I made a valiant effort to keep the horror off my face.
It was the yearly care conference for this resident and her four children sat in our meeting room with the doctor, physio, dietary staff and others. The purpose was to review her care plan and tweak it if needed. I had just explained the “levels of care,” a document we reviewed every year. The family, familiar with the language, smiled and stated they’d decided to choose level one for their mom.
Level one?! This was reserved for residents in the last days of their lives. It contained “comfort measures,” but would not treat any infections if she got sick. Appropriate when someone is close to the end, this woman had been out watering our patio garden the day before. She had dementia, but participated in all activities and loved to care for other residents by patting hands and chatting with them. Level one? What if she needed antibiotics?
I knew my role was to run the meeting and not judge the family’s decision. I kept my words soft and my expression neutral, but tried to convey with my eyes to the doctor that I needed help.
He got the message.
With a measured, professional tone, he explained all the levels and the implications for their mother. They’d heard it all before, but he was able to use the power of his position to change their minds.
After the family left, the doctor leaned over and whispered in my ear, “Don’t ever play poker.” I burst into gales of laughter. The curse of having a face everyone can read like a newspaper!
Mutual Respect
Respect is the key to the relationship between the medical and social aspects of eldercare.
Most frail elderly people have multiple medical problems, take at least 10+ prescription medications a day and may deal with other problems such as poor eyesight and hearing, incontinence–the list goes on. The medical staff who handle their care balance an incredible amount of issues. They are frail and something minor like a urinary tract infection can cause huge issues. Is it any wonder that sometimes the scale tips toward medical care and leaves the social aspect behind? Add to this all the horrors of infection with COVID, and the medical aspects of care can race to the front.
It’s not enough. I’ve seen it many times where the best possible medical care is given, but the resident is miserable without social interaction.
When I retired, it was the best and worst of times. Best, because I knew the timing was right for me. Seeing what COVID did to my neighbourhood would have gutted me, and my body could no longer handle the commute. Worst because COVID forced isolation when I’d already left behind all the camaraderie of coworkers. I tried to cope by walking each day, but my deteriorating hip made that a chore. When I had my surgery, the new hip was certainly a blessing, but the greater joy was my friend staying with me for a week, another friend dropping over to do my laundry and several others popping in to walk my dog. I needed the help for my medical issue, but more than that, I needed the company.
One of my favourite times at work was Hallowe’en. On that day, you saw nurses dressed as Dracula, an Advocate as a hot dog and one of the maintenance team as a clown. Everyone still did their job, but joined in the fun because it was fun. Residents laughed. We all laughed.
At the end of the day, quality of life is achieved when we work together. We acknowledge that everyone brings a contribution to the table, and each contribution impacts our elders for good.
If you care for an elder at home, how do you achieve this balance?
Next week…
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