Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (2)

Caring Bridge: Using The Internet To Monitor Your Loved One’s Health/Hospital Status

When Beth found out that her husband had cancer, a friend suggested that she look into creating a page on CaringBridge.org.  As she puts it, “CaringBridge became a tool to help us communicate with others.”

I spoke with Sona Mehring last week, who is the owner of CaringBridge.  The site started as a simple webpage for a friend of Sona’s who was going through a difficult pregnancy.  Sona and her friends used the site to keep friends and family informed of updates, keeping everyone in the loop without having to make several phone calls each day.

Thus, CaringBridge was born.  Anyone with an illness or those who are taking care of someone with an illness can create their own webpage through the site to keep friends and family informed of the patient’s progress.   It’s free, there are no ads, and Beth states, “I appreciate its ease of use. It is an intuitive interface, so it didn’t take much time at all to set up and use. I’ve never been frustrated using it!”

Sona pointed out that using the site is beneficial to 3 different groups of people.  The patient stays connected to family and friends through updates.  Those who get updates can then sign a guestbook with questions or words of encouragement.

The patient’s main caregiver can also benefit from messages of support.  Being a primary caregiver can become very isolating as they become more and more involved with the patient’s day to day care – traveling to appointments, trying to procure test results or helping out in the hospital.  The caregiver might also find comfort in being able to journal their feelings on the site.

And the site can aid the community’s ability to rally around the patient and caregiver.  Sona mentioned a study showing that contact with family and friends can decrease significantly when someone is diagnosed with a major illness.  One of the biggest reasons was that the patient’s community did not want to “bother” the patient or caregiver.  This concept was not lost on Beth, who said, “I sense that some are eager to keep in the know, but do not want to feel like they are bothering me.”

CaringBridge not only connects patients with community; it also connects patients with other patients.  Sona explained that patients and families often meet others going through the same thing in waiting rooms or treatment rooms and swap CaringBridge websites, thereby forming a support group of sorts amongst themselves.

Sona says that people come to use the site mainly through word of mouth from current and previous users.  Hospital employees also refer patients and families, and CaringBridge is active in trade conferences as well.

Personally, as a nurse, I think this site is a fantastic idea.  I certainly have days at work when I’m getting call after call inquiring about the status of a patient from different family members.   We always encourage families to designate one person to call the unit for an update and then disseminate that information to everyone else.  Rather than making numerous phone calls, that designee can update the website.  People visiting the site can enter an email address to be updated automatically every time an entry is made.

Beth did say that it’s sometimes difficult to know how to say things: “One of the challenges has been knowing what to share and how to share it, as the information is broadcasted.”  She went to on explain that when both caregiver and patient are contributing to the site, the needs of both need to be taken into account.  One person may have the desire to share a lot of information when the other person might want to show a little more restraint.

The last feature about the site I want to mention is the ability to easily turn a journal/pictures/guestbook into a real book.  Sona mentioned that some of these books are even used at memorial services.

If you’ve been reading codeblog for awhile, you know that I don’t regularly endorse websites.  I find CaringBridge.org to be exceedingly useful to patients and families and wanted to help spread the word.

You can also find them on Twitter and Facebook.

*This blog post was originally published at code blog - tales of a nurse*


You may also like these posts

Read comments »


2 Responses to “Caring Bridge: Using The Internet To Monitor Your Loved One’s Health/Hospital Status”

  1. EILEEN CLEVENGER says:

    so how is everything going with eileen?

  2. At this moment I am going away to do my breakfast, afterward having my breakfast coming yet again to read other news.

Return to article »

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

Read more »

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

Read more »

See all interviews »

Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

***

Click here for a musical take on over-testing.

See all cartoons »

Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

Read more »

See all book reviews »