Sunday, July 29, 2012

    On Friday I checked my patient census and found that one of my patients had fallen. She had been instructed by the physical therapist and myself to be mindful and to not move around her room without supervision.
     So why did she do that? I don't think it was a case of simply forgetting. Her memory is in fact quite good.
In her case there is a lot of psychological turmoil in her eighty some years. I also questioned her request for a walker in her room. Her body is frail but her mind is not. As I look back at the whole picture and our cautions about being careful and mindful, I see that the request for the walker, was suspect. She has COPD and needs oxygen 24/7. She has told me things about her childhood and how she was a foster child. She also liked to take chances and fell off a playground apparatus and broke a bone when she was just eight years old. She said "I was doing something I shouldn't have done." This brings me again to the thrill seeking even in old age. I can't contribute her fall to just forgetfulness. She told me she was adjusting something on the window and fell with the walker.
She was over reaching and took a chance.  Boom. Onto the floor she went. 
    I went up to see her, she seemed in good spirits despite a femur fracture and possible hip fracture. I helped the nursing assistant change her and get her reading for the trip to the hospital. One of my favorite CNA (certified nursing assistant) lovingly admonished her as I held(L's) hand. We had to turn her slightly to get the adult diaper on her. There was some watery blood on the bed pad but she was a trooper. Then she directed me to put some things in  her tote bag for the trip to the hospital. "Eye glasses and carrier, her pen and face cream of course" she said. 
    She lives in the facility so won't ever be going home and she knows this. I believe that deep down she wants to die. She has no family but does have a care taker that takes care of all her business affairs. We are her family and it is heartbreaking to see that after all the care she has received, that she is suffering.
 

Saturday, July 7, 2012

Goodbyes

Today I got text that one of my patients died. This was a surprise as she did not seem to be that sick. And now I will add her name to the little jeweled box on my kitchen table. It contains the names of patients I have treated either as an Occupational Therapist or as an end of life caregiver/chaplain. The little box is getting full.

When I saw her yesterday she had two family members sitting by her bed. Lucy ( not her real name) was her usual impish self. Her son in law and daughter were concerned that she would miss therapy because of her bronchitis. Well, unfortunately that came to be the truth. None of us thought she wouldn't be here come Monday morning.