NIGHTS, WEEKENDS AND HOLIDAYS

This past week, there were a number of news stories highlighting an article posted in the February 20th issue of the Journal of the American Medical Association. In it, researchers verified that "hospital patients who have the misfortune of suffering cardiac arrest [and stroke] at night or on the weekend are less likely to survive than those who have a heart attack during weekdays or weekday evenings... The immediate cause of poor survival on nights and weekends may be one of timing: either there is a delay getting critical procedures or a delay in diagnosing the cardiac arrest in the first place. 'We're literally talking about a difference in seconds, which makes a significant impact,' said Beth Mancini, associate dean of Undergraduate Nursing Programs at the University of Texas at Arlington. "It's time for hospitals to look critically at their processes'... Overall survival was 14.7 percent for nights/weekends, and 19.8 percent for weekdays."

These findings certainly validate my personal experience. Over the eight months of my husband's hospitalization, virtually every time there was an emergency on a "night, weekend or holiday," problems arose. Two of the most notable problems included:

• refusal to call critical personnel at home on Thanksgiving;
• 1 nurse to 16 patient nursing coverage on Mother's Day.

While neither of these or any other "night, weekend or holiday coverage" cost my husband his life, many could have had I not provided 24/7 advocacy coverage. One of the most interesting things about "night, weekend or holiday coverage" is that these are the times when nursing staff inevitably tell you to "go home and rest." Given the above findings and my experience, these are the times where we need to be absolutely certain there is someone present to be with the patient. While nurses are caring individuals and undoubtedly mean it when they encourage you to "get rest," this is NOT the time to do so! Stand your ground and stay by your patient's side during these periods of vulnerability else your rest cost your patient his/her life."

HIS HEALTH AFFECTS MY HEALTH

According to an article posted on HealthDay News for Sunday, February 10, 2008, "having a husband or wife who needs to be admitted to a hospital with a serious illness poses health risks for the partner." Well, duh! (but it's nice to have it validated by statistics). "The culprit: The stress and upheaval the partner experiences while enduring the hospitalization of an ailing husband or wife... Overall, [the] study found that a spouse's hospitalization boosted the risk of a man's death by 22 percent compared with the death of a spouse. A husband's hospitalization increased a woman's death risk by 16 percent.

Some diseases posed more of a burden than others. For example, a woman's hospitalization for stroke, congestive heart failure or hip fracture raised her husband's death risk by 6 percent, 12 percent and 15 percent, respectively. Similarly, a man's hospitalization for colon cancer did not significantly influence his wife's death risk, but other diseases did have a major impact.

A spouse's hospitalization for dementia proved most stressful, raising risk of death 22 percent for men and 28 percent for women... In fact... having a demented spouse is as bad for you as having a dead spouse.

The study also identified certain time frames during which caregivers are particularly vulnerable, including immediately after a hospitalization and again three to six months into the illness.

The findings should frighten family caregivers... but more importantly, hopefully, help them give priority status to their own health needs."

There are lessons in these findings for those of us who care for a spouse or significant other.

1. We must pay attention to our own health first. Most of us get here when all else is resolved. To do so, threatens our own health and no one who loves us would want us to go down for the count while caring for another.
2. We must ask for help. We need the help as much, and sometimes more, than the patient. The patient has his or her health care providers focused on them. Who is focused on us?
3. We must take time for ourselves, without which we have few resources to assist us in dissipating our stress. Whether the time is for a hot bath, a massage, meditation, prayer, exercise, reading or any other "time out," these few moments of peace and solitude are critical to our survival.

Suzanne Mintz, president and co-founder of the National Family Caregivers Association, in response to the findings states that, "Spousal family caregivers' risk of depression is six times greater than that of non-caregivers. And, they are less likely to reach out for help, she said. To protect their health, Mintz urges family caregivers to spread the work load.

Caregiving is much more than a one-person job, especially when both the family caregiver and the care recipient are elderly... Often, spousal caregivers do not want to ask for or take help from their grown children, but that really is the first place we should all turn."

TAKE CARE OF YOURSELF!