no surprise). Then instead of saying “no” to her request, he agreed to perform a surgical procedure to fix the problem.

In a younger woman, the type of surgery he proposed is considered safe, easy, and effective—in and out of the hospital in 24 hours. But for an almost-centurion? Not so.

Here is what happened:

• He performed the procedure and claimed it went well. He didn’t notice, however, that she began talking with a crooked mouth—sign of a possible TIA (mini-stroke).

• A neurologist ordered a CAT scan to look for stroke damage. (Although she did not have a stroke, the droopy lip persists.)

• She spent five days in the hospital, then the urologist sent her home without regard for physical therapy and with a catheter in place. (Geriatric patients lose muscle tone very quickly lying in bed and require rehabilitative therapy.)

• Two days home, she came down with pneumonia-like symptoms and had to go back into the hospital.

• The internist treated her chest congestion and she stayed in the hospital for another five days.

• While she was in the hospital, the urologist removed the catheter and released her (at our insistence) to a rehab center.

• At 11 p.m. the evening of her release, she was sent to the ER with severe bladder spasms.

• She was readmitted to the hospital, and two days later, the urologist performed a second major procedure to undo part of his surgery in order to relieve the bladder spasms. (That is major surgery No. 2 within 10 days.)

• Three days later, still in the hospital, she again experienced bladder spasms. The urologist took her in for her third major surgery to undo everything he should not have done in the first place.

• She was finally released to go to the rehab center—still with a catheter.

The prognosis? She may require a permanent catheter—a condition much worse than she had had prior to the first surgery.

Three major surgeries within less than three weeks. Almost three weeks in the hospital. Weeks to be spent in rehab. And possibly a major physical limitation.

And we wonder why our healthcare bills are so high!

Was that doctor a namby-pamby—unable to say “no” to a patient?

Was he ignorant of the special needs of the elderly?

Or was he just money-hungry and wanted to take Medicare and her excellent insurance for all it would pay?

I don’t know the surgeon’s motivations. All I know is that I am angry. I am not opposed providing good quality healthcare to the elderly. I am opposed to doctors’ doing needless procedures whose risks outweigh the benefits.

This blog entry did not have anything to do with communication, but I felt a need to write it.

Until next time,
Linda Segall
Segall Enterprises: Writing and Editing Solutions
www.segallenterprises.com

I read an article recently stating that job seekers should never disclose to prospective employers anything that might suggest they were disloyal to their former employer. That started me thinking …

Employers expect loyalty from their employees. Not an unrealistic expectation, I think – except some employers have a skewed understanding of loyalty.

For example: Is an employee disloyal if he:

To my way of thinking, none of these things shows disloyalty. Yet, over the years I’ve known employers who expect their employees to “live” their jobs 24/7, never question decisions, never leave, and to cut off all communication with former co-workers because anyone who has left is disloyal.

So, what is loyalty?

Loyalty is more than merely staying with an employer. I believe loyalty is giving full commitment and energy to an employer throughout the entire working day, being faithful to the company by never doing it any harm and always working toward its success, and not bad-mouthing it to outsiders.

In other words, loyalty is working a full day for a day’s pay and respecting the person (entity) who signs the paycheck.

A person is not disloyal because he has a life outside of the office. And an employee is not disloyal just because he wants the workplace to be better.

Employers who question their employees’ loyalty should look at how loyal they themselves are to their staff, because loyalty does not travel down a one-way street. And they should consider these truisms:

• Disagreement is not disloyalty. Disagreement encourages a diversity of opinions and better solutions to problems.

• People who live a balanced life are more productive than those who are workaholics. People who live only their jobs eventually burn out, and burn out leads to disgruntlement and lower productivity.

• Employees who remain with a company because they are afraid to leave are likely to be less productive than those who stay because they like working for the company. Fear in any form has no place in the workplace.

• Loyalty is not a given. It must be earned.

Until next time,

Linda Segall

Segall Enterprises: Writing and Editing Solutions

www.SegallEnterprises.com

Sometimes the decisions people make blow my mind. Case in point: Turning down the opportunity to be interviewed.

As I was working on a freelance writing assignment for a business magazine, I contacted several sources provided to me by the editor of the publication. The assignment was to interview these individuals about a specific topic; they were the experts and I was to get their opinions and ideas. There was nothing controversial about the article.

Two of the four individuals opted out of the interview. Their reason: They were too busy.

Too busy to get free publicity for their company? That’s what an interview for an article is — free publicity. It’s better than by-lining an article. It’s better buying an advertisement. It’s even better than authoring a book! It’s better because the writer is contacting you as an expert. Your expertise is being endorsed by a third party.

This isn’t the first time people have turned down the opportunity to be interviewed for an article. It won’t be the last. But it still astounds me. Opportunity knocks and they refuse to open the door.

Don’t make that mistake. If a reporter or a writer asks to interview you, make the time. Answer the door.

Until next time,

Linda Segall
Segall Enterprises: Writing and Editing Solutions
Linda@segallenterprises.com
www.segallenterprises.com