Why don’t doctors check in with each other when they are treating the same patient?
To Christy, 55, a self-employed performer who cares for her 92-year-old mother, Amy,* it’s a simple question—but for some reason it has been hard for her to get an answer. Indeed, if Amy’s doctors had just talked with each other about her condition, it would have saved Christy and Amy countless health care headaches, and a lot of heartache too.
After caring for her mother for 11 years, Christy has a lot of stories to tell about how her mother’s doctors don’t communicate with her — or with each other — and how that has made life harder for both Christy and her mother.
Nearly a decade ago, Christy took her mother to the hospital for a urinary tract infection. Amy’s primary care physician was too busy to examine her, so he sent a colleague to check on her instead. But the colleague never checked in with Amy’s primary care physician to discuss her baseline condition, Christy says.
After about a week in the hospital, Amy had recovered from the urinary tract infection but nonetheless seemed to be getting worse; she was weak and couldn’t get out of bed.
Still, the on-call doctor decided to send Amy home.
Christy protested, but her pleas fell on deaf ears. As Christy was helping her mother get to the bathroom before they left the hospital, Amy collapsed in her arms. Christy picked her up, carried her back to the bed, alerted the on-call nurse and insisted that she take her mother’s temperature. The nurse found that Amy had spiked a fever, and the medical team finally agreed to conduct another round of tests.
The on-call doctor returned to inform Christy and Amy that she had double pneumonia and should stay in the hospital for a few more days.
"I thought that was just her baseline," the doctor said to Christy when explaining why he wanted to send her home even though she had not recovered.
Christy says he would have known that her mother was still ill if he had taken the time to talk to Amy’s primary care physician about her baseline condition. Both were in town and working, she says.
"If her primary care doctor had been there, or had even been in contact with his colleague, he would have known this was not her baseline," she says.
Christy’s story doesn’t end there.
A speech therapist came in to evaluate Amy and determined that Amy should not be given anything by mouth for a couple of days. After that, the therapist said, Amy could start a diet of liquids and soft foods and work her way back to solids.
The following week, a nurse stopped Christy in the hospital hallway to ask if Amy was getting worse. Christy responded that she thought her mother was getting better, in fact, and then asked why the nurse thought differently. The nurse responded: "Well, I just wonder why we haven’t fed her in five days."
Christy stopped in her tracks. "My mother hasn’t been fed at all in five days?" she stammered.
Christy later learned that the order to resume feeding had been overlooked, leaving her sick mother starved for food. The nursing staff simply hadn’t read her mother’s medical charts, Christy believes, and no one took the time to double-check the order. Who knows how long Amy would have gone without food if Christy hadn’t been there to monitor her mother’s care? How close to death would Amy have to be before the nursing staff would have checked the chart themselves? And what happens to patients who don’t have the benefit of a relative or friend to keep a close eye on the health care system?
After that incident, Christy didn’t feel safe leaving her mother alone in the hospital anymore. "Think about that: It’s not safe to leave a loved one in the hospital," she says. "It’s a shocking reality."
From now on, whenever Amy goes to the hospital, Christy moves in too. Christy spends her days there, eats her meals there, and sleeps in an upright chair — or a recliner, if she’s lucky.
Christy is always grateful when her mother is released and they can go back home, even though she has to sleep on the sofa instead of in her room so she can be close to her mother at night. Unable to do much work, Christy is virtually penniless, and she has lost a lot of friends because of the time-consuming work of caring for someone who cannot eat, walk, or feed, clothe or bathe herself. "It’s a sacrifice," Christy says. But keeping her mother as healthy as possible is well worth the effort.
* A pseudonym has been used to protect Christy’s mother’s privacy.