Sunday, May 17, 2009

OT: Hospice

Had to call Emergency Services yesterday for the first time since starting the Hospice Care at Home program for the elder relation being cared for here. She... expired... on us. But then, after the incident was over, she said, "They sent me back."

When the EMTs got here, maybe three minutes after calling and perhaps ten minutes after she "expired", she had somewhat revived, was breathing and semi-conscious, and they did their tests and exams, pronouncing her "Eh, OK," and -- after some discussion about DNRs and whatnot -- decision was made to keep her here, not to transport her to the hospital (all her vitals were good enough, and there wasn't anything they could do for her at the hospital that we couldn't do here.)

She came to after they left, and her first remark was: "I don't want to go anywhere!" I said, "Oh no, they're gone now. They're not going to take you anywhere. You're home. You're going to be all right."

That's when she said, "They sent me back." She said she didn't remember anything of what happened, wondered if she fell down, though. I said, "No, no. You just collapsed. Passed out. You didn't fall. You were unconscious."

Well... she's been having bowel trouble, persistent diarrhea that we treat with medication. The medication works fast but it's temporary, and what's been happening is that she will have a normal bowel movement followed by diarrhea. In the past, this has made her cranky, but apart from the clean-up, it hasn't been a big deal.

This time was different. She had a normal bowel movement, but she was complaining about head aches and dizziness, and quite suddenly she said, "Oh, it's coming," and she practically exploded with diarrhea. As she was sitting on the commode, she started to drool and fall over and become less and less responsive. I sat her on the bed. She was unconscious but breathing with difficulty. Then those... erm... rattles. Then she stopped breathing. Her pulse stopped. She started turning gray. She was completely unresponsive. This went on for maybe a minute or two. Time to call. While I was on the phone, she began to revive, haltingly, but come back she did. And then she had another episode of diarrhea, poor thing.

According to the EMTs, she'd probably pinched the vaugus nerve at some point while she was having a bowel movement and that caused her to lose consciousness. Fairly common in old people. It had never happened to her before, but there's always a first time. There was no sign that she'd had a heart attack, but it was possible. They'd have to check that at the hospital. No obvious sign that she'd died.

But I've seen people die, and that's what I saw her do. She herself thinks that's what happened. But... "They sent me back."

And though she is very weak right now, she said, "They sent me back, so I guess that means I'm supposed to live to 100, eh, like our neighbor did. Good!"

She'll be 89 next month. I'd say she's good for at least a few more years.

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