Jim was a 52-year-old ex-marine built like Adonis. He had no significant medical problems, but had been experiencing vomiting and diarrhea that he thought was a stomach bug. Jim was not big on going to doctors and decided to wait it out.
Jim’s wife, Kim, called 911 when she found her husband unresponsive. He was dead on arrival to the emergency department. The couple’s parents arrived immediately after the ambulance and were beside themselves, asking repeatedly, “How could this have happened?”
The answer to this question centered around Kim. She was the next of kin and had missed the “Caregiver’s Code Green.” Like a “Code Blue” that alerts hospital personnel of a patient who has stopped breathing, the “code green” supports a caregiver’s authority in making sure their loved one receives advance care when needed.
Kim was used to Jim being in charge and respected the premise that “What Jim says, goes.” While giving him the benefit of the doubt, she supported both Jim’s denial and supposed invincibility. Kim was torn between being his wife and stepping up as his caregivers. If she’d been given the green light to take charge of the situation, she would have insisted that Jim go to the ED sooner rather than later.
Just as drivers anticipate the traffic light changing from red to green, family caregivers need to be prepared for the Code Green. This code is the call to action for caregivers to STOP! LOOK! LISTEN! FEEL!
Learn how to stop being passive and follow your intuition by using these tools:
Don’t deny the situation and get angry. When you care deeply for another, his or her thoughts and actions do affect you. Medical illness not only strikes your patient – it impacts your entire family. Deference is given to your patient, giving him or her what they want. But you need an equal respect for the illness in order to manage it effectively. When the buck stops with you, the “bunk” – a patient denying the illness – needs to be stopped by you.
As a family caregiver, your duty is to distinguish fact from fiction and not pretend that everything will get better. Begin to establish certainty about your patient’s medical condition and prognosis. Allow yourself to be angry and obtain realistic answers. You may become bossy in response to the patient becoming testy. Being bossy means you care. When given the green light to begin caregiving, you may be required to stop being nice and start acting in your patient’s best interest. You become distinguished as a leader when you stop being passive.
The Caregiver’s Code Green is not sounded at the life. This responsibility generally occurs in the “summer of caregiving,” when you least expect it. During the prime of life, the growing season, everything appears sunny and green. The days are long and you become energized by the sweet fragrance of success along with the impetus of full speed ahead! You are apt to become blinded by the sun until the eclipse occurs – your loved one being taken to the hospital.
Wait! What? Do your eyes deceive you or are you having trouble awakening to the new reality of life-threatening illness? You will need to come to terms with this illness before your patient is able to accept it. Believe it or not, all eyes are on your being in charge. Your “Code Green” triggers the response to get out in front of the illness rather than lead from behind. Look before you are driven over the deep end of denial.
Caregivers are focused on listening to their patients. Most people experience an awakening when they listen to their hearts. You may need to take what your patients say with a grain of salt and become skeptical. Are your patients hopes and dreams aligned with reality? Is the physician being realistic or overly optimistic? What you’re your own search for answers tell you? Do you want an unbiased opinion or do you prefer listening for what you wish to hear?
The metaphysical color of the heart center is green. When the Code Green is activated, you must fine-tune your listening skills – lending an ear to your heart. The Emergency Broadcast System has conditioned us to pay attention to the sound of its alarm and the words, “If this had been an actual emergency, you would have been instructed . . .” As a caregiver, you are inclined to take instructions from outside sources, but the best caveat is to listen to your own heart and trust your intuition.
A caregiver is blessed with a ‘mother’s intuition.’ This tends to challenge the perception that a medical degree is the end-all to physicians knowing everything. You are better in touch with your own feelings and those of your patient than a treating physician. This mutual exchange between you and your patient is referred to as empathy. Empathy allows you to say what’s on your mind and speak from your heart. You will never be faulted for using empathy to your advantage. Code Green implies acting from a call to duty.
Code Green allows you to act on a hunch or a feeling. You are not called to wait at that moment. Caregivers often say, “It’s better to be safe than sorry.” No one will fault you for playing it safe, but it’s difficult to forgive yourself if you believe that you have been negligent. Heed any distress signal your heart sends out. Recognize the pulsation of your heart as feelings and awaken to the messages they send. You cannot expect others to know what is in your own heart.
Like Jim, most patients use denial as a starting and stopping point with the prospect of life-threatening illness. This period of time calls you as caregiver to be on guard – to stop, look, listen, and feel. While waiting for the green light and opportunity to take the lead, plot out your strategy. Create an appropriate advance care plan in order to know where you need to go when your patient takes a turn for the worse and the light turns green.
Karl looked to be in the prime of life. He was 62-years-old with an athletic build and an easy-going personality. He came to the ER with his wife, Julie, for difficulty breathing. Karl had experienced a series of unfortunate illnesses that began with an ankle injury. Following surgery, he developed a flesh-eating infection that resulted in the amputation of his leg below the knee.
When Karl underwent pre-op testing, a chest X-ray showed lung cancer. Karl had been receiving chemotherapy following ankle surgery until this treatment destroyed his bone marrow’s ability to produce red blood cells. Karl was prone to anemia and had been receiving periodic blood transfusions.
Karl’s lung cancer created a pleural effusion, or fluid collection, between his left lung and chest wall. This new finding on his chest X-ray indicated that his cancer was worsening. During the summertime of caregiving, many medical conditions, like flowers, bloom at the same time. During this stage of life, patients feel as if they’re bombarded by an onslaught of medical problems. Karl maintained a strong will to live, but interspersed in his season of summer were emotional thunderstorms.
Caregiver’s can best handle the onslaught of multiple medical conditions with these tips:
Karl was near death, but did not feel or look as though he was dying. Yet, the ER doctor thought it was important to give Karl the option to either have the fluid drained from his lung cavity or allow natural death. Julie immediately perceived where this conversation was going and knew Karl was not ready to give up. She spoke up on his behalf and claimed, “We’re not there yet.”
As a caregiver, you need to be proactive and sense what is most important to your loved one. Your day- to-day interaction with your patient provides clues to his or her level of commitment. Although Karl was nearing his final days of summer, he was still able to enjoy life and did not appear to be suffering.
Julie’s stand to defend Karl’s desire to live demonstrated her commitment to him. She had his back. As an effective caregiver, your ability to be a mind-reader will earn the respect of your patient. You must be less committed to one way of managing the situation, while remaining open to the treatment your patient prefers. Your patient’s ability to trust you will better serves your ability to guide the situation through the remaining seasons of caregiving.
Prune back co-morbidities
Co-morbidities are medical conditions that pile up and add to your patient’s suffering. Having a leg amputated is a tragic life event, yet that was Karl’s least concern now. His progressing lung cancer was cutting his days short along with his breathing. If Karl intended to thrive during this stage of life, he would need to declutter his life of treatments/medications that him feel ill.
Caregivers are prone to worry about almost everything. You need to train yourself to trim the overabundance of medical issues based on what your patient choose to focus on. If your patient refuses to follow his diabetic diet, managing his diabetes becomes less of an issue. The “end of summer” is a good time to cut back on unnecessary medication and cancer screenings that challenge your patient.
Sick patients often claim that they have no medical problems while caregivers roll their eyes. These patients are still in the summer of their lives. Managing your patient’s medical conditions allows him or her to live fully. Your ability to roll back any unnecessary burdens helps lessen the oppressive dog days of summer.
Use plant food for better stamina
Fresh fruits and vegetables are in season during the summer and need to be a staple in your meal planning to boost your vitality. A healthy diet supports patients with chronic illness.
Many caregivers share the same food plans as their loved ones for convenience. But this bond also reminds caregivers of the need to take care of themselves as they care for others. Leading by example demonstrates that you are in this situation together.
Patients often live healthier lives following a life-threatening medical condition. This might appear as a last-ditch effort or last hurrah. Make the most of it and let your patient enjoy more time in the sun. Spend time eating outside and connecting with nature. Promote sunset strolls and be certain you both get plenty of rest. Plants teach us what we need to thrive.
Provide adequate water
Water is vital to life and an important part of summer fun. Not only does it hydrate our cells, but it also feels great on our skin. Encourage your patient to take a refreshing shower or bath daily. Drinking six to eight glasses of water per day needs to be readily available and easily accessible.
Water naturally fills any empty spaces and typically soothes pain. It provides direction to either go with the flow or swim against the current. People feel buoyant in water and lifted to a more carefree existence. Having the ability to float only occurs when you and your loved one learn to let go. A sense of calmness and rejuvenation will ensue.
Summer rainstorms and thunderstorms are part of life and create the opportunities for cleansing along with an awakening. There is a period of upheaval followed by assessment in the aftermath. After Karl had the fluid drained from his lung cavity, he could hit the shower and begin life anew with a different perspective of his cancer being worse. Water has inherent surface tension and hydropower. Having enough exposure to water will provide Karl the wherewithal to reset his priorities as he enters the next season of life.
One man’s summer is another man’s autumn. While Julie respected Karl’s desire for an endless summer, her overall goal was to have Karl appreciate all four seasons of his end-of-life journey. Few people wish for summer to end and winter to begin without experiencing autumn. “We’re not there yet” meant that autumn may not occur happen in Karl’s lifetime. Julie should ensure that Karl enjoys summertime as well as harvest time.