Tis The Season for General Weakness

As I have said in the past, we go through seasons in the emergency department. By that, I mean that certain diagnoses seem to come into our ED more often at certain times of the year than others. This is my first fall/winter season in the ED, and I'll be honest about being a little more than scared about it. I have heard horror stories of wall to wall patients and ridiculously busy days as flu season gears up full-speed ahead.

We have had a little bit of a cold snap in North Florida this past week, and let me tell you... it has brought in a lot more "general weakness" chief complaints than what we normally see.

I decided to take this time to do a little bit of thinking about why that is and I asked a few of my patient's family members to see what their thoughts are.

So far my top answers thus far have been:
1) The weather
2 ) The holidays
3) Insurance reasons
4) Busy family members

I decided to break down those three reasons a little bit better, and I hope that this breakdown will improve your interview questions and may make you think about your own family members.

1) The Weather: the two major answers I got for this were more trip and falls because of increased joint stiffness from the constant weather fluctuations. At least when its blazing hot, your joints stay pretty warm and lose. The other reason I got was increased shortness of breath due to increased dryness in the air. There definitely is much less humidity in the air right now, and I am sure that can affect people with very sensitive respiratory systems.

2) The Holidays: Its not even November yet, and people have been reporting that they are beginning to feel the stress and burden of the holiday season. Enough stress will almost always result in exacerbation of physical ailments and co-morbidities. Furthermore, it can serve as a lonely family member's way of getting some much needed attention from their loved ones.

3) Insurance Reasons: It seems, for whatever reason, that this time of year is known for more services being dropped than other times of the year. More research on my part is needed, but my best guess is that it must have something to do with open enrollment and insurance companies reviewing patient statuses. I had one patient this week say that her insurance decided to stop covering the oxygen deliveries that she has been receiving for two years now for her COPD. She was able to tolerate being at home for 3 days and then had to come to the ED for an extreme COPD exacerbation. Because of insurance reasons.

4) Busy Family Members: This is sort of a secondary cause rather than a primary cause of worsening general weakness. This is a time when the caregivers of family members  tend to be much busier than usual with holidays, kids, work, church, you name it. That can result in two different things: 1) family members feel lonely and needy, resulting in increased phone calls and requests for attention. But more commonly is number 2) family members tend to slip and fall more often because their caregivers are a little busier than usual and cannot spend as much time looking after them and checking in on them as usual. Mix this with number 1 where joints are stiffer than usual and you have the perfect storm for a broken hip, or worse.

So, what do we do with all of this information?

1) If you are the nurse: hopefully you have gained a little bit more perspective from this post and will have better questions to ask these patients as it may be time to consider some further steps such as home health, rehab, or assisted living facilities. Also, I hope it has helped you gain an additional dose of sympathy for these people. You know exactly who I'm talking about. They are oftentimes our frequent flyers that don't always smell so pretty and aren't always very friendly. But they need our love just as much as anybody else, if not more. Be kind to them, sometimes there is no one else around to be kind to them.

2) If you are the family member: make sure you check on your loved ones. And maybe even consider having an Amazon Echo or some other time of camera/voice device installed, you could even go old school and get a Life Alert necklace. One nice thing about these devices, is that your loved one can get help for themselves from just about anywhere in the house, even if they are not by a phone. Additionally, if you have a camera-type device, you can check in on them if they aren't answering your phone calls. If you are a family member that lives a few states away and it is very difficult for you to get to your loved one, maybe consider hiring someone to go check on them a few times each week, such as a companion caregiver. In the long run, that is a much better option that leaving them to fend for themselves and risk getting hurt.

Thanks for hanging out with me and I hope this brought to life some points for you! Happy Holiday Season! And always remember to love on your patients as if they were your family, they are someone's loved one.

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