News From the World of Medicine

[Susan BAV]

NEW PERSPECTIVE:

"I started my lecture to a class of graduate nurses studying the 'Psychological Aspects of Aging' with the following case presentation:

"The patient neither speaks nor comprehends the spoken word. Sometimes she babbles incoherently for hours on end. She is disoriented about person, place and time. She does, however, respond to her own name. I have worked with her for the past six months, but she still shows complete disregard for her physical appearance and makes no effort to assist in her own care. She must be fed, bathed and clothed by others. Because she has no teeth, her food must be pureed. Her shirt is usually soiled from almost incessant drooling. She does not walk. Her sleep pattern is erratic. Often she wakes in the middle of the night, and her screaming awakens others. Most of the time she is friendly and happy, but several times a day she gets quite agitated without apparent cause. Then she wails until someone comes to comfort her.

"I asked how the nurses would feel about taking care of such a patient. They used such words as 'frustrated,' 'hopeless,' 'depressed' and annoyed.' When I said that I enjoyed it and thought they would, too, the class looked at me in disbelief. Then I passed around a picture of the patient: my six-month-old daughter.

"Why is it so much more difficult to care for a 90-year-old than a six-month-old with identical symptoms? A helpless baby may weigh 15 pounds and a helpless adult 100, but the answer goes deeper than this. The infant, the class and I agreed, represents new life, hope and almost infinite potential. The aged patient represents the end of life, with little chance for growth. We need to change our perspective. Those who are ending their lives in the helplessness of old age deserve the same care and attention as those who are beginning their lives in the helplessness of infancy."

--Paul E. Ruskin, M.D., in Journal of American Medical Association [reprinted in a pretty old Readers Digest]

I hope you enjoyed reading this; I've hung onto the clipping for quite some long time and thought I would share it with you. I recently copied it and thumbtacked it on an information board of a local nursing home where an aged relative lives. The biggest problem with this post, however, is that it isn't likely to get followup posts, so it will rapidly sink to the bottom of the Small Talk.

 

[Blanche]

Susan:
Thank you so much for the thought provoking post. Rather makes me look at some things with different eyes. And, speaking of eyes, mine were not dry when I finished reading your post.
Kind regards,
Blanche

 

[Nancy]

Such an important article. We need to take care of each other the way we would like to be taken care of, with kindness and love, and the understanding that when someone is ill, it is not something they wish either, nor have they selected to be that way..

Thanks for posting it.

Every hospital and nursing home should display it prominently. In the ICU it should be posted in every room.

 

[geebee]

Not to imply that people and animals are equal but the animal shelters are full of adult animals that people take there because they are no longer cute kittens and puppies. They seem to require more care than was initially thought and they are dumped.

Perhaps that same type of thinking runs through many people's veins when they think of babies as cute and helpless adults as troublesome and often distasteful to take care of and often those adults are "dumped" in nursing homes. Now I realize not all adults in nursing homes are "dumped" so don't get upset. I had to put my own mom in a nursing home because her Alzheimer's became too advanced for me to be able to care for her at home. However, I did care for her as much as possible in the nursing home.

For some reason, size makes a difference. Being able to "pick up and hold" seems to be a different thing that merely "holding".

Pretty sad.

 

[Phyllis]

Thanks for posting this, Susan. All so true and I agree- it should be posted in all nursing homes and ICU units!

 

[Nan]

Great article Susan. Thanks for sharing it. Should be required reading in all HS health classes!

 

[Susan BAV]

...Should be required reading in all HS health classes!

I think that many younger people somehow erroneously and simply don't think older people have similar feelings as younger ones do and I think that could be a big part of the problem.

And like Nancy said, "We need to take care of each other the way we would like to be taken care of, with kindness and love, and the understanding that when someone is ill, it is not something they wish either, nor have they selected to be that way.."

Education, enlightenment, could surely help.

 

[Karlynn]

Great article. Having a disabled brother and having taught both preschool and high school severely disabled children, I think the article applies to them to. The little preschoolers with their tiny wheelchairs and braces, and their vocalizations of joy (because they can't talk) are so adorable. There never seems to be a shortage of people wanting to work with that age. Fast forward 10 - 15 years when the bodies are full grown and the vocalizations of joy aren't nearly as "cute" and the perception changes. And putting a 150 pound person on a toilet is a lot harder than changing a 3 year-olds diaper or taking them to the bathroom.

The people that work in my brother's group home and facility are terrific and way under-paid. The people that don't love these disabled adults don't stick around too long because of the pay. When my brother had some difficult hernia surgery last year they had staff at the hospital with him around the clock so that he wouldn't hurt himself (his pain threshhold is unbelievable and would do unwise things for a person who just had their belly laid open). One evening I was there and talking with one of the young men that was there from his group home. He took this job straight out of the Army and had been doing it for 9 months. I was telling him how grateful my sister and I were for the care that our brother received and how we knew that the pay was not terrific. He said this was the first job he ever had where he didn't have to force himself to go to work. He said as long as he could make ends meet, he was sticking with it. He brought tears to my eyes.

These are special people that take these typed of jobs with the disabled and elderly because they like it. Unfortunately I think there's more positions needed than there are people that love the work, and I think that's when we see poor care and treatment. Either the staffing is low, or they are just putting bodies in positions they need to fill.