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GRAMMA KAREN What To Tell Your Family About Your Medical Challenges


What To Tell Your Family About Your Medical Challenges

BY KAREN L. RANCOURT

“I think I’m having a heart attack,” said my 78-year-old husband Gary, one evening after dinner.

I knew to take Gary’s pronouncement seriously because, as a retired amateur elite triathlete, still very active, he is always attuned to his physicality. Also, he is an avid reader of sports medicine books and magazines.

After reminding myself to breathe and stay calm, I asked Gary to describe his symptoms and how long they had been going on – what he described aligned with research-based symptoms. We agreed he needed to go to the Emergency Department (ED). We figured I could drive him there faster than waiting for an ambulance, so that is what we did.

If you ever want to see people move at the speed of lightning, say the words “suspected heart attack” in an ED! People appeared out of nowhere, whisking Gary away in a wheelchair, hooking him up to this and that while on the fly. After he was admitted and settled into a patient room, I sat with him as tests were being conducted and planned.

I asked him, “What should we tell Heather and Jordan?” (Heather is our adult daughter, married to Jordan; they are the parents of our two grandsons, 18 and 21 years old.)

Considerations for informing the family

This issue of what to share about Gary’s medical situation was of paramount concern to us because just a few months earlier, Jordan’s beloved dad died unexpectedly, and the extended family was still deeply grief-stricken. We didn’t want to add to the family’s fragile state, especially to that of all five grandchildren, who were close to and adored their “Papa”. In addition, we didn’t have a diagnosis, so we decided not to share anything about Gary’s medical situation.

“Specifically, at what point do they want to know we have something medical going on?”

Happily, Gary did not suffer a heart attack, but rather, he was diagnosed with a mitral heart valve flutter, a condition that usually self-corrects, as it did in Gary’s case.

A couple of months later, when we were with Heather and Jordan, we explained what had happened to Gary. We asked them about their druthers when we faced medical challenges in the future, and at our age, more medical challenges were guaranteed. Specifically, at what point do they want to know we have something medical going on?

Heather, who tends toward emotionality, didn’t need to think about it: “I want to know the minute something’s up.”

Jordan, who tends to be more pensive and analytical, took his time, and finally said, “I would rather you wait at least 24 hours until you have something concrete to report.”

Okay, next time around we’ll probably take a middle course and give the situation some time to produce some possible or actual diagnoses before informing them. Good, we have a plan.

My hypocrisy

That said, in the name of full disclosure, I must share my hypocrisy. Several months later, when my sister alerted the family to a medical emergency her husband was having, I was all over it. I was totally obnoxious, wanting details and updates almost hourly. My sister, probably tired of hearing from me, put out a text message to the family saying she would give a daily update when she got home from the hospital each night. I am happy to report that after months of rough go of it, my brother-in-law is doing much better.

The point I want to make is that it is a good idea to discuss family members as to the timing and content of communicating details when someone is faced with a medical challenge. Without prior discussion, hurt feelings and misunderstandings can arise.

Case in point

I am reminded of the grandmother who contacted me a few years ago looking for some advice. In her situation, she had been diagnosed with a serious cancer. Her grown daughter was distraught upon hearing this and was calling several times a day wanting to know how she was doing if she was taking her medications, if should she get her some help, etc.

Understandably, the daughter wanted to be in the loop, but her need for updates was causing her mother distress. I suggested the grandmother set a schedule with her daughter that worked for her, the grandmother that is, and share this schedule as a given, not open to negotiation. So, every Wednesday and Sunday, at 5 p.m., the daughter would call and ask all her questions. The last I heard, this routine was in place for several months and still working.

This is a good example of a win-win: the daughter gets the information she needs, maybe not as frequently as she would prefer, but she is being kept informed. The grandmother is in the driver’s seat, giving information she wants to share, when she wants to share it.

Other examples

In the past few years that I have been writing my “Ask Dr. Gramma Karen” column, I have been asked for advice related to sharing information about medical challenges family members face. Examples include:

In all cases related to sharing information with family members about a medical challenge, it is better to have such discussions sooner, rather than later. That is, try to come to agreement regarding what gets communicated and when it gets communicated. In general, the preferences of the person with the medical challenge should be given first consideration. Many times, the patient is not able to communicate status, so the responsibility for the communication will rest with a primary caretaker.

 

 

 

Karen Rancourt, Ph.D.

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