Patient Navigator Mediates Complicated Family Situations

Starting the end-of-life conversation.

Nick’s wife had been very ill with an incurable disease for five years. She had begun to ask about end-of life options, especially hospice and palliative care.  Patient Navigator provided Nick and his wife with useful information that they could use to begin a family conversation.  We suggested local palliative care providers.  Once the entire family understood how palliative care could help, and how it differed from hospice, everyone agreed seek it in the hope of providing relief and comfort to Nick’s wife.

Educating on treatment decisions.

Mandy’s mother had failed her second round of cancer chemotherapy.  Mom was 86, severely anemic, had lost most cognitive function and mostly slept.  Mandy sought our assistance to find help in the home as her mother prepared for a third round of chemotherapy.  We suggested to Mandy that she also review her mother’s advance directives to see whether Mom would want to undergo another rigorous treatment in her fragile condition.  It had not occurred to Mandy to question the oncologist or to consider whether to stop treatment and instead investigate the option of hospice care to improve the quality of her mother’s life.  She was grateful that we opened this avenue of decision-making for her and to realize that her mother did not have to undergo more chemotherapy if she didn’t want to.

Debbie’s sister in another state was in trouble.

Debbie contacted Patient Navigator when her desperately ill sister in another state would not participate in planning her own care.  Debbie traveled frequently and could not be on site with her sister.  Patient Navigator stepped in to negotiate a discharge plan with the rehabilitation center.  But most importantly, we helped Debbie to see her own role as her sister’s caregiver in a new light.  Debbie stopped feeling guilty and understood that her sister, ultimately, had to take steps and make decisions – or not –  about her care.  This gave Debbie a new peace of mind.

Help for a young victim of medical error.

When a 4-year old suffered cardiac arrest due to medication errors while hospitalized for another condition, the child’s parents called Patient Navigator for help.  The consequences of this medical error were severe.  Patient Navigator served as facilitator during a difficult meeting with the treating physicians and hospital officials, accompanied the parents as they began malpractice discussions with an attorney, and arranged for brain injury organizations to begin providing services for the child at home.

Out of state adult sons need help dealing with their difficult mother.

Their mother had been diagnosed with an advanced cancer, but none of her children lived nearby.  She was reluctant to accept or admit she needed help, dismissed caregivers who came to see her and was not likely to move closer to one of her children for treatment.  Patient Navigator provided pro bono guidance on dealing with an elderly parent and caregiving options in this type of situation which helped the sons decide on next steps.“Thank you so much for taking the time to speak with me on the phone… I appreciate your advice and kindness.”

Sandi needed urgent help for her distant grandmother.

Sandi’s grandmother, who still lived alone in another state, was found wandering in her hometown and taken to the hospital. Sandi was called to come and take her grandmother home with her. However, her grandmother had advanced Alzheimer’s and Sandi quickly realized she could not provide the intense care and attention that was needed. Moreover, since her grandmother had always been a fiercely private person, Sandi had no information on Grandma’s health, insurance or financial records. The grandmother was furious and uncooperative about being taken away from her home. The family was distraught and confused about what to do next.

Patient Navigator spent hours with the family to sort through and organize boxes of papers to determine which records were relevant. Once her insurance coverage and care requirements were determined, Patient Navigator researched facilities in both Sandi’s state and her grandmother’s home state that could accept a high-need, Medicaid patient immediately. We explained to the family the process to transfer her Medicaid coverage from one state to another. Patient Navigator provided Sandi and her family with help, information and guidance during an exceedingly difficult and stressful time. The family was able to make difficult decisions with more confidence and knowledge.“They guided us every step of the way through the very difficult process of what to do about care for my grandmother. They have a wealth of knowledge and expertise and provided it in a loving, caring way.”

Paula was dying, and her angry family members were not speaking to each other.

Her caretaker uncle asked Patient Navigator to serve as liaison.  Patient Navigator helped mediate the hospital’s conference with the family about removing life support. After Paula passed away, the navigator assisted with funeral arrangements and subsequent administrative matters.

Christine’s rare and debilitating illness forced her to return home to her parents.

Her husband’s work kept him in a different state. Even as her parents tried to help her, Christine struggled to regain her independence. When Christine’s sister found Patient Navigator, the family was desperate for help. We facilitated several family meetings to help relieve tension, assign tasks, and develop and implement action plans to care for Christine. It helped both Christine and her parents to have Patient Navigator involved. As Christine came to trust and rely on her Navigator, care decisions were made more quickly and the situation improved enough for Christine to return to her husband.

Phyllis was trying to deal with her father’s illness and death.

The demands of distant relatives who had not been involved with his care were very stressful to her.   Patient Navigator helped mediate funeral arrangements among family members and served as a buffer during the funeral. This gave Phyllis the peace of mind that she was not alone in coping with one of life’s most difficult situations.

Their mother died of cancer.

Teenagers Paul and Amy were forced to live with their father and new stepmother, whom they did not know well. Patient Navigator spoke to their school counselors and provided the family with a list of counseling resources and bereavement services for teenagers.