Can we know what’s happening when parents can’t advocate for themselves in hospitals and care facilities?
An upsetting last stage of life is precisely what we don’t want–for aging parents or anyone else. Several decades ago I spent a night as a patient in a non-private room at one of America’s best (and overcrowded that night) teaching hospitals. I took quick notes and shortly thereafter wrote this piece, long before aging parents were part of my life. It just surfaced when I unpacked the last box from our move. Hopefully things have changed, but have they? If not, how can we know? Are health care proxies the answer? Do our parents have them?
Not a sound was heard, yet the forms of her tiny legs agitating up and down under the white hospital sheets gave testimony to her distress. The medical resident, intently bending over her small body, tried yet another time to insert the IV needle into her vein.
Mrs. S, a stroke vicim in her 70’s, managed to wrest free of her IV. This was the second round of attempting to reintroduce it since the newly arrived nurse on the afternoon shift discovered it had come out.
“When did it come out?” she questioned. “Where could it have gone?” (It was behind Mrs. S’s tiny body, under the covers.) Thus began the first in a series of attempts to insert the IV, with never a sound uttered by Mrs. S, who didn’t–or couldn’t–speak any more. Only her legs betrayed her feelings.
Later that evening the medical resident’s cheery “How are you, Mrs. S?” (no answer) awakened me to another ordeal. He explained how she needed to swallow a tube because “you have to eat.” A discussion ensued between the resident and a nurse about the difficulty of her swallowing this particular tube.
I sensed one felt if Mrs. S. didn”t want to, she shouldn’t have to. Nevertheless, I assume hospital policy or something required that attempt after attempt–with some intermittent choking (“that’s good, it will help your mucous”)–be made.
At one point the resident remarked: “Why are you looking so angrily at me? I’m only trying to help you.” I was beyond upset. I unravelled my own IV tubes, got out of bed, and pushed my IV pole as quickly as possible around the medical people, past Mrs. S, and out of the room.
I spotted an intern. “I think it’s morally reprehensible what they’re doing to Mrs. S,” I said. “She has to eat. It’s good to leave the room if it upsets you,” he responded.
Mrs. S. ultimately swallowed the tube but this did not end the attention paid her. Still later that evening another voice awakened me. “Mrs. S, I’m Dr. K. I know we’re doing lots of things that seem like we’re being mean to you, but we’re making it better for you. I’m coming back to get some blood later and if you relax it will make it much easier. Close your eyes if you understand what I’m saying to you. Close them tight.”
Indeed blood was drawn (not easily) later and still not a sound was uttered; yet everyone seemed aware of Mrs. S’s silent resistance and suffering. Just before her 11 o’clock shift ended the nurse came in to check her patients. “Mrs. S. has managed to get her tube out again,” she stated. “Maybe she’s trying to tell us something, I responded. “I’m sure she is,” the nurse replied.
I wondered about her family. I became acquainted with them late the next afternoon–unavoidable eavesdropping through the curtain that separated our beds.
…………Continued and concluded tomorrow.
I look forward to the rest of the story. I’m a small woman in my mid-70s and I dread being in that woman’s position more than death itself. Why, oh why, can’t the medical-industrial complex respect the wishes of older people at the end of life if we have made known what we do–and do not–want done to us.