....is what the number-crunchers will call it. Just another 80-something female who had a ground-level fall and fractured a hip, came out of surgery worse than when she went in, and then transferred to a skilled facility for rehab. What no one knew at the time is that this was the beginning of the end for a noble lady, loved by all who had the privilege of knowing her. She was my co-worker's Grandma, and she was one of my favorite residents.
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It had been a good weekend, full of sunshine, relaxation, great food, and even better companionship, and I was still in a cheery mood when I walked through the door at work this morning. In fact, I was even whistling as I put my lunch in the refrigerator and nosed around the break room for stray notes with resident names or room numbers on them, which is a write-up for the offender if I find one. Satisfied that there were no potential HIPAA violations afoot, I proceeded to the med room, which is almost always my first stop of the day.
Then I saw the stack of pill cards on the counter next to an empty chart and my heart plummeted into the depths of my stomach, for it could only mean one thing.
Ellie* was gone.
As I looked through the chart notes describing the manner and time of death, I wondered stupidly why I hadn't gotten a phone call when she passed. The staff ALWAYS calls me when a resident dies, no matter what the hour, because they know I want to know. Our night shift med aide is new, however, and I made a mental note to speak to her about it at our next staff meeting.
I'd known things were going to go badly for Ellie the instant I laid eyes on her, as she was being settled into bed by the hospice nurse and aide. You can't be in this business as long as I have without knowing the "look".....unless, of course, you are related to the patient. And all it took was one glance at my friend and co-worker, Hanali*, to know that she had no idea whatsoever that her grandmother was literally at death's door.
They say that love is blind, and never was it more true than of Hanali that morning. She's worked in assisted living for years and seen many residents off on their final journeys, but she didn't see the gray lips, the sunken eyes, the labored respirations. She didn't see the furrowed brow or hear the tremor in Ellie's weak voice as she tried to follow Hanali's animated chatter. All she saw was the grandmother she had loved all her life, the woman who had nurtured her when her own mother couldn't, the "Grammy" who treasured their weekly outings and visits from her large family more than anything.
No, Hanali never saw how ill Ellie was until last Friday evening, when she took a sudden nosedive and began the active dying process. It was with a heavy heart that I noted the blueish cast to Ellie's nail beds......the cognac-colored urine in her Foley.....the obtundation. Hanali was officially on vacation, but when I called to update her on Ellie's declining condition, she was at the facility almost before we hung up the phone.
That was when she finally saw the truth in Ellie's heavy-lidded eyes: death was on its way, and there was no bargaining with it or delaying it. The only question was when......and as Hanali wept, it was all I could do not to break down right beside her, for Ellie was one of my favorites and I knew when I walked out of that room that I'd never see her again.
You know how you just know this stuff? This was one of those times I wish I didn't. Because in the end, Ellie will wind up as just another statistic: the one out of five women who die within a year of fracturing a hip. Who she was to the people who cared about her won't matter to the people who collect those numbers, let alone the state's medical assistance program that just paid out thousands upon thousands of dollars for her surgery, anesthesia, hospital and rehab stays, medications and so on. A pathetic end to a life that was so well lived.
But I don't care about any of that right now. I'm too tired and too sad to allow my emotions to wander along paths better left unexplored. Maybe I'll be more rational about all of this tomorrow, or the next day. But tonight, a much-loved resident is gone and my dear friend is hurting.....and statistics be damned.
