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Avoid the quantum leap: make informed decisions under pressure

By Terrv Lynch, Independent Living Consultant

Is a Place The Answer?
The emergency room physician looked my mother over, checked her files, then motioned me outside the cubicle. He would run some tests, but then we should discuss the “ultimate resolution of this case. ” That evening, I sat next to my mother as she slept in her hospital bed, and reflected on that chilling discussion in the ER. After seven years of helping her survive medical crises, I was a seasoned veteran when it came to “Quantum Leap ” advice from those who should know better. It always shocked me, nevertheless.

The “ultimate resolution” to Leila Lynch's medical problem was, of course, not a treatment plan, but a place. Not a specific place. Just anywhere called "nursing home." I stifled my reflex response to the physician's suggestion and told him that my mother and I were doing just fine in our current situation. What I expected from him was pain control and a diagnosis that would help get her back on her feet again. He shrugged, said “OK” and went back to his job. Tests confirmed that my mother had, once again, fractured a vertebra. She was admitted for treatment.

Although I was upset that my mother had to go through this again, we had been here before. She would recover, come back home, and continue the life she loved. What gnawed at me was my conversation with the doctor. My mother’s battle with physical and cognitive disabilities exemplified a familiar national crisis. The ER incident pointed to a more insidious, related crisis that has an enormous impact on many older Americans, their families, their financial resources, and the taxpayer. This is the crisis fueled by: service professionals’ uninformed attitudes about aging and older people; and by widespread failure to recognize that small, careful, relatively inexpensive steps often could resolve problems that are being "resolved,” instead, with a devastating Quantum Leap.

Just what is this Quantum Leap? Too often, older people and their families make hasty and drastic decisions in crisis situations because they are not helped to see their options. By Quantum Leap, I refer not only to unnecessary nursing home placements, but also to other, sometimes unwarranted, life-transforming decisions such as elders’ moves to assisted living, or job resignations by family members due to their caregiving burdens.

Families need to understand that many older people can recover from serious illnesses or injuries, if given the opportunity. They must learn much more about the valuable resources around them in their communities and must be taught creative and practical ways to use those resources cost effectively.

Who should be educating our communities on these matters? Regardless of what government does, I believe the Quantum Leap will be curtailed onlv through the actions of community institutions and businesses. The Quantum Leap for many of our elders occurs at the end of a hospital stay. Most often, it is a permanent move to a nursing home. Many hospitals offer valuable community education programs. They could do much more, however, to educate their communities on ways to keep older people out of the hospital, and, when that is not possible, on ways to help them return home. Patient and family assistance with post-hospitalization options should begin in the ER and continue through discharge. Nursing homes should be educating families on the rehabilitation potential of their older loved ones. Some churches and religious associations provide community education and outreach programs on issues related to aging. Many more must take up the cause.

Businesses are positioned uniquely to reach the majority of family caregivers through their employee assistance programs. It is unquestionably in their best interest to do so. Various national surveys have shown that employed caregiver absences, work interruptions, lost productivity and resignations cost businesses billions of dollars annually.

Conserving The Most Valuable “Community Resource”
What should our community institutions and businesses be teaching families and employed caregivers about avoiding the Quantum Leap? At the core is the question the ER physician should have focused on: what will it take to help this person return to as self-reliant, healthy and vital a state as possible? The doctor looked past the most important community resource in my mother’s case—my mother—to one that did not belong in the equation for Leila Lynch or her son: a place to put her.

Some keys for helping our aging family members stay as active and self-reliant as possible for as long as possible: