Feeling Helpless...

  1. This is too sad.

    We have the sweetest patient at our dialysis clinic... an elderly black gentleman who is one of the kindest, most gracious people I have ever had the pleasure of knowing.

    His dilemma : Although he is yet mentally extremely sharp, has great wit about him, and quite independant, his doc is now attempting to encourage him to go to a nursing home. He is absolutely heartbroken. He was so downhearted last time.. I have never seen him this way. I was deeply moved and my heart went out to him.

    I pulled up a chair and talked with him awhile. He told me how the doc felt he would be better off (as in safer) in a nursing home. He has great difficulty ambulating..actually, he is now wheelchair bound. He is strong, but his legs simply will not cooperate with the rest of his body. He ordered a motorized wheelchair for himself this past Christmas, and was so tickled when he received it ! He told us he would let us nurses use it on the floor during his tx., as he saw how we continuously run our legs off.

    I believe the doc has his best interest at heart, for he has fallen a time or two at home, and there is noone close by to tend to him in an emergency.

    I went over all possible options with him, everything I could think of. He does have the emergency alert to wear around his neck. He has the "scooter", and he has a aide to come in dailey in the mornings for several hours. I think the doc wants somebody there in the evenings to help get him into bed, and on weekends.

    He has not had any luck in finding anyone yet. I spoke with our Social Worker about his concerns, and even asked if he could contact this gentleman's HH socialworker and put their heads together...come up with some kind of a plan.

    I know he is devastated and worries about what to do with his home, furnishings,etc. Everything he has worked so hard for all his life. He also watched as one of our other patients ( lovely little lady) ended up in the nursing home, and how she went downhill from there. She wanted nothing more than to return to her home. Her health spiraled down steadily after this. And when medicare ended up taking her home, she gave up. She is now all but gone. She simply quit eating.

    I know there's not much I can do... I want to intervene.. offer some tiny ray of hope... think of something.. ANYTHING that might keep him in his beloved home just a few more years. He is SO able in all other ways. I also see that he does NOT want to go and is feling pressured, or that he HAS to do as the doc asks. I assured him that the choice is HIS.
    I don't think I could bear to watch him lose his home and independence , go to a nursing home and die of a broken heart. Not when he has so very much life in him as he yet does !

    I know this is out of my hands and I feel so very helpless. I feel like I'm letting him down .. almost unworthy. He is one of those rare patients who NEVER complains about ANYTHING.. is always grateful, always kind, always appreciative of any small token of kindness shown to him. AAAAAAARGH !!!
    My heart breaks for this fine man, and I don't know how to handle it !

    Thanx for letting me unload this heavy burden. Having a hard time with this one.

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  2. 18 Comments

  3. by   SmallTexan


    I really detest the way our society treats the elderly. After paying taxes and being honest their whole lives they are left helpless and hopeless to die. Don't get me started, this is a real peeve of mine.

    I'll say a prayer for the fellow.
  4. by   liberalrn
    Ask pt or soc. worker to contact his church--they might rally round. 'Bout the only thing I can think of at present. Best of luck.
  5. by   PennyLane
    Jnette, you are such a kind person to try and help this man. I hope you are able to help find a good solution for him. But there are some problems that are too great for any one person to solve, I'm afraid. As SmallTexan said, we as a society don't do a very good job at taking care of the elderly. Even if he does end up going into a nursing home, I'm sure he will remember you and appreciate your efforts. Just sitting and talking with him probably means a lot to him. You are only one person and you can only hope to do your best. You're NOT letting him down, but rather it's as a collective that we are ALL letting him and others like him down. Too sad. I wish him all the best.

    Mel
  6. by   Merry1
    True...you are only one of billions of people walking the earth...but one person can make a difference! You do not have a magic wand to wave to make it all better but YOU are the advocate...talk to everyone, social services, nursing agencies, churches, the doctor making the recommendation for NH placement...if you truely believe that this is not in this pts best interest then fight for him. We all have hectic crazy lives even a phone call to him at his home would make a difference?? I am the eternal optimist, it takes work but I try to pick my hills to die on carefully and then charge right up. If you fail at least you did all that you could do within your scope and I think that would be easier to live with than to just do nothing. We all know that nursing homes, God bless them, is still not home to the people in them, this is not what they worked so hard for, suffered for and sacrificed many other comforts for, it was their home they did all that for. When I grow up I want you for my nurse
  7. by   MelRN13
    Sending prayers to your wonderful patient! I hope that a feasible solution for his situation can be reached.
  8. by   VickyRN
    Does he have any family that will stay with him at night or take him in? (Know this is a long shot, just had to ask.)
  9. by   live4today
    ((((((jnette)))))) You deserve a huge warm hug for the kindness and compassion you show to your patients. Just being the wonderful person and nurse that you are is a big help to that man. I agree with the others. Do what you can and pray for the best to become a reality for him. I hope and pray things turn out in his favor. Afterall, it's his life....no one elses. :kiss
  10. by   sjoe
    "I really detest the way our society treats the elderly. After paying taxes and being honest their whole lives they are left helpless and hopeless to die. "

    HOWEVER, how much time and effort did these same people, when they were younger, put into establishing appropriate systems for taking care of the elderly at that time? Had they done so, the systems would be waiting to help them now, as well.

    For those of us who are concerned about our healthcare when we get much older, if we are not actively creating and designing the necessary systems, they'll not be there for us, either. They won't somehow be magically created--it will take a lot of very hard work.

    We reap what we sow.
    Last edit by sjoe on May 15, '03
  11. by   SmallTexan
    Originally posted by sjoe
    "I really detest the way our society treats the elderly. After paying taxes and being honest their whole lives they are left helpless and hopeless to die. "

    HOWEVER, how much time and effort did these same people, when they were younger, put into establishing appropriate systems for taking care of the elderly at that time? Had they done so, the systems would be waiting to help them now, as well.

    For those of us who are concerned about our healthcare when we get much older, if we are not actively creating and designing the necessary systems, they'll not be there for us, either. They won't somehow be magically created--it will take a lot of very hard work.

    We reap what we sow.
    Well I know in my dh's grandparents case they had no idea they would live as long as they did. Not to mention most people in that generation were working so very hard they really didn't have time to lobby.
  12. by   James Huffman
    An earlier post says: "I really detest the way our society treats the elderly. After paying taxes and being honest their whole lives they are left helpless and hopeless to die."

    I guess I'm not sure of the relevance of this statement to the question at hand. The man's doctor is concerned about his safety, and is recommending nursing home placement. "Recommending." He's not forcing the gentleman into a facility, and he appears to be suggesting it on the basis of the man's safety. Likewise, jnette is trying to do something about his situation. SmallTexan, what would you suggest as an alternative in this concrete situation? It sounds to me like the man is being treated quite well. He obviously has health issues, and I'm sorry for that. Whether he wants to remain at home is ultimately something he will decide, but while there may be other older adults who are treated badly, I don't think this man is one of them.

    Jim Huffman, RN

    www.NetworkforNurses.com
  13. by   SmallTexan
    James, this topic just hits home for me for personal reasons -- you're right , it is irrelevant to this poor man's situation. Sorry if I annoyed you with my comment.
  14. by   sassynurse78
    All Nursing Homes are not bad, it is a very hard situation to give up your own home (I couldn't even imagine) but there are many other people in the same shoes as this man, and often these people form great friendships in the nursing homes and support each other. What about assisted living? There are many great facility's popping up around here to provide this option. Also we have many pts. in the nursing home I work, that bring their motorized w/c's with them. The pts. garden outside, go fishing, sew, we even have computer classes. All done with the help of volunteers. A nursing home is not the end of living. Falling is a serious problem, this could lead to a serious injury. What if he falls in between caregiver visits, hits his head and no one knows it? And much worse if he broke a hip, his situation would go from bad to worse, as hips do not always ill well in the elderly and they often lose more of their independence and mobilty. Just a few thoughts. I am glad there are great nurses out there like you to help bring some caring and compassion into the world.

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