Monday, March 10, 2014

old and alone

She was fragile and thin, like a lot of old people, somehow managed to stay in her own apartment despite having no children or close relatives. Today would change all that. She tripped and fell, ended up with a fracture that will change her life. She's headed for a nursing home, never going home again.

I know this, even though I only spent a couple of hours with her.  I see her future because I know how this kind of situation goes. I know what happens to old people who don't have anybody.

She was in a lot of pain. She was so old, we walk a tightrope giving her narcotic pain meds.  On the one hand, we want to relieve her pain and on the other hand, we don't want her to stop breathing.  At one point we had to move her around for something and she cried out in pain and it just broke my heart. (yeah I still got one)  Seeing old people in pain sucks.  It just seems like, they have made it this far, they shouldn't have to suffer.  But they do.

Hopefully she will make it out of the hospital. Hospitals are no place for fragile old people.  The risk of complications is high: pneumonia, UTIs, etc.  Getting her out of here quickly would be the best thing.

I wish we didn't warehouse old people. I wish we treated them better.


Mike said...

How lucky she was to have you as her nurse.

Spook, RN said...

Long (but true) story:

I had a 94 year old grandma in my waiting room. Track had just opened up for the day and her CC was arm swelling. Triage didn't think it was broken, more like cellulitis. So I grabbed a wheelchair and walked up to her. She tells me "Whatever for? I'm old not crippled!"
So with her cane and her tiny feet making tiny steps, she walked with me all the way back to track - followed by her amused neighbour whom she'd called for help (because she lived alone).

So I get her in a room and get her on the bed. Take a look at her hand. Swelling. Redness. Some tenderness. Good RoM. I agree with triage but order an x-ray anyway and draw some prelim labs.

She says "You won't have to tell Dr. Smith, will you?" (Good ortho guy. Skills and bedside manners).
Turns out apparently he'd seen her recently for something and told her to be careful around the house as she was getting old and brittle.

I ask her "Why do you think Dr. Smith will be mad?"
"Because I was gardening in the back yard when I fell yesterday. I took aspirin and ice to the hand but the swelling didn't get better and the pain got worse. Oh Dr. Smith is going to be mad now!"
I was amazed! 94 years old and still gardening!

"So you garden as a hobby?"
"Oh no! I garden for food!"
I was confused. "For food?"
"Listen young man, I don't have a lot to go around. Every Social security check I get, I cut 10% and donate it to my church. They run a shelter. So to make up for it, I grow some of my food."

I was speechless.
She continued, "I know Dr. Smith means well. But as long as I can walk and use my limbs and with the Lord with me, I'll take care of myself."

X-ray confirmed no breaks but she had an elevated white count. Cellulitis it was. I gently informed the patient that she would be admitted to the hospital for IV antibiotics.
"Oh no! I can't stay! My son is visiting from Detroit and I have to make dinner!"
I smiled inside - her son HAD to be atleast 70 years old! Mothers will be mothers I suppose.

But more than my amusement for her concern and affection for her son, I was blown away by her resolve. In that hour that I'd known her, this 94 year old widow had shown more courage and character than hundreds of people in my generation. And I asked myself that silent question I'm sure nurses the world over ask themselves whenever they are confronted by extra ordinary patients - "Why can't there be more people like her?"

Anonymous said...

well of course we can't take better care of the elderly we are too busy taking care of (and paying for ) all the drunks, drug addicts and pain seekers that come in on a daily basis.

Sara said...

Thank you for that post.