Susan

One of my residents is a 56-year old woman with ALS, or Lou Gehrig's Disease. Like Stephen Hawking. The muscles waste away but the mind remains intact. She cannot speak, but she can mouth words and also uses a special computer with a remote mouse attached to her forehead like an Indian "dot." I have taken care of Susan for several years. We have a special bond, being that we are only a year apart in age. We consider ourselves aging hippies. She loves Steven Tyler, I love Gordon Lightfoot. But anyway.
Yesterday while giving her her meds, she gestured with her eyebrows raised, her signal that she wants to tell me something. I guessed several of her possible needs, all of which she shook her head "no" to. Finally I guessed, "Does it have something to do with me? Not you?" She nodded "yes." I realized she must have noticed I had been crying. (My beloved friend was in the process of dying at her home at the time, and I had bid her goodbye the day before.)
 I said to Susan then, "Are you wondering why I am sad?" "Yes," she nodded. Then I told her about my wonderful friend Holly, dying of kidney failure which had developed due to old age. Susan continued to mouth one or two word questions pertaining to my friend. I have never been able to understand these  mouthings before, not being a lip reader.
But I believe because we were connecting on a heart to heart basis,  it somehow became very natural for me to see what she was saying instead of hearing it.
Susan was able to communicate with me rather easily in this way and I believe it was because we were sharing on a spiritual level. She mouthed the words "I love you" and I said "I love you too, Susie."
Sometimes being a nurse is not so bad, as long I am real.

Holly 6/29/12

This past week a dear friend of mine died naturally of old age. She died the way we all should, at home, in the loving arms of the one who cherished her most. He did not shirk his duty and scuttle her off to an institution to be euthanized so he wouldn't have to deal with the misery and helplessness of watching a once vital, intelligent and extraordinary being slowly slipping away. He did the right thing, the brave and honorable thing. He participated in her death as he had participated in her life.
What a grand lesson we can learn from this. Instead of warehousing our old people in nursing homes, find a way to keep them where they belong, surrounded by familiar sights, smells, and objects. Do not unmercifully prolong their lives with technology and invasive procedures. Respect them enough to accompany them on their last adventure, the passage from life to the end of life.

I have a resident who turned 102 today. She has no children and her Power of Attorney is a  niece (who I have never once seen visit her). She went to the hospital a couple weeks ago with a BUN of 101, which is extremely high. To make a long story short, she returned with a PEG tube. We are all just sickened by this. A feeding tube going directly into her stomach to pump "nutrition" into her.
 The reason the niece did this? She said that the resident told her once "I love life." Yes, but who knows how long ago that was, and what does loving life include? Being force fed when you are over a century old?
I read the paperwork from the hospital readmission notes. There was an ethical committee meeting to consider the morality of placing a feeding tube in a person of this age and condition. She also has very bad skin breakdown,  Stage 4 and beyond pressure ulcers due to age.
The notes were appalling. The doctors concluded that she was "a relatively healthy 101-year-old who enjoyed eating" and that placing a feeding tube could "help with wound healing."
And today, on her birthday? She did receive a bouquet of roses, from the Nursing Home, which she couldn't even open her eyes to enjoy, let alone inhale their fragrance. And from her beloved niece? Nothing.