Turn About Is Fair Play

By Lolly Wigall

I like to think of myself as a pretty good audiologist.  I’ve been seeing patients since 1970, and I think that I have learned how to listen to patients and their families and how to explain test results so that the normal layperson can understand them.  I also believe that I can help patients by fitting them with hearing aids as needed, and then teach them how to use their hearing aids.  In my judgment, I am a pretty good professional who follows the rules.

That all changed yesterday.

I found out that I am just like any other daughter who wants to “bend the rules” when it comes to my parents.  I abide by HIPAA (patient’s privacy rights) every day at work.  But, I didn’t want HIPAA to apply to me when I was the daughter taking my mom to see the doctor yesterday.

Parents and Patients

I am visiting my elderly parents. I can say that because they are celebrating 67 years married this year.  They are in their late eighties.  For two vibrant, active people the aging process has brought some surprises.

Neither of my parents hears well anymore.  Unfortunately, since I live 3000 miles away, it has been impossible for me to get them to an audiologist for a hearing test.

Their physician has recommended they have their hearing tested, but so far that has not been enough of a push for them to follow the recommendation.

My parents live with one of my younger sisters and she has her hands full.

I came to visit for two reasons:  first to visit with my parents, and secondly to give my sister a mini-vacation.  I am only here for a week, which is a really short time.

My Mom has a frozen shoulder.  Ouch!  Here is a woman who likes to sew quilts.  With a frozen shoulder, she has a difficulty sitting comfortably.  With only one arm it is really hard for her to sew and to hold the fabric as it is fed under the needle. Her mind is constantly going toward projects that are partially finished.  She wants to finish them and move on.

Her mind is sharp and she is curious about the world and its events.  But, with her mobility limited, she is frustrated.  Do I dare say, this normally happy person is actually grumpy?

Trying to Follow the Rules

I know that a patient’s privacy is paramount.  Patients have the right to share their medical information with others or to choose not to.  I knew it would be breaking HIPAA rules by asking to talk to the nurse or doctor privately.  I knew it was a risk.  Would the nurse listen to me about the problems I saw about my mom’s health?  Would she share that information with the doctor?

Here I am the professional who knows the rules, but when it comes to my own mom, I want to break the rules. Hmm. Hard choice.

I know that my mother likes to “paint the best light” on her situation.  She likes to tell the doctor that everything is fine.  I was afraid she would not tell the doctor that she can hardly walk.  I was afraid she would not say that the pain was excruciating.

I was afraid she would lie about how much exercise she was doing. I was afraid that she would forget to tell the doctor all the problems she was having with her health.

And, my biggest fear was that she wouldn’t hear what the doctor’s diagnosis or treatment was. I was afraid that she would look as if she understood what the doctor was saying, but not really hear or understand the implications of what the doctor was telling her.

A good doctor understands the importance of effective communication.

Fortunately, the physician has known my parents for a number of years.  I was very impressed with him and how he interacted with my mom.  He clearly could see that she was in pain.  He was not rushed. He asked her the same question in several ways to hear her answers and to gain a clearer understanding of what she meant when she was describing her problems.

He didn’t just take her first answer to be the complete answer.  He kept asking her probing questions to make sure she heard his questions.  He repeated the same question a little louder when it was clear she did not hear him or understand what he was asking.

He “got” that her hearing is impaired.  He was patient.

And, I was appreciative that he looked at me out of the corner of his eye to see my reaction to his questions.  He was double-checking with me to see if the information my mom was telling him matched my assessment.  He asked about a medicine that he has prescribed to see if she was taking it.  I was able to tell him that she had had a reaction to the medicine he had prescribed.  He then prescribed a different medicine.

Enlightening Experience

I became a better audiologist yesterday when I tried to “help” out and explain my mom’s situation to the physician.  I found myself as a professional understanding more clearly why a patient’s adult children are so anxious to “help” explain their parents’ hearing situation.  I was in their shoes.

I love my parents and want them to have the best care possible.  I wanted to make sure the physician had all the important information so he could make a diagnosis and help my mom feel better.  I wanted to answer for my mom.

Now that we are home, with new medicine, I find that my Mom did not fully hear or understand what the doctor had told her.  She heard part of what was said.  She understood part of what was said.  But she didn’t understand the new routine.

I became a better audiologist yesterday.  I learned I need to re-evaluate when I schedule follow-up visits for patients who are being fit with new hearing aids.  I learned I could better incorporate the family into the patient’s hearing solutions.

I need to develop written material, or better written material to give to patients and family members.  I learned yesterday that I am not as good as I could be.  I learned that I can improve my patient care.  And, I will.

*images courtesy blog.archerweiss.com, myhealthnews.co.uk, flickr.com