Sometimes there are patients you know very little about other than the medical history contained in their charts. When that is the case, it’s important to try to learn a few things about the person in order to foster a more therapeutic nurse-patient relationship. That relationship is at the very heart of nursing. That relationship helps you provide the best possible care.
Rosemary had one daughter who was married with a family and they lived in California. She called every day for updates on her mother. I spoke to her a couple of times on the phone, and she told me how hard it was to lose her mother in small bits and pieces over the years. She also told me how incredibly painful it was to live with the fact that her own mother didn’t know who she was. It was apparent that she loved her mother deeply, even though she wouldn’t be coming back to see her again.
On the first day I cared for Rosemary, she asked, “Who are you” every time I entered her room. And I would repeatedly reply, “I’m your nurse, Rosemary, my name is Kelly.” Rosemary was in the final stages of Alzheimer’s disease. She was admitted to the hospital due to a pneumonia infection.
Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys one’s memory and ability to think. In its final stages, patients are bedridden, have difficulty eating and swallowing, need constant help with personal care, and lose their ability to communicate with words. Levels of awareness vary, with the world often experienced primarily through the senses in the last days of life. Most of the time, Rosemary slept.
One day, when I came into Rosemary’s room, she opened her eyes and looked right at me. She tracked me as I moved around. She watched me as I picked up a framed photo of her daughter and her family. I held the photo in front of her. I pointed to each person asking for their names. But her face remained expressionless as she closed her eyes and went back to sleep. She was so small in stature; she looked so lost in the hospital bed. That sweet image of her remains in my mind to this day.
Rosemary seemed to have an affinity for lace. She had several small pieces of intricate, white lace in round and square shapes on her bedside table and on the windowsill in the room. There was one piece of lace that was framed with the words, “dew of the sea” on the bedside table. I later found out that “dew of the sea” was the meaning behind the name, “Rosemary.” She also had a few hand-painted seashells in her room, and a photo of her at a much younger age where she appeared to be holding a bunch of carrots that looked like she had just picked them fresh from her garden, at least that is what I chose to believe.
In Rosemary’s final moments it didn’t matter to me that she hadn’t opened her eyes in days. It didn’t matter to me that she didn’t know who I was or if anyone was present in the room. I chose to sit with her because from what I learned, she lived a gentle life and liked pretty things. Rosemary gave love back to the world.
I witnessed Rosemary’s death right by her side. She was completely unaware that I was there.
But I knew I was there.
And I wasn’t going to let Alzheimer’s disease or death do anything to change that.
This is a true patient story. Only the name has been changed.
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