Cath Lab Digest

  You think you’ve trained them right. You do everything you can to make them confidently independent yet cared for. You admonish them about the dangers of the world — that money should be discreetly handled, that they need to be wary of strangers. Then one night, you get a phone call in which you are exuberantly told how he got lost and a young man offered directions by getting in the car and showing him because it “was on his way anyway.” My husband has said it a million times: It’s not easy raising parents.

  I write this because OWM is on a mission to start collecting and sharing checklists — ie, organized approaches to segments of care. Checklists pare a process down to its basic components, serving as subtle, succinct, logical reminders of if-then methods. Do this. Don’t do that. Checklists can be mnemonics (A-B-C: airway, breathing, circulation) or flowcharts or algorithms. Their simplicity sometimes insults the intelligence of experienced caregivers. These professionals obviously never had to pack for vacation or plan a holiday dinner.

  But it is not the caregiver that elicits my concern. It is the care receiver, the one who smiles and nods and pretends to be with the program and then doesn’t follow the stepwise plan because he/she doesn’t understand or want to stay in sequence or because…. because…. because. A checklist can only work if each item on the list is actually checked.

  Today my plea is to instill the lesson to not let the “because” be for lack of convenience. My father, he of the stranger in the car incident, could not see why his 87-year-old older brother, his 50-something daughter, and his 30-something granddaughter (among the many he told) saw no humor in the fact that he invited a potential criminal into his car. Plus, although nothing unfortunate occurred, the poor stranger, who in reality didn’t know how to get to my dad’s destination, wound up going to a funeral (in a T-shirt and jeans) and the after luncheon before he was deposited at the bus stop from which my dad had picked him up. The saner members of the family couldn’t get past all the “what if’s” of, You let a stranger get into your car? My dad thought having someone in the car directing him would be more convenient. Safety flew right out the open window along with every other item on my list of cautions because he was tempted with a shortcut.

  So, when you offer checklists and advice, especially to your elder, know-it-all patients, please make sure that they are listening and get why caution out-trumps convenience.