Sunday, May 31, 2009

These are the stories that linger

Not long ago I saw a patient I'd met months past, an old man with dementia and other severe health issues. I'd seen him a few times before he got better and went to a nursing home, and I loved him. He had not had a very easy life, and I imagine he hadn't always been a very easy man. His family had some conflicts and struggles too. He'd been a stubborn man, and he didn't like asking for help, and he really just wanted to be in his own home, but he needed more care than family members could provide, so he had to live in a nursing home. He came back to the hospital not long ago, his dementia by now very advanced, and his other health problems as well. There had been some sort of accident at the nursing home, a bad one. He had fractures and bruises and cuts, and lots of stitches. I was horrified when I saw his poor battered self resting in a bed. The medical staff had determined they needed to get his pain under control before even doing a full assessment of his condition, so they were waiting for medicine he'd been given to take effect. He was moaning--I got his nurse, who checked him and got more medicine. I sat beside him, trying hard not to cry. So many bruises and bandages and cuts and stitches, no wonder he was hurting so. And his breathing sounded awful. I touched his hand, and he grabbed mine and held it tightly, his face turned slightly toward me. He would doze a bit, awaken coughing, and start wailing, or maybe it was keening, again. I told him we would get him feeling better, but he just kept on keening. On a hunch, I said to him, "We'll keep you safe here. We'll protect you." THAT had an effect--he stopped keening and seemed to settle, only to wake again. I tried the reassurance several times--he always settled to the words, "We'll protect you." He was so frightened. He didn't know where he was, or why, and he was in terrible pain, and I don't know about his accident, perhaps that frightened him as well. Even a healthy old man would have been upset, and this was not a healthy man. A family member came in to be with him. We decided he was chilled, and I went to get him a warm blanket, and told the nurse I thought he was afraid. I told her the words that had calmed him and she wrote them down to use later when she needed to give him more care. Back in the room, I helped tuck the warm blanket around him, very gently so as not to hurt him more. He wasn't afraid of me, it seemed; I could touch his head, his shoulder, his battered face. I murmured more assurance to him, told him we loved him, told him once more we'd protect him. Medicine was starting to work, and he was settling. It was time for me to get out of the way so his family could be with him without interruption. I checked on him a couple times before my shift ended. He had finally been able to rest, but his breathing was even worse. The family had been called back in. Early the following morning, he died.

I couldn't get him out of my mind for days. I will never know what all transpired to bring him back to the hospital. He'd had his accident some days earlier and been taken to an emergency room for care, and apparently he'd been taken back to the nursing home to recover, and then been brought back in. I just hated seeing him so hurt, so vulnerable, so terribly frightened. This is not what he wanted or what his family wanted for him. It isn't what I would want for anyone. It isn't the way we'd want anyone to die.

We don't take the best care of our vulnerable elderly in this country and culture. They're pushed to the side by the younger generations; they aren't making money anymore; they aren't the demographic that even churches want to attract. Those who care for them in nursing homes are not well compensated. And sometimes, our vulnerable elderly end up like this poor man, broken and bruised and terrified, because their medical needs are too great for care at home. Their friends are dead or dying, their political clout is zero, and in most cases only family members are left to care about what has happened to them. They have become anonymous.

So, today, I want to make this man a tiny bit less anonymous. Sure, he was an old man with dementia who could no longer even recognize his family members. When I first met him months ago, his capabilities were already greatly diminished. Nonetheless he was full in personhood to the end. He liked music (big bands, Sinatra). He liked a good meal. He liked company--he liked having his hand held, he liked to laugh. He was a lifelong Baptist who'd been a member of a huge urban church. He liked church music and hymns. He liked the Bible, and he loved to watch religious programming on TV. He liked a kind of religion that was upbeat and gave him hope. He liked the Lord's Prayer. He had a radiant smile and wispy hair that stuck out every which way no matter how often it was combed. He liked being outdoors, watching television, and birds.

Now he is gone, and his suffering has ended. May he rest in perpetual light.


Blogger Brad said...

Well, it sounds as if keeping him alive was both irritating and expensive; best all around that he's dead.

4:38 PM  
Blogger terri c said...

Well, hallelujah, I have got a troll. I must have "arrived" as a blogger.

8:12 PM  

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