11/08/2006

Lessons Learned

Attorney writes caregiver manual from own experience

BY AL PARKER
Special to the Record-Eagle

Record-Eagle/Douglas Tesner
Jeanne Hannah, a resident of Old Mission Peninsula and attorney, recently published the book "Taking Charge," which offers information on how to help elderly family members receive proper care.

Don't miss Jeanne Hannah's new blog about senior care at blogs.record-eagle.com

OLD MISSION — In the fall of 2000, Jeanne Hannah was enjoying a thriving career as a family attorney when she was suddenly thrust into the unfamiliar role of a long-distance caregiver for her 84-year-old mother, who lived downstate.

"My bright, active and independent mother became ill with a urinary tract infection," said the Old Mission resident. "This was correctly diagnosed at the emergency room of a downstate hospital.

"What was not diagnosed was the delirium that was caused by this infection, even though disease-induced delirium is common in the elderly."

Her mother's symptoms led to a psychiatric hospitalization and the use of drugs that can be dangerous to the elderly. Complications were triggered by drug interactions that were misinterpreted by health care providers who attributed them to Parkinson's disease.

Despite the best efforts of Hannah and her sisters, their mother's condition worsened dramatically and she died 65 days later.

"I woke up crying every morning for four months," said Hannah. "I was devastated."

Hannah subsequently learned that her mother's death was linked to several developing complications that commonly affect the elderly, whether they live in their own home, with a caregiver, or in a long-term care facility.

"My mother's last days were horrible and her death was very traumatic for me, primarily because I felt so responsible," remembered Hannah. "After all, I'd made the choices — or participated with my sisters in making choices — that had led to her death. I set about to figure out exactly why she had died."

As an attorney, she was used to doing research. As a caregiver she felt compelled to share the information she found about six common and often fatal conditions that threaten the elderly. They include delirium, medication errors, adverse drug reactions, dehydration, malnutrition and falls.

Those conditions are detailed in a caregiver's manual that Hannah wrote based on her mother's experience. In an easy-to-read format, it's titled "Taking Charge: Good Medical Care for the Elderly and How to Get It."

"This was a labor of love. I wanted to put a human face on these issues," said Hannah. "What I now know could have saved my mom's life and may save the life of your loved one.

"I now know that the primary caregiver is the person most likely to know when a loved one needs medical attention. I thought mom's doctors and nurses were monitoring her care. I was shocked when my research revealed that a person living in a nursing home may see a physician once a month for five to 15 minutes."

Some of the book's major messages are:

• Family caregivers do not need medical training to be effective members of the caregiving team.

• Most medical caregivers have little or no training in geriatrics, making misdiagnosis a serious danger.

• The elderly are most at risk to suffer medication errors, adverse drug reactions, delirium, dehydration, malnutrition, and to fall because of age-related problems.

• Family caregivers are able to detect subtle changes in the status of their loved ones and should advocate for an accurate diagnosis and proper treatment.

• Family caregivers are in a good position to work with medical caregivers to prevent complications.

• Family caregivers can protect their loved ones and themselves by utilizing clearly written, legal documents that will make their decisions about end-of-life care enforceable.

"This book enables me to give confidence to the elderly and to their caregivers," said Hannah. "I want them to know that you don't need a medical degree to be effective. The caregiver spends more time with their loved one than anyone."

Hannah, who earned her B.A. in English Literature from the University of Michigan and graduated magna cum laude from Detroit College of Law, turned to the medical community for help with her book. Dr. Joseph H. Friedman penned the opening chapter on "Why the Elderly Can't Get Good Medical Care."

She also relied on pharmaceutical input from Dr. Mark Beers, author of "The Merck Manual of Diagnosis and Therapy." Also vital was Dr. Wendy Harpham, MD, FACP, author of "Happiness in a Storm: Facing Illness and Embracing Life as a Healthy Survivor." For more information about Hannah and her book, go to www.goodmedicalcare.com or see her new Record-Eagle blog at http://blogs.record-eagle.com/