Mr. Fisher stared at me with the intensity of an angry father. If his eyes could shoot lasers I would be dead a hundred times. I was so nervous that I kept averting my eyes, pretending I had information to check in the chart. But every time I looked back at him his stare was unchanged. Like the cannon on a Naval Destroyer. I knew why he was angry. Basically I was taking away any of the little independence he had left. But I had no choice.
Basically Mr. Fisher has many medical problems. He is getting to the point that he is not safe at home anymore. This story will be about how he has become more and more frail and I am unfortunately going to have to send him to a nursing home for further care. It has got to be the most horrible feeling for him. He feels helpless to stop it and he realizes that he probably won't be able to go home again. He is losing his independence and his thinking is good enough that he realizes this is basically the end of the life he currently knows. He will be told where to go and when to eat and use the bathroom.
For me, on the one hand I care about his freedom and independence. On the other, he will be too unsafe at home. 2 months ago he was going to the bathroom in the middle of the night while his wife was helping him. He lost his balance, and fell backwards ON his wife! He broke her arm and he fell on his head and had a tiny bleed in his brain. So obviously he is not safe at home for himself or his wife. She also has finally admitted that she can't help him at home anymore either. I'm between a rock and a hard place.
ANY IDEAS OF WHAT ELSE I SHOULD DISCUSS IN THIS STORY. ANY SUGGESTIONS ARE ALWAYS APPRECIATED.
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ReplyDeleteI am redoing this as there were a few words missing in my previous post. I appreciate your thoughtfulness in making this difficult decision for your patient. I am always amazed that freedom is more important to people than safety and dignity! I hope that someone will care enough for my well-being if/when such a decsion has to be made. It is good that the spouse had you to help with the best placement for Mr. Fisher. None of us wants to be in a nursing home, but I would not want to burden anyone if I became that frail or dangerous!
ReplyDeleteNot every one has the luxury of even living to an old age (my best friend died 6 months ago at the age of 62, my brother, 59, has leukemia with not a very optimistic outcome) so we have to prepare ourselves for what old age may bring us with acceptance and dignity.
It is an interesting statistic that about 75% of all people over 65, who ever inhabited this planet, are living at the present time.
Thank you for your caring!
I find it fascinating how important independence is to my patients. I am sure an overwhelming majority of people here would say that they would rather die at home due to an avoidable injury rather than having to live in a long term care facility that could prolong their lives. I wonder if there are differences in the notion of independence in Canada (isn't that where you live)?
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