Remember the ancient Indian parable of the blind men and the elephant? In the story, six blind men are brought before an elephant. Their task is to figure out what it is they are dealing with. But each man’s experience of the elephant is limited to the part right in front of him. Touching the elephant’s trunk gives a completely different experience than touching the ear or leg, so they come to very different conclusions about what the elephant is.
So often our experience of being a patient in the health care system can feel like being that elephant. Every specialist we see understands a part of us, but no one is looking at the big picture, or seems to have responsibility for making all the parts work harmoniously.
That’s certainly what I felt after my mother had surgery to remove a hematoma in the brain resulting from a fall on her back porch. There was a neurologist, a cardiologist and a pulmonologist to track down and get updates from. But you could never get them in the same room at the same time. And no one pulled all the data together to present to me. No one spoke for the whole person that was my mother.
Even worse, at moments, I could see her through their eyes and realized they were seeing a passive, diminished person. She looked somehow shrunken sitting in a chair in her hospital room. And, face it, no one looks powerful in a hospital gown.
But she was only 78, and I knew that just a week before the surgery, despite some health problems, she was a dynamic, vital woman who was looking forward to starting another season of teaching her piano students. She had been teaching piano and music pedagogy for over 50 years. She was a recent past president of the Music Teachers National Association. In many ways, she was just as smart and just as on top of her game as the doctors were. It was painful that they didn’t see it.
That experience informs the way I want to interact with our home care clients. No matter their age or health status, these are human beings with goals, values, abilities and desires that matter. Our job is to give them support for their health and well-being with as little compromise as possible to their independence and personal integrity.
To succeed in this we need to gain an understanding of the whole person. That means considering not only a client’s health needs, but her personality, physical environment, social support network and her preferences. Everything from the client’s medication schedule to the fact that he prefers his coffee in the blue cup can be important to providing high quality, respectful care.
We are fortunate in home care that we can take the time to talk to the families and clients we serve and get to see them as individuals. Our initial RN assessments and interviews are extensive. Our nurse always asks the client what his or her goals are, and we judge our success by how close we can come to achieving them.
And with my mother’s experience in the health care system in mind, we spend a lot of time communicating with other care providers and encouraging them to share important information with the clients, their families and each other.
Looking at the whole person helps us do a better job for our clients, and it makes our days a lot more fun and interesting.