The Hospital Visit Scale

Dear Readers:

Because of my many  trips to the hospital to visit family member or other loved ones,  I started to think about my variety of stress levels I experienced upon making an entry  or upon departing the hospital. One (1 ) being least stressful of visits, five (5) being most. My perspective is from being the primary caregiver of the hospitalized patient. General visitors are likely to be less stressed, except when they have first time entry into specialized units such as Burn Centers, Cancer Units, Pediatric NIC units.

 

I created The Hospital Visit Scale by Terry Prince 2016© to help visualize this.

 

hospital-visit-scale-v1

 

 

I am calling myself a Covert Hidden Hero. Covert because end stage caretakers of military disabled veterans are not necessarily the ones at the onset of a military disability.  From 2002 to 2013,  I served as my father’s primary caregiver. My father was a WWII veteran who lost his leg at age 20  (as well as hearing ability in one ear) in military service in 1944 from a V2Rocket while in Belgium.  He was British and in the RAF and deemed 80 percent disabled but was able to live a full life (marrying, pursuing a career in aerospace engineering, having 3 children, sailing and motorcycling). However in his late 70’s  his medical care became much more complex when his meniscus in his only “real” leg tore and he had to have surgery. In his later years he had stage 4 kidney disease with dialysis for 2 years (likely caused by high use of over- the- counter pain medication for his osteoarthritis in his remaining leg and normal use of prescription medicine when he had phantom pains in his missing leg), neuropathy, steroid induced type II diabetes and heart issues. My father in his last 4 years of life had an annual average of 2 major hospital visits (all exceeding 1 week), with follow on transitional care in rehabilitation facilities and follow on skilled nursing either in home or in a facility.  He had at least 12 doctors or specialist services  (primary PPO Doctor, Cardiologist, Neurologist, Nephrologist(kidney)  Pulmonary, Orthopedist, eye doctor, audiologist, dermatologist, US Veteran System Primary Doctor, Sleep Apnea Specialist, Wound Care Clinician, Anticoagulation Clinic)  as well as many revolving hospitalists each time he was hospitalized.  

Having experienced hospitalization exceeding 10 months of a loved one in many ways, in many different times and hospital settings, I feel confident that this scale reflects most of the instances of hospitalization. But I am open to suggestions, any thoughts out there?

 

 

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Cleaning Distinctions – Let’s Make Them!

One of the difficulties we face as we age is seeing and smelling the dust, dirt and general debris. Sensory decline in older adults increases clutter potential. 

Make a distinction between light housekeeping and general housekeeping and deep cleaning services. Make a push for twice a year deep cleaning to your older or physically challenged clients.

For someone who is aging, especially those who are unfamiliar with housekeeping services, they may think “light housekeeping’ is good enough. But it really isn’t.  Light housekeeping services which are often provided as part of in- home care provider contracts, are just that. Light! Contracted Caregivers don’t seek to do more than is in their required contract. They may in fact be discouraged due to liability limits to do more.

Deep cleaning which involves lifting or moving the heavy furniture (to vacuum the carpet or floor below), dusting the heating or air vents and baseboards, is a household chore that needs to be done at least semi- annually.

Another area to observe for deep cleaning is the computer desk and  television corner. Older PC’s and TV monitors are notorious dust bunny attractors. Fans and air vent areas need to be checked and cleaned for dust build up.

Cleaning out the refrigerator is also a deep cleaning chore. In fact this is not an easy service to find help for. Deep cleaning a refrigerator can take an hours worth of time.  Light housecleaning services do not offer or desire to provide this helpful service.  Often this is because they don’t want to get into a battle with the homeowner about good food and bad. Reaching into the back or bottom of a refrigerator is not an easy job. Many refrigerators have various parts that need removal for deep cleaning and putting them back together is often a puzzle.

In-home servce intake providers (often LCSW) or professional organizers need to start serving as educators. At the onset of client work state firmly that a household will need to get some additional cleaning services in order to keep the house clean and safe, not only for the client but for the contracted caregivers.

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Clutter is the Cholesterol of the Home

I ran across this interesting metaphor for clutter – Clutter is the Cholesterol of the Home (1) . After searching the web I came across earlier usage of this metaphor by Maria Cilley – The Fly Lady in her 2002 book Sink Reflections.  On page 25 she states Clutter is to our home as Cholesterol is to our arteries.

Her points in the book:

  • Clutter invades the pathways of our homes
  • Clutter causes stress in your life
  • Clutter decreases joy in living
  • Clutter pushes money away from you
  • Clutter destroys closeness in families
  • Clutter is a result in overindulging in stuff
  • Clutter causes hearts to harden

Try using this metaphor with your own home or chronically disorganized clients.

Are there any other metaphors you use to describe clutter?

 

1  LA Times Opinion Article of 2013  by Howard Mansfield titled An American dilemma: Your clutter or your life.

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Home Organizing Notable Authors

Professional Organizers have been tearing up the social media airwaves with their thoughts on the latest book entree into the organizing world. Marie Kondo’s book The Life Changing Magic of Tidying Up is the latest star in a long line of New Concept books.  Concept leaders include Stephanie Winston, Julia Morgenstern, Peter Walsh and now Marie Kondo.

Here is a table to help review the New Concept – Home Focused Organizing Books. Be sure to take note of the lower part of the chart which lists the subset of authors who have sold to specific markets and have also done extremely well.

Home Organizing Notables - Organizers – A Historical Perspective

Tell me what you think. Have I missed anyone in the general audience home organizing category?

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February 9, 2016 · p:55 pm

Traffic Light Thinking

The traffic light is a great metaphor for reviewing where you are in terms of project development and productivity or creativity in general.

Project Development – Are you at a standstill? Have you come to a red light? Full stop?  Are you at a transitional time when you are in caution mode? Are you in the flow with the green light going full speed ahead? Knowing where you are on a project, in terms of the traffic light,  is a helpful tool to  monitoring your activity and progress.

Creativity – Everyone is creative in their own way. You can look at your personal or professional creatively in terms of the traffic light. Are you being creative and flowing, as in being in the green light? Or are you in a cautionary or transitional phase as in yellow. Maybe you are at a stopping point and are at the red light waiting for time or inspiration. Again the secret is to be aware and clear on where you are in terms of the traffic light.

Knowing where you are at the traffic light is a great tool for understanding your productivity and creative status. Green may be good, but too much green may be exhausting and unhealthy.  A long time at yellow may mean you are in a transition and may need to try other things. This could include seek help from others such as a coach or make some required changes. Being in the red may be frustrating, but it can also be the well needed rest. Red can also be the warning sign to make some changes

 

Try using the traffic light metaphor in  measuring or examining some of your projects or activities. Let me know what you think.

 

A shout out to Shannon for getting me thinking about this today.

 

 

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Sensory Decline Increases Clutter

The senses of smell, taste, vision, hearing and touch are taken for granted by many. However,  as one ages,  some sensory decline may occur. I recently gave a presentation in which I discussed sensory decline and it’s effect on clutter and disorganization in relationship to the aging client.

Smell and Taste

  • Doesn’t smell rotting food/trash
  • Doesn’t smell mildew or dirty laundry
  • Unsure if perishable food is “good”

Thirty percent of American’s over the age of 70 have experienced some form of problem with their sense of smell.  Problems with taste, although less common, often appear in older adults.

Vision

  • Doesn’t see expiration dates on products clearly
  • Doesn’t see “spills” around toilet or kitchen sink
  • Mail processing takes longer due to changes in vision
  • Doesn’t see dirt or dust

Approximately one in three adults over age 65 have vision reducing eye disease.

Hearing

  • Doesn’t hear sounds of  invasive pests in attic or basement
  • Doesn’t hear dripping pipe or faucet
  • Doesn’t hear warning beep of household appliance or timers

One third of adults between ages 65 – 75 have some form of hearing loss.

Touch

  • Unsure if item is too hot
  • Hard to pick up small objects or physically sort small objects
  • Increased incidences of  cuts or scratches because client does not initially feel sharp edges, chipped dishware, or broken items on floor

Keeping The Clutter- Hoarding Scale in mind, these issues are especially important to explore when working with aging Level II – Level V residential client homes.

PS – check out my presentation on Seven Types of Residential Households

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The Three Losses in Five Years Syndrome

Over the past 10 years, I have come across a subset of individuals who begin a sudden onset of chronic disorganization. These are individuals who are serving as family caretakers who have experienced at least three significant losses in their life over the span of 5 years. This subset has usually served as primary caretaker for either parent(s), spouse or sibling(s). Many of them also serve as the executor of one or more of these estates. Many of these individuals seem to take about 7 to 12 years after the final loss to come to terms with this in their life.

What I would like to see is a more active approach to treating this, more on the onset prevention than as an after effect treatment.

It would be beneficial to have physicians and their staffs work to identify caretakers who are already at two losses in five years, and encourage them to get additional support through grief counseling, caretaker support group participation and for those financially able, consider the services of a skilled professional organizer. A skilled professional organizer can do wonders to help the “primary caretaker client ” in terms of time management, goal setting, project planning and management. Many professional organizers can help establish bill paying and document management systems to handle the growing paperwork that complex and long-term medical conditions usually entail as well as documents for estates probate. A professional organizer can help the client simplify his or her life and environment as well as serve as a body double for difficult and often procrastinated tasks.

While a professional organizers services are not inexpensive, they are a valuable tool that may help the primary caretaker live a more vibrant and fulfilling life while and after experiencing heavy losses in their life.

The Three Losses in 5 Years are primarily death losses. For some, however, one of those losses can be the loss of a pet, divorce or significant job loss.

I believe more research and education is needed in this area. Let’s hope that this syndrome can be more clearly understood and helpful strategies for success developed and promoted to the general public.

 

This is a best of post

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