Hospitals

Hospitals aren’t exactly our favorite places, but there come times in our lives when they become practically a second home, because we ourselves are patients or have a close family member or friend who needs to be there often.

For the last two or three decades we have seen many changes in hospitals to make them less intimidating and antiseptic, more comfortable, even home-like (or at least hotel-like). The better ones follow international guidelines for accreditation, rating not just competencies and advanced technologies but also quality of care.

Nevertheless, it is still difficult when you find yourself a suki (frequent or regular customer) of hospitals.  And quite often, it is more difficult for the family, friends and caregivers than for the patient.

We all have to prepare for the time or times when we will find ourselves frequently shuttling between home and hospital, or office and hospital. Changing disease patterns largely account for this. Infectious diseases used to be the main killers, taking their toll very quickly with almost no time for patients to even be taken to a hospital. Today, we have much more of chronic diseases—cardiovascular, metabolic (for example, diabetes)—and cancers, which mean many prolonged battles, some of which are fought in hospitals.

Changing demographics also account for more hospitalization. As life expectancy rises, we will see more of the degenerative diseases associated with aging, again with more hospitalization.

Sandwich generation

I belong to the sandwich generation, having to care for elderly parents and young children. I’ve described going through two open-heart surgeries for a daughter. That was difficult, but I’ve been in hospitals more frequently for my mother, with less serious but still precarious ailments.

Just last week I was heading out to a university workshop in Subic when I received a text message from her midwife-caregiver, “Please call, urgent.” It was a replay of what we went through just last December, when my mother began to resist eating. She was hospitalized in December and began to eat again. This time around, it was more difficult for me because I was out of town. I thought several times about returning to Manila early, but updates from our very capable caregiver assured me she was doing fine.

I am also lucky in having a mother who, even when she had a serious stroke in 2010, actually told me after she was settled in the hospital, “Go back to the university. You have to teach. I’m OK.”

Teach I did that time, and last week I did the workshop and inspected construction sites for our university in Subic and Clark, returning to Manila to find her back in shape, talkative and eating. I brought her home Sunday, but the next day her physician called and said there were some lab findings requiring her to be readmitted. So here I am again, working and checking my phone for updates, planning hospital visits for the evening and early morning, and visiting my father in between to assure him.

People ask how I manage, and I thought I’d share some tips, like I did the last time when my daughter had surgery.  It’s always easy to tell people to pray when there’s much more that you need to do. The bottom line is that if we want to be effective in our care for the patient, we have to be strong, physically and mentally, and to be prepared for all kinds of new needs and unexpected outcomes.

Here then are tips for hospital survival.

First, keep busy. If you have someone as understanding as my mother, and a good caregiver, that means going to work. But even if you can’t do that—and I do make time to be with my mother after work—idle time can become a trap. The saying about idleness being the devil’s workshop isn’t just about lust; it’s really more of fears and anxieties and all kinds of irrational emotions springing up in your mind if you’re doing nothing but sitting and watching the patient.

Read. Listen to music (privately, of course). TV I find annoying but others find some comfort there. Sometimes, too, especially when driving, I find more solace in silence (don’t listen to the news with all the gruesome reports). With certain types of music, sometimes you end up more restless. To each his own.

By all means, don’t overeat. It makes you sluggish, and may even invite another medical emergency.

Make sure the financial angle is addressed. With the poor, so much time is spent looking for the needed money. But even with middle-income and rich people, hospital expenses can be formidable, and you need to be sure about your bank balances and PhilHealth and HMO (health maintenance organization) coverage. PhilHealth has all kinds of requirements that you might have overlooked, so do check with the hospital on what’s required.

Second, and this will surprise you, walk (a lot). It can be up and down the corridor, or out in the gardens (many Philippine hospitals don’t have them, sadly). I like walking up and down the stairs, especially the hidden ones that few people take. It’s also very good exercise, a form of aerobics that gets your body releasing endorphins and other “feel-good” chemicals.

Walking has also been shown to be good for mental breakthroughs as you get new insights to old problems, or just new ideas… for a column, or for keeping the patient entertained.

Reconfigure

Third, learn to reconfigure your cognitive pathways. Or more simply: Reimagine the hospital. Don’t think of it as a place of illness (or worse). Think of it as a place where people get well, from medicines and technologies, but most importantly, from people who care.

I always try to get rooms with a good view of the outdoors for my family, but there have been times when my mother ended up in a room without a view, once even without a window. It hasn’t mattered for my mother because she’s unable to see very well, but I remember getting very depressed.  Then one day I realized that from a corner of the room, I could see dried leaves on the roof of one of the hospital wings, and there was a certain calm about it all, with a different color to the leaves depending on the time of the day.

But no need to get all New Age-y about this. Just find comfort in whatever you see.

Which takes me to the last tip: Touch, hold, hug (oh, no, I just got all New Age-y again). We tend to avoid touching our patients, partly because we think they’re fragile, or we might give them a new infection (or get an infection ourselves!). Touching does wonders for both the patient and the carer. You can continue reading or listening to your private music but having some kind of contact does both the patient and the carer a lot of good.

I always start with just touching and letting the patient signal if he/she wants you to hold their hand or to tighten your grasp. It is more difficult with male relatives, but you’d be surprised at how much they need touching and holding, too. And, as women do, they will sometimes signal that they do need some hugging.

Silent hugging works better than saying all kinds of cheesy “I care for you” or “God loves you” stuff. Just listen to each other’s emotions. From a medical viewpoint, you might actually sense that something’s wrong with the patient’s breathing, as has happened with me.

Hospitals… They’re places for catching up with hugging, which is a way of saying thanks for all you’ve done, whether patient or carer. Thank you, too, for this hospital, thank you for all the good doctors and nurses and caregivers. Life can be good, life is good, in this hospital.

(E-mail: mtan@inquirer.com.ph)