What Makes A Family?

A few weeks ago, a frail little 98 year old woman pointed her finger at me and clearly said, "When I die, write a book." Yesterday she died. Her name was Edith. This will not be "the book", but it will be a brief account of what led to her death. She was 98, you say. She was frail. Until June 24, she lived alone in her own home. She took care of her personal hygiene and meals.  Her mind was clear and sharp. Her memory was excellent. That day, a Sunday, she went outside to get her Atlanta Journal and fell. The paper boy called 911. She was taken by ambulance to the hospital. Her neighbor called her daughter-in-law, Pat. Pat called her surviving son. She had no broken bones and no head injury. She was bruised and sore from the fall. She had fallen the week before. Her daughter-in-law took her to the ER and when there were no broken bones or other injuries, she was released. She was then taken to her personal orthopedist, who confirmed that she had no injuries. On that Sunday, June 24, when the hospital physician learned that she had fallen twice in a week, he admitted her to the hospital for observation. On July 5, she was sent to a nursing home. She was told that she would just have rehab until she was strong enough to go home. She did not want to be in the nursing home, but her son signed all the paperwork and she thought she had to be there. So what happened, if she had no injuries and no illness prior to entering the nursing home? Well, first she had a urinary tract infection, for which she was given antibiotics. Then she began to lose her appetite. She began to resist drinking because it would make her go to the bathroom. I witnessed the fact that the night shift did not respond to calls to change her and in fact argued about whose turn it was. She asked Pat to contact her attorney. She asked that he come to see her, which he did and she let him know that she wanted out and she wanted her finances taken care of. But, then she caught a highly contagious infection known as C-Diff. This runs rampant in nursing homes tending to the elderly. It causes diarrhea and dehydration.  It can be fatal. She was put in isolation, which meant she could not leave her room to go to therapy or have her meals in the dining area. It meant that her roommate was moved out and she was alone in her room and in her bed most of the time.  It meant that anyone who came to her room had to wear mask, gown and gloves. It meant that her unappetizing food was delivered in Styrofoam and was often cold. She gradually ate less and less. Pat visited twice a day and often left to get her any food or drink that she was interested in. With the virulent infection and strong antibiotics, her appetite lessened. Pat asked the nurse practitioner if Edith should go to the hospital and that she was afraid Edith was going to die. The nurse checked to see if Edith was dehydrated. Yes, she was dehydrated and received several IV units of fluid. No, they did not send her to the hospital as the nurse said she was "no where near dying". Each day she became weaker and ate less. She was initially furious, frustrated and fighting to recover and get back to her home where she could watch her beloved Braves baseball and golf; where she paid her own bills and kept track of her investments. Did I mention that she wore hearing aids because she was extremely hard of hearing?  She did not have them at the nursing home and many times could not understand what was being said to her. The less she ate and drank, the weaker she became. Pat was working with an attorney to get guardianship, so that she could put Edith in the hospital, get her well and get her back into her home, with live-in nurse care. Sadly, she did not live to be examined by the court-appointed physician. Every day she would ask when she would be examined. August 21 did not get here fast enough.

I cared for both my parents in my home, during hospital visits and through Hospice. They were loved and cared for and their wishes were honored. This precious woman had a loving daughter-in-law, who gave her the same care and attention she gave to her own mother. Pat's husband, Edith's younger son, passed away four months ago. Pat was married to Fred for 42 years. Since the death of Edith's husband 30 years ago, Pat took Edith to every doctor appointment, eye appointment, dental appointment, and hospital visit. She also filled, picked up and delivered all of Edith's prescriptions and kept all of Edith's medical information. This situation should have never built into such a tragedy. Edith could have recovered her strength in her own home, with nursing care and live-in assistance, where she would have eaten what she was accustomed to and not caught the deadly infection.

I tell this story with deep sadness at the loss of an intelligent, sharp-witted, interesting southern lady. Yes, she might have died anyway, in her own home, in her own bed. That was her right. Sadly, she died alone and feeling forsaken by all but her trusted daughter-in-law.