Tip #320, Keeping a Journal Part A: Communicating New Developments

     Write it down. All of it. Always. That's one of the biggest things I can tell you, no matter what stage of recovery (or caregiving) you are in. Write it all down. It's too hard to keep track of all you need to know without writing it down. And, even better, if possible write it all down with some semblance of order so it's actually helpful to you. You won't regret it, I promise you that. Why do you need to keep a journal? Well, that's a bit of a loaded question, so I'll divide my answer into a few parts:

Part A: Communicating Progress and New Developments

Part B: Recording Recovery Milestones 

Part C: Getting a Complete Diagnosis

Part D: A Call for Order

Communicating Progress and New Developments

If you're recovering at home after a hospital stay you may still have a team of professionals assisting in your care, even if the team is composed of different people than when you were in the hospital. If you want to maximize your recovery (or that of a loved one):

1) It's important to inform team members about new developments/recommendations from other team 

     members. For instance:

• The physiotherapist will be interested to know that the occupational therapist has ordered a shower stool and railing. The physiotherapist can help get you prepared to actually use those items while you are waiting for them to arrive, and help smooth your transition to using them once they do arrive.
• The family doctor will want to know that the physiotherapist thinks you need to see an orthopaedic surgeon, neurologist, or other specialist, since it's the doctor that makes the referral. Then, the physiotherapist will want to know if the family doctor agreed and completed that task or if they decided to proceed another way.
• The nurses that care for you in your home will want to know if the physician has changed one of your medications, or has diagnosed you with something new, or is recommending that you see a particular specialist etc.

2) Individual team members will ask you about your progress with respect to their particular discipline. 

     For instance: 

• The nurses always want to know things like: when was your last bowel movement? any fevers? What has your pain been in the last few days/week? appetite? rate of feed pump/IV? etc.
• The speech and language pathologist may want to know things like: (especially for swallowing difficulties) have you tried eating? drinking? What did you have? How did it feel? (or after a stroke) have you been practicing speaking, practicing your sounds? words?
• The physiotherapist may want to know: what's the pain been like? How long have you sat up each day? walked each day? how far? etc.
• The dietician may want to know your candy intake for the last 2 weeks, what your weight has been each week for 4 weeks, etc.

I know that these examples may not fit your situation exactly, but I think you get the gist. I also know that to some it might be an insult to suggest that you are not aware enough to recall when your last bowel movement was, for example. I am not doubting your intelligence nor am I questioning your memory, but I offer this instead:

• If you are ill enough to need to recover at home, you should conserve the energy you would otherwise expend trying to keep all of the info sorted in your head. Use that extra energy for spending time with loved ones, and actually peacefully recovering.
• Many medications make it difficult to concentrate and/or affect memory even if you are focused in the moment.
• Even when you are well, it is very hard to keep all of the information straight, because, most times, it really is a boatload of information to remember.
• Sometimes ordinary things don't register as important in the grand scheme of things and thus are hard to track. Truly, every community care nurse will, for example, ask you when your last bowel movement was. If you are constipated for 6 days the nurse's response will be different than if you answer 8 days or 16 days.

Well, I think that's it for now. Stay tuned for the next 3 parts of this discussion. Part B will suggest what info you might want to keep specifically for your own records, and why you would want to do this. 

Have a great day!