Resolutions and Solutions

What difference do I make?

Tonight I sat beside a 72 year old man and talked to him. I listened to him cry out his frustration and humiliation at being “locked away” in a nursing home because he can no longer care for himself. A man suffering from Alzheimer’s, but still cognizant enough to remember soiling himself the night before, I assured him that his incontinence does not repulse me. I offered my presence as proof that he could not scare me away just by one messy night.

I held this man’s hand as he begged me not to tell his son about the previous night’s incident, nor that he was so depressed he could neither get out of bed nor eat. He began referring to me as his wife. I don’t look like her, he just couldn’t remember and the fact that he had refused food, drink and medication all day did nothing for his mental state, especially not after being taxed by a long conversation with me.

I the role of his wife, I convinced this man to take pills that he did not want. I succeeded in feeding him 10 spoonfuls of yogurt and almost a while glass of water. I felt triumphant at this, even though I know it’s not enough. It’s not even close.

So my question is, what difference do I make? Is it worth it to spend so much time with a patient only to accomplish so little? Or does the fact that a man knows that he is not alone, if only for the duration of my shift, enough to outweigh the fact that I was not able to give his body the nourishment it will need to keep him alive? Is it even ethical of me to tell this man that living is the best thing for him, when he clearly doesn’t want to live like this, in this state of half-awareness.

I will never willingly participate in helping a patient die by active means (giving an extra dose of morphine, pulling a ventilator wire, stopping IV nourishment, etc.) I know that I have no choice when it comes to the passive means, such as not starting the IV or ventilator in the first place. At the same time I feel like such a liar telling a man that he’s better off alive when he has been reduced to an existance that is really just short of living.