today was a good work day. one where questions were asked, answers were provided, solutions were found, and good support for patients was located. things just fell into place.it matters that one of the patients i was privileged to visit has amazing family support. her adult children work around her needs. after suffering from a hip fracture, she is re-learning to sit, stand, transfer, and walk, in an effort to re-gain her independence. she wears an emergency response system, though she did not use it when she fell. her meals are prepared by one of her children and they enjoy eating their dinners together. her children assist with all of her daily living activities. the patient has properly prepared for long term care with policies that will cover future needs. her financial situation is sound, as she collects retirement, social security, and various dollars from investments. at the young age of 45 she made all of her funeral arrangements and paid for them in full by time she was 55. we reviewed her advanced directive and she is clear on end of life decisions, DNR, etc. i was very impressed to learn of all of these fine details that are so often overlooked by 85 year old patients and their families. this lovely woman seemed to have it all together. or so i thought.
all except one thing...she doesn't like to leave her home. she fears social situations, except for those that involve her family. she says she has no desire to overcome this fear, especially at her age (85). we are working on involving her in an adult day program of some sort. perhaps a senior center or a senior companion program. there are options, even in our small community. we just have to work through the psychosocial dimensions of a somewhat fragile situation (fragile health and state of mind).
WHAT I AM LEARNING FROM THIS PATIENT: we must continually put ourselves in challenging situations or be willing to step out of our comfort zones. it is easy to get "stuck," as the patient mentioned above has done. she almost fears the unknown or unexpected because she cannot predict what will happen or how she will be received by others. no matter what stage in life we are at, there are difficulties that must be overcome. we must all be willing to work towards a goal and endure life with positive and "can do" attitudes. assisting others with creating and meeting their goals simply means that they must have ownership over these goals...encouragement and accountability certainly help too.
