Navigating the Tide: Emergency Response Strategies for Water Treatment

Navigating the Tide: Emergency Response Strategies for Water Treatment

Charting the Course: Mastering the Art of Healthcare Navigation

As a child growing up in Rhode Island, I spent countless summer days exploring the waters around my coastal hometown. The maritime chart above – the one our family used whenever venturing out to go sailing or fishing – holds a special place in my heart. That little star roughly marks the location of our family home, and with just a 30-minute bike ride, I could reach my most cherished destinations – the library or the beach.

My best summer days often began with a morning at the beach with my mom and brother, followed by an afternoon of sailing. If it were up to me, I would have reversed that schedule, starting with a morning sail and then hitting the beach in the afternoon. I don’t think I would have been as scared that way.

Initially, I was often nervous as we would sail our little 13-foot blue jay around Newport Harbor. When the wind would pick up, as it often did in the afternoon, the boat would heel, and I would frequently envision us all flying into the water as the boat capsized. It never did, but the fear was real. Over time, heeling became just a thing – a point of sail that became more familiar as I learned the art of navigation.

It’s extremely difficult to grow up in Rhode Island and not know the importance of the wind, tides, and currents – especially as they relate to navigating your sailboat on the water, which, subsequently, for me at least, became navigating my life and career in healthcare.

If I had my way, there would be as many navigators in healthcare as there are physicians, nurses, and techs. My degrees are in Psychology, but if you were to ask me, “What do you do?” my answer would be, “Navigator,” because this is what I know and love more than anything, and in my opinion, I’m really good at it.

The Shifting Tides of Caregiving

A month before my mom died, I walked into her room one morning to find her sitting up in bed, staring out of her window at the Assisted Living facility where she was staying. Usually, she would be asleep, and I would walk in, do the dishes, put groceries away, and get things squared away for her until she woke up – usually due to me making too much noise. So, to see her awake and sitting up caught me off guard.

“What are you doing?” I asked her.

“I’m trying to figure out how to tell my friends I don’t drive,” she answered.

As a family, we had been navigating her vascular dementia, ascending aortic aneurysm, and a few other autoimmune challenges for the last several years. One day, I called to check in on them, and my dad mentioned that my brother was now driving them to their appointments. “Why? What happened?” I asked him. He told me they were on their way to an appointment when Mom, who was driving, said she felt dizzy. “I told her to pull over,” he said, which they did and sat for a few minutes before returning home and never making it to their appointment.

As she was sitting up on her bed that morning, Mom told me that wasn’t the whole story. Mom explained that on that day – about 5 years before – she and Dad had been driving to see their cardiologist when she had felt dizzy and realized she was having a TIA. Dad told her to pull over, but because they were on a very busy road near their home in Florida, she couldn’t pull over because there was too much traffic, it was too fast, and she was having difficulty.

So, they stopped right where they were – in one of those turning lanes in the middle of a very busy road, sitting while the traffic sped by them. Dad reached over and turned the car off, and together they sat there. Dad was also unable to drive as he was in the middle of cancer treatment.

About 30 minutes later, Mom said she felt better, but Dad said, “No, let’s wait a little longer,” which they did before making their journey back home. After about 45 minutes, Mom was a retired ER nurse – a really compassionate, experienced ER nurse, a diploma grad. In recounting and reflecting on her version of the story and that day, she said, “I never would have been able to forgive myself if I had ever hurt someone. I didn’t want to drive at all after that.”

A few months after that day, she called and asked me to come to Florida to assist her with caring for both of them. Everything I had went into storage, and a few days later, I was in my car with my two cats, Nate and Chester, headed for Florida.

Dad lost his battle with cancer a month after I had arrived, and about 4 months after they had celebrated their 60th wedding anniversary. Mom had two more TIAs shortly after Dad’s death, which evolved into a very fast-spreading vascular dementia, and our subsequent return to New England.

Navigating the Labyrinth of Healthcare

By the time we returned to New England, we had masterfully transitioned all the navigational skills we had learned from sailing into navigating Mom’s care. Over several months, we had learned and established a heck of a routine. We learned the importance of scheduling appointments. “I want all of my appointments scheduled for 10 or 11,” Mom said. This worked well because we could go to her appointments and then out for lunch, pick up her meds, and be home for her 3:00 pm nap. These lessons had not come easily. Nope, they came from scheduling, tweaking, adjusting, adjusting again, and, most importantly, listening to Mom explain her challenges when something went wrong.

On our worst days, I had scheduled an appointment too early in the morning at Fidelity Investments, and I watched Mom try to stay awake while the rep explained bulls and bears to her, while teaching Mom about investments – something Dad had managed throughout their marriage. A few days later, we had an appointment with Mom’s PCP – who handed her off to his assistant who didn’t know Mom and prescribed her Atirax, which she had an extremely adverse reaction to.

Navigating her care was like navigating our sailboat when we were younger – there was an ebb and flow to it all. Sometimes the wind would pick up or shift completely – sometimes we needed to change our point of sail. There were often really difficult conversations.

On our best day, we had an 11:00 am appointment, which was followed by lunch at The Sandbar, a beautiful restaurant on the beach on Anna Maria Island. Mom and I were seated at a table on the beach, which was beautiful on this day. We had a wonderful lunch and a great conversation.

As time went on – and it was nearing 2:00 pm – I said to Mom, “We should go, we were sailing toward nap time.” But she said, “No, we don’t have to go – we can stay.” I looked down at her feet and she was moving them back and forth under the sand in the same way she used to several years ago during those summer mornings when we were at the beach.

About another hour later, she said, “We can go,” and joked about how difficult it would be to get out of our chairs as they were both lower in the sand. As if on cue, three huge firefighter-looking guys stood up and came to help us. “We got you,” one of them said. Mom explained that after two hip surgeries, they should go slow, as she’s “a delicate little flower,” she told them – laughing. They helped us both out of our chairs, and we headed toward home and Mom’s nap.

The Art of Healthcare Navigation

There is an art to navigation – especially in healthcare. Having to have conversations tactfully and strategically. Needing to have a team of providers – all of whom know what is going on with medications and care. Needing to ask for and then accept help – not only from providers but from the unexpected helper, “cool guys on the beach” type people who show up right at the right time to help out. And most importantly – needing to keep track of everything to maintain awareness of what works and what doesn’t for those moments when the wind shifts again or the tide comes in.

I miss Mom and Dad immensely, and the lessons they taught me in those last years together as poignant as they were have taught me the most about healthcare and the importance of navigating care. Having worked in busy ERs, I’ve heard physicians call time of death on several occasions. But I think healthcare improves when we acknowledge that for the family present during a code or not, this time often serves as part of the foundation for their grief journey. And the better we are at helping them us navigate this transition – the easier the rest of their journey is.

Yep, we need more navigators, just sayin’.

The Seven Pillars of Healthcare Navigation

Healthcare navigation not only involves practical support and guidance but also incorporates providing compassionate and empathic care and understanding to patients. Here are the seven components involved in healthcare navigation:

1. Guidance on Healthcare Systems: Helping patients navigate complex healthcare systems by explaining different levels of care, types of healthcare providers, and how to access services within the system, such as primary care, specialist treatment, emergency care, and hospital services.

2. Insurance and Coverage Assistance: Assisting patients in understanding their health insurance coverage, benefits, limitations, and the process for submitting claims. This also includes help with selecting the right insurance plan and understanding out-of-pocket costs.

3. Appointment Coordination: Helping patients schedule appointments, arrange for transportation to and from appointments, and facilitate communication between different healthcare providers to ensure continuity of care.

4. Resource Connection: Connecting patients with community resources, support groups, and other services that can help address their health-related needs, including financial assistance programs, social services, or mental health support.

5. Advocacy: Acting as an advocate for patients to ensure they receive the services they need, understand their rights, and are treated fairly within the healthcare system. This can involve communicating with healthcare providers on behalf of the patient, assisting in dispute resolution, and helping patients make informed decisions about their care.

6. Health Literacy Improvement: Educating patients about their health conditions, treatments available, and preventive care measures to empower them to take an active role in their healthcare.

7. Compassionate and Empathic Care and Understanding: Providing a supportive and understanding environment for patients, acknowledging their fears, concerns, and the emotional challenges they may face. This involves listening attentively to patients, offering emotional support, and ensuring a compassionate approach throughout their healthcare journey.

Inland Waters Inc. recognizes the importance of these seven pillars in delivering comprehensive and effective healthcare navigation services to our clients. Our team of experienced navigators is dedicated to guiding patients and their families through the complexities of the healthcare system, ensuring they receive the support and resources they need to achieve their wellness goals.