"She complains about everything. Mrs. D, do you need pain medicine, "yes my hip hurts so much." This was the nurses's assessment for a patient at one of the nursing facilities I visited during my geriatrics rotations. She told me that the patient appears comfortable and is usually wheeling herself around perfectly content but anytime someone asks her about pain or asks how she's doing, she always gives an exaggerated list of complaints.
During my encounters with Mrs. D, she gave me a similar report of pain. When I asked her if the interventions we made to control her pain have helped, she responds, "I don't know, it's all the same." When asked if she is able to make it to the bathroom on her own, she states "no I need help." And again I think back to the nurse who reports with a smile on her face "she uses the bathroom on her own ALL the time."
I can't help but wonder why this patient seems to be exaggerating her symptoms, or is she? What I realize though is that she is unhappy with her current state and wants nothing but to go home. She doesn't seem to realize that the more she engages with the interventions for which she is here, the sooner she will be able to go home. I also wonder if her cognitive deficits are so severe that she is unable to remember her daily activities. I wanted to hear something original from her. Some way to connect with her and make her realize that I cared.
I asked her what she does at home, what are her hobbies...no response..."Do you like gardening? Ah hah...her face lit up, her eyes popped open and she looked up at me and finally make eye contact. She said, "yes I do gardening at home." I told her that my mom also likes gardening. She started talking to me about what she plants and that she loves watching something grow from a seed and then be able to use it. and for the first time, I saw her smile at the thought of her garden and I could see in her eyes that she was imaging herself in it and you could almost see the vegetables in her garden though her eyes.
All the patients that we care for in a nursing facility are people and sometimes in our rush and in our own stressors, we forget to stop and chat with them as we might with a younger patient who presents to clinic. It's so much easier to present that "the patient said 'I don't know' to all my questions." We quickly listen to their heart and lungs, disregard their "complaining" and say, "I'll let your nurse know."
Perhaps we should remind ourselves more often that these quiet figures scattered about the nursing home on their wheelchairs with their heads slumped down are...people. People very much like ourselves who still have fondness for happiness, love, and satisfaction in life. Taking 2 minutes extra to connect with them and recognizing their unique personhood gives them joy and also helps as practitioners find satisfaction and meaning in what, sometimes, becomes our daily chore.
Mrs. D certainly brought warmth to my heart that day and I hope I brought some to hers even if it was only to provide her a reason to retrieve a memory and imagery that was already tucked away in the corner of her brain.