This morning began as a good day, turning into a great day with the potential for being a phenomenal day.
Yesterday by Dad’s report was not a good day, with nausea after all three meals. It’s often more about who you know than what you know, and so it goes in institutional facilities. They still awaken him at 5AM to take medication, which is absurd, but at least during the week I can talk to Mona – a nurse who has some sensibility. For example, you don’t wait to give a patient anti-nausea medication until after his nausea has resulted in giving his meal back.
It was a great day because Diana was an aide sent by the agency supplying individuals to help care for dad who was proactive. Seeing that he soiled his shirt three times yesterday after each meal, she put a gown over his clothes to give him more measure for error. As with the staff of the Rehab/Nursing Center, the caretakers for the Senior Agency vary widely in their competence and caring. Diana was top shelf. It was a good day when I saw her in action, and it was a great day when Dad began to crack jokes. It was a phenomenal day when Diana and I accompanied Dad to therapy.
Yes, Ben really is that tall, and my father really has become that small. Normally the Center does not allow family or aides to sit in on OT/PT, but Sunday they are understaffed and Ben – who only works there on Sundays – seemed to welcome our participation rather than keep what goes on in therapy (or perhaps what does not go on in therapy) a secret. Given that the ratio during weekdays is one therapist per eight patients, it is no wonder that little is accomplished on a daily basis. Group therapy is challenging under idealized conditions, but when you’re dealing largely with patients in their ’90s there is considerable idle time. Both my father and I were delighted to see Ben push him in therapy in a very positive way. It turned a good morning into a phenomenal morning.
Marcia Angell’s book review of Atul Gawande’s Being Mortal: Medicine and What Matters in the End didn’t make the front cover of this week’s issue of the New York Review of Books in which it’s contained, but it really should have been featured. I realize that because I’m immersed in many of the issues Gawande discusses, it resonates for me in a way that it may not for others. But elder care is at such a pivotal point in this country, and we generally do it so poorly, that it has become a considerable public health crisis.