Monday, March 3, 2014

The Advocate Within

Today I served as advocate for my 86 year old mother.

If you knew me now, you'd have a hard time finding said advocate. But, she's here, deep within - experienced, vocal, determined, steadfast, stern, accomplished, All within me. I, myself, am often surprised by this.

My earliest recollection of possessing this quality was about age four; I was in headstart, a preschool program for low-income children... it was in it's infancy. By that time, I could read.  I found myself at odds with the fact that because of my age, I could not advance to kindergarten in traditional elementary school. Although, I was still not able to convey my opinion to those in charge of my early education, I recall being disappointed by their decision... extremely disappointed.

Another time, at age five, I found myself disagreeing with family doctor about his reluctance to request specialist to remove a large birthmark on my right leg. This birthmark was a crippling presence all my life.  I'm still insecure and embarrassed by it.

So, since those early days I've learned to speak up for myself regardless of the outcome... I've always felt that I should at least be heard when my best interest was at stake.

Fast forward to today.  Mom needed me to advocate on her behalf. I found discrepancies in course of treatment for her chronic illnesses. Just last week, my sister and I received information which indicated that Mom now only had to take a few meds out of the 10 or so she had previously been prescribed.  My questions was why.  She has Type 2 diabetes, hypertension, thyroid deficiencies, anxiety and a few other things that must be managed with medication.  I thought it odd that none of those discontinued were tapered off, nor was there an explanation as to why they had been discontinued..

Mom recently was issued  new caregiver. It was this caregiver who took her to her last doctor follow-up visit.  It was this caregiver who provided incomplete copies of Mom's doctor's notes.  I needed answers.
So, I called her doctor's office this morning, and understood that I was not authorized to communicate with them about my mother's care without her consent.  I immediately called mom, asked her to get ready - this 86 year old was dressed to the nines when I picked her up; I was in a t-shirt, yoga pants and sneakers - I'd be picking her up to go take care of business at hand.

Regretfully, office staff... or, more accurately, front desk receptionist, did not seem the least bit interested in even acknowledging me when I approached the counter.  I did notice she presented a much more pleasant demeanor toward a toddler roaming the waiting room.  I had notified by phone that I'd be right over with my mom to sign authorization. I mentioned that I had several questions regarding her treatment.  Over the phone, it seemed that they were more that willing to accommodate us with everything we needed.

Sensing her unmerited disdain for me, I asked if there was anyone else to assist me. She replied yes, but didn't feel the need to ask anyone else in the front office, when in fact the assistant who I would eventually speak with was sitting right beside her. I sat to wait, but became inpatient when I took note that she seemed to dismiss me.  I got up to stand at the counter, all the while waiting for eye contact or an acknowledgement from her.  Keep in mind, the office did not seem one bit busy; there was only the woman with the small child, who seemed to be waiting for someone.

I was eventually passed on to Mom's doctor's assistant and was relived that she was professional - but, nonetheless put off by my questions. I was bothered by their lack of concern with regard to Mom's med management.  Her doctor actually appeared from exam rooms, but did not make a single inquiry as to what was being addressed.

I was tired, I was unprepared, I was frustrated... I focused, I gathered all the information I felt would help me tackle the next phase to take care of the matter of correcting error made by caregiver.  Satisfied, my Mom, son, and I left with doctor's medication list, and current pharmacy history. At Mom's apartment, my son and I spent about two hours sorting meds, verifying dosages and how administered.  Did I mentioned I was tired? At this point I was hungry and distressed. I needed to leave Mom's to do school pick-up carpool.

Tonight, I requested assistance from my sister and her daughters, my nieces. We all agreed on times to call Mom to remind her to take her meds at times indicated on physician's script. I'm optimistic that we can manage Mom's care as a team, in her best interest.

Today, I revisited the advocate within.

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