By Warlita Barcelona Au, BSN, RN, CCRN
One Saturday morning, I met my neighbors’ caregiver walking to the bus stop. She has taken care of a lovely couple for many years. The neighbors rarely venture out, and we rarely see them, but my husband checked on them when half of our community lost electricity for 13 days in the wake of Superstorm Sandy. I told the caregiver to call us anytime, day or night, if they needed help or items from the store. Before going our separate ways, I told the caregiver I was a critical care nurse and to call me if she ever needed me. It wasn’t long before I received a call.
When I arrived at their house, I was ushered to the bedroom where I saw a 92-year-old frail-looking woman in a hospital bed. She was very pale, diaphoretic and cool, and her legs were mottled. She was barely responsive. I asked if she was in pain, and she barely gestured a “no” in response. I heard expiratory wheezes, but I noticed there was no oxygen tank and suction setup at the bedside.
The woman had Alzheimer’s, a stroke and a broken hip in her medical history, and was confined to bed most of the time. She had a DNR document and a healthcare proxy. I was told she wished to die at home and to avoid hospitalization if at all possible.
Her 95-year-old husband sat in a chair close by. He was fully oriented and pleasant, but he also appeared sad and stunned. He confirmed he was the primary healthcare agent for his wife of 72 years. He remained quiet, but his presence seemed to comfort his wife, whose breathing became less labored even though she was deteriorating rapidly. He said the physician had been notified, but she was the covering physician who hardly knew his wife’s history.
I asked the husband if he was OK with us calling an ambulance. He said he was willing if I thought it would help her, but asked me to call the son first. After speaking with the physician, we called the son to inform him of what was happening.
In the meantime, I wiped the patient’s face, soothingly telling her we were getting help and that her son was notified. Her breathing was slower, not as audible, and she never opened her eyes. I called the husband to her bedside to hold her hand.
While he was walking cautiously with a cane, I guided him to a chair next to her bed and offered her hands to him. He said, “She cannot die now. I am too old to get a new wife,” trying to make light of the inevitable.
Holding her hands, he asked, “Are you OK, Boobie?” When he received no response, he shuffled back to his chair, not knowing what to do. He started telling me he made all the lovely furniture in the room and if my husband needs to use his workshop he can come by anytime. He is a very accomplished man who replicated furniture from museums and pictures of antique furnishing.
The physician informed us she would be prescribing sublingual morphine. The son was driving in that night and hoped to arrive by midnight, but his mother was having agonal breathing. The husband sat by his wife’s side, as I gave my condolences.
I left after helping the caregiver give her a bath and change her gown and assessing they were capable of making the necessary final arrangements. She died soon after. She was at peace, and her last will and wishes were fulfilled.
I met the son and daughter-in-law the following morning, and they expressed their gratitude for what I had done. The husband was very glad to see me and thankful for the care we gave his wife.
A month later during my annual barbecue for neighbors and friends, the husband accepted my invitation to join us. A few months later I hosted his 96th birthday party with a few of his friends and his caregivers. I promised to do it every year for the rest of his life, and did it again for his 97th.
Once neighbors and friends learn you are a nurse, you are placed in a different category from their other friends, as far as guidance and knowledge of health issues are concerned. Being there for others in their time of need is what we do. •
Warlita Barcelona Au, BSN, RN, CCRN, retired in December from her position as a clinical nurse IV in the critical care unit at St. Francis Hospital in Roslyn, N.Y.
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