One of my jobs these days is to take my father-in-law, known as “Bimpy” to his grandchildren, to his doctor visits. Bimpy is 85 years old and lives alone, having been widowed for 14 years.
Over the past couple years Bimpy has suffered two serious falls leading to hospitalizations, the first when he was living alone in a condo south of Seattle and the 2nd after we moved him (85% consent/15% Shanghai, as we like to say) into an independent senior living apartment a half-mile from our house.
The main reason I take him to the doctor is that I want to know what’s going on. After Fall #1 (dropped without warning on the golf course after playing “pretty well,” came to in ambulance, doesn’t seem to have hit his head) he had bad headaches and his sense of taste was screwed up, so nothing tasted right. He stopped eating regularly, dropping at least 20 pounds.
“What did your doctor say?” I asked.
“Well, he didn’t seem too concerned,” Bimpy replied.
What?!? What did his doctor do? How long was he in the hospital? What were his discharge orders? All these answers seem to have vanished down a rabbit hole of vague medical records and diminished memory.
(As an aside: A year after giving birth to my first child, I read my medical records from 20 years of being a member of Group Health Cooperative. From 1976-1995, there was one slim folder that contained test results and prescription carbons. For the hospital admission and emergency C-section in 1996, there were roughly 4 inches of machine records with some handwritten notes by OB nurses. At least one of the test results in my folder belonged to a female relative of mine, and another was for someone else entirely.)
One thing his doctor did NOT do after he lost consciousness, inexplicably, was tell him to stop driving. The Washington State DOL says, “Drivers with a history of seizure should have been seizure-free for at least 6 months before they can resume driving,” and after Fall #2, his doctors invoked that. I don’t know if that recommendation is in his medical record, but my husband, his sister and I celebrated by taking his keys out of his pocket while his was still in the hospital and moving his car to an undisclosed location.
One thing Bimpy did not do was tell us he was hospitalized after falling on the golf course. That is, sometime afterFall #1, he said, “I think I’m going to have to give up golf. Did I tell you I was in the hospital a while back?”
He told us the whole story. I took lots of deep breaths. I said, “Look. I just spent several months taking care of my father while he was dying. We were able to convince him that allowing us to help him was a gift HE was giving US. I would really appreciate it if the next time you find yourself needing emergency medical attention, or in the hospital, you give me a call. I’m not speaking for your kids, I’m speaking for myself. It upsets me when you say things like this, or like, ‘I drove myself to the ER one night because I was having chest pains,’ which you mention long after the event.”
“Well,” he said, “I just don’t know what good it does when I’m in the hospital.”
“I don’t either,” I said, “and I don’t expect making phone calls is the first thing you’re going to think of when you wake up in a hospital. I do hope it can be the 2nd or 3rd thing.
All this comes to mind because at his monthly blood-check appointment yesterday, the nurse said, “Now let me ask about your social history.” Ooh, I thought, this should be interesting.
Not at all. “Social history” is doublespeak for “Do you drink or use illicit drugs?” Huh? I thought social history meant, in the non-medical-god vernacular, Who do you talk to? Who do you spend time with? How do you engage with the world? Those questions, which do not come up in these monthly visits, are central to my concept of human health.
My family doctor is my family doctor in part because he cares about actual social history. He takes photos of all my family members and puts them in each others’ charts. He asks questions about the family, about work, about stressors, about relaxors.
When I take Bimpy to see his new-new doctor (replacing the new doctor I found for him after he moved last summer, both because it was more convenient to go to a clinic a block from his apartment and because why would we make a special effort to stick with the asshole who left him floundering without any follow-up support after Fall #1?), I explain and re-explain my role: I am his daughter-in-law and I’m there because Bimpy no longer provides accurate self-reporting, either to the doctor or back to us after doctor visits. (Asked about which medications he was taking and how frequently, he spoke of the sizes of the bottles and the shapes and colors of the pills — so now, we pay his facility a fee to have CNAs deliver meds twice a day.)
I’m there because I want someone present who can probe and clarify and ignore the repetitions and digressions Bimpy defaults to. I strive to speak FOR Bimpy only if absolutely necessary; I prefer speaking TO him to show other personnel I expect them to do the same.
I have my own goals for Bimpy’s health care: to determine whether his symptoms are those of the normal aging process or brain injury or dementia. Or medication problems. He confessed to me that he “broke the rules,” by buying himself over-the-counter sleep medication because “those gals don’t always give me a sleeping pill when I need one.” (Do you ask? It’s on their orders to give one if you ask…)
I said, “I like the idea of being able to determine whether a side effect is caused by medication or something else, and you’re not a reliable reporter. It’s not about following the rules, it’s about keeping track. But you’re an adult. It’s your body. It’s your life.”
As time goes on, Bimpy’s social history gets more intertwined with mine, and I’m glad he has someone who is paying attention. Those who have to go through aging all alone — how can they stay healthy?