24 Aug 2012
Anne had her 93rd birthday today. This feisty woman from Brooklyn didn’t look anything like the woman I first met five years ago. At that time she was about to be put on hospice since she had stopped eating and was wasting away in a nursing home. She was literally gray, rigid and staring at the ceiling. She had bedsores all over and was unable to communicate in anything like intelligible language. Although the doctors told her daughter she didn’t have a chance at recovery, her daughter simply didn’t believe that there was nothing more she could do.
She hired geriatric care managers to be her patient advocates and we went to work. Our first consult was with a wound specialist at Pomerado Wound Clinic who told us that in order to give Anne the chance she needed to heal her bedsores and recover her general health; she’d have to have a gastric tube placed to improve her nutritional status immediately. Low protein stores in the body had to be overcome so that her ulcers could heal. Her doctor gave the order and the G-tube was placed. Ann began to go to the wound clinic to get her wounds treated.
Within a short time Ann went home with home health care and private home care. She had her stomach tube in and was still primarily in bed but home health therapists and her caregivers started to get her up to a standing position on a daily basis. With her physician’s support, good therapy and a diligent home care team she soon was out of her bed and up in a chair. She began to eat again, talk again and walk again. Her wounds healed and eventually the G-tube was removed and Anne was back. Everyone was amazed but it was really very simple … this woman wanted to live. She has gone on from that rough time to enjoy her home and her family for several more years. Recently she was placed in a care facility where she continues to have a good quality of life.
Thank God for a daughter who cared enough to give her Mother another chance. Thank God for doctors and nurses who didn’t give up either simply because this woman was in her late eighties and down on her luck. Thank God for geriatric care managers who aren’t satisfied with the status quo; who believe that every day of life is precious and worth fighting for.
Thank God for doctors who will give their elderly patients the benefit of the doubt when they are very ill and allow their families to try aggressive treatment. It seems the majority opinion these days is that such patients should or even must go with hospice. Hospice would never have had a G-tube placed. Hospice would have never had engaged the wound clinic. Hospice would have never given the rehabilitation therapy that was necessary to get back to the former level of function.
I am a veteran hospice nurse and dearly love the hospice philosophy. There is certainly a time and place for hospice but it should never be the pathway of choice simply because of advanced age and chronic illness.