Frail & Forgotten - Patient Care - @

Frail & Forgotten


A.J. Heightman, MPA, EMT-P | From the June 2010 Issue | Monday, May 31, 2010

People love stories with a happy ending. But the story I’m going to tell you actually has a happy and a sad ending. The happy ending to my dad’s life story is that he never developed Alzheimer’s disease. In fact, at the time of his death at age 88, his memory was as sharp as a knife.

The sad ending to his life story is that, in the final months of his life, he was treated like a prisoner or an inanimate object in a nursing home, subjected to humiliation, indignity and loneliness.

These painful memories resurfaced for me as I read this month’s article on Alzheimer’s (“Lost and Found,” p. 50), so I thought I’d tell you what my dad endured at the end of his life, in the hope that you’ll remember his story when called to treat and transport elderly, infirm or Alzheimer’s patients.

My dad was the consummate “ambulance man” and public servant throughout his 38-year career as captain-in-charge of the Scranton (Pa.) Fire Department’s ambulance division.
Dubbed the “Gray Fox” because of his wavy gray hair and propensity for doing whatever was necessary to make life better for those he served, he was respected by his peers, admired by the community and feared by his opponents.

He supported reporters when they wanted the inside scoop on issues; and they reciprocated by giving him priority media coverage whenever he needed funding for a new ambulance or special project.

He also had the same gift that Jim Page had—an incredible memory. Like Jim, he never forgot a face or a name. My dad would amaze me with his ability to recall not only how he met someone, but also where they worked and when, where and why he cared for them, (or their relatives) on ambulance calls that spanned decades.

He was one of the best caregivers and emotional support agents I’ve ever known and was the one responsible for my recognition of the fact that 99% of what’s done in the field involves BLS and words, not technology, terminology or advanced treatment.

He was forced to retire when he reached the age of 65. He soon learned to enjoy watching TV, something he rarely took time to do throughout his career. When it became difficult for him to care for himself, my sister arranged for him to move to a wonderful assisted care facility. He loved it there. He had his own TV, portable phone and even a bell on his walker. I was able to talk to him every day at that facility.

The employees treated him with love and respect, most calling him “captain.” His favorite female staffers carried on the “Gray Fox” nickname, and he lovingly called them his “chickens.” As he aged and had to be transported to the hospital after a fall, I’d hear how “sharp” the ambulance crew that transported him was dressed.

But when he became too frail and needed more than “assisted care,” he wasn’t allowed to return to his assisted living facility and ended up in a nursing home. That’s where his life of public service and contributions to his community no longer mattered to the staff; they rarely got him out of bed and made him “wait his turn” for his medications.

They refused to pull up his pajama bottoms for him after he was finished in the bathroom and was unable to bend down far enough to reach them. There was now no telephone in his room, and the staff refused to bring a portable phone to him when I called him, routinely saying, “Sorry, he’s in bed.”

The man who managed thousands of elderly, infirm, urine-soaked patients in his career without complaint couldn’t even get someone to pull up his pajama bottoms. He might have been better off living in the world of an Alzheimer’s patient, where reality is blurred and you might not be aware when someone’s rude or insensitive to you.

We’ve always been called on to manage elderly patients, but not the increasing volume being thrust upon us as the baby boomers age. When I started out in EMS, there were no Alzheimer’s patients, just those considered to be “losing their marbles,” “senile” or “insane.” “Dementia” was the popular term for these folks, who were either medicated and kept at home or taken to state hospitals or mental institutions.

But over time, government backed out of the mental hospital business and caused us to shift patient flow to mainstream hospitals, emergency departments and nursing homes.
The fact is, we often look at those we’re called on to assist as customers or “assignments,” and forget that, first and foremost, they’re people. They’re unique individuals who mean the world to their friends and loved ones. And, most importantly, they’re people who have made contributions to the world we live in.

Treat them with the respect they deserve and some day their grandchildren might treat you the same. JEMS

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Related Topics: Patient Care, Special Patients, Jems From the Editor

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A.J. Heightman, MPA, EMT-P

JEMS Editor-in-Chief A.J. Heightman, MPA, EMT-P, has a background as an EMS director and EMS operations director. He specializes in MCI management.


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