Advocating for a Loved One in the Hospital

You are in a tumult.  A loved one is in the hospital and besides the overwhelming layered concern and worry you are experiencing, there is a modicum of powerlessness.  You might not be familiar with the hospital system, you don't know what would be helpful.

It would be impossible to address all individual and specific needs in this post.  Every population, sub-culture and age range gets hospitalized with a myriad of illnesses and complicating factors, be it social, psychological, emotional or geographical.  So, I will speak in broad terms.  Take what is useful and leave the rest.

In broad terms, a hospitalization is a medical crisis, a traumatic situation. Most hospitals are (usually) well oiled machines with practice and procedure protocols and usually have well trained staff.  They are looking after your loved one's acute medical needs.  In my experience, it is the family's job to advocate for the patient's "soft medicine" needs.

What is soft medicine?  Technically, soft medicine is anything that supports the Parasympathetic Nervous System (PNS), decreases stress, or allows the relaxation response to kick in.  Hospitalization correlates with one's stress and Sympathetic Nervous System being on overdrive; hospitals can be a very threatening, vulnerable place for an ill person. Medical staff aren't primarily concerned with this aspect of healing; loved ones should be.

Why? We need a state of relaxation to heal. When our bodies are stressed with illness or injury and we are in a sterile, foreign environment we have no control over, it is very difficult to relax.  The Parasympathetic Nervous system impacts the body's endocrine response.  Under stress, we are putting out more cortisol, adrenalin, stress hormones and insulin, further taxing the body, blocking the body's natural healing response (its in an "emergency" survival mode). Our breathing is not full bodied, but shallow further inhibiting our respiratory response.  The added tensions and anxieties to be expected in this situation just compound the already existing problems of pain, anxiety, nausea and insomnia.  Our advocating loved ones are our lifeline to wellness in this way.  As good as most nurses are at advocating for their patients, it's really the families that are left with that responsibility.

So, what to do.  Start by assessing your loved one's stressors and try to eliminate the easy ones. (ie: if the food is terrible, bring some of his favorites in to be labeled, refrigerated and reheated at meals. Nutrition is obviously key to healing.  Sick  people don't eat much, so make it nutritionally count).  If she hasn't been sleeping well, make sure stimulation is minimal, door is shut and note on door if necessary to not disturb unless bell is rung. Stressors that can't be eliminated (like morning blood draws or bed baths) can be addressed by interfacing a ritual that is positive and that could counter the negative scenario; like listening to a meditation tape upon waking, before the blood draws or before an afternoon procedure.

Showing up is literally a huge support; it is everything in a nutshell.  Loved ones' faces bolster patient spirits. An enhanced spirit increases one's sense of wellness which will:   kick in her endorphins, PNS or relaxation response, improve her healing attitude and promote the healing process.

Plan some strategies (with her if she is able) to have several times a day a "wellness routine" such as:

-- A Guided Imagery scenario or two, using all five senses, concentrating on her proprioceptive strengths (ie: visual, auditory, kinesthetic, olfactory). this might be a landscape she loves, an environment that makes her feel peaceful, as simple as imaging water over stones in a brook; the simpler the better.  Doing this before a rest/sleep period will deepen the rest and promote a faster recovery.  This is something you can begin doing with her, but eventually a skill she can do herself by herself when she needs to (before a test or a challenging hospital moment). A pointer for you is be in your own low breath, speak melodically, leave lots of empty, unspoken spaces, go through the scene yourself, enter it with her. Peggy Huddleston (Prepare for Surgery, Heal Faster) has GREAT Guided Imagery cds out on the market, as do others. Some are focused on surgery, recovering from surgery, etc.  This would be a wonderful thing to have on hand.

-- An active prayer practice.  Does he pray? Does he have a favorite prayer?  Does he use objects, like a rosary or beads in his practice? Does he have holy pictures that are meaningful you can include?  Set the stage so to speak; it's a special time when one's breath deepens, hypervigilance is put at rest and one is just with God and/or the holy moment.  Setting the stage pronounces this as a special time, creates ritual and reinforces the act.  The hospital's pastoral care department will be sensitive to this and a help.

--Light, loving touch on non hurting parts of the body like hands, feet, face.  Do a repetitive light pattern "sweeping massage" on fingers, arms, etc.  The repetitive patterning gets 'read' by the rest of the body, and is anticipated with relief and pleasure. This again, kicks in the PNS.  Talking in low tones, being with one's own breath and body will help her to mirror that in herself.  Hospital patients are in a hypersensitive mode.  They pick up EVERYTHING energetically.  So, what you want for her, create in yourself first.  Peace, quiet, stillness, deep breathing patterns.

--Humor!  Engage his and your own. The power of humor is underrated in healing.  Lightness and laughing kicks in the PNS.

--"C.A.R.E. Channel"; some hospitals have a calming, nature slideshow on their hospital TV program available in all patient rooms, which is often accompanied by meditation like music. Also, at night there is a "starry night, constellation" visual channel that moves slowly and is very relaxing.  Pastoral care or a case manager would know about this.  Probably at least, there is a music channel.  Or maybe you have an old portable cd player around with some good cds; sometimes a hospital provides cd players as well. All stimulation should be peaceful and low key.  Regular TV programming just isn't conducive for healing.  It's a distraction, not healing.

-- Moving-- laying around in one position all day everyday is deleterious. Promote better circulation (preventing stasis blood clots) by doing hand, ankle rotations, moving arms and legs up and down, becoming aware of what movement does feel good. Passive range of motion is something all nurses learn in nursing school but rarely have time to do with their patients.  Of course, movement will be minimal.  The main thing is not to let her wane there day after day.  She should have bed PT to keep musculature from atrophying (ask the doctor about the appropriateness of PT in your loved one's situation).  PT works for 15-30 minutes a day, just a bit to improve breathing patterns and mobility.  This will help her from not developing pneumonia too, a big problem for non ambulatory older people. Once you see what PT does with her, a loved one can do that at another part of the day or on weekends.

--Resources:  ask the case manager about pastoral care, integrated medicine practitioners (nurses, lay volunteers who do healing touch? therapeutic touch? hand massages?), music therapists, art therapists.  Most hospitals have these resources, but you often have to ask for them. You might be lucky enough to get nurses who practice CAM.  Make it known you want your loved one to have these nurses when they are on shift. If you have the financial resources, consider bringing in your own practitioners.  I've known acupuncturists to make visits to the hospital with MD approval.

--Getting the most out of staff.  Being an interested, congenial and non judgmental regular presence at the bedside is key.  Whereas the squeaky wheel gets the grease, a demanding, pushy family member provokes fear and an inner hostility in staff.  It's a slippery slope, a double sided coin.  A well-informed, quietly insistent, appreciative family member who is responsive (not reactive) is powerful and usually inspires great care from staff.

We want to promote rest and relaxation for our healing loved ones; the conventional medical setting won't ensure this, you will have to. Advocate for your loved ones.