At times I wonder which affliction is worse - to be so physically incapacitated (despite retaining a sound mind) that one loses his/her independence, or to be wrought with progressive cognitive impairment that one begins to lose the self, with devastating consequences:
I remember a patient (Mrs. S) whom I met six weeks ago. She is in her early 80s, of English background and highly educated - she held a few university degrees and worked as a nurse before turning to law. An extremely independent woman, she had her own law firm and was actually working until she was diagnosed with breast Ca in her early 70s. Things went downhill thereafter. She had an operation, which resulted in multiple medical and surgical complications. She had to stop working. She could no longer play tennis with friends. She also could no longer care for her husband who has Alzheimer's and Mrs S. had to eventually place him in a nursing home. With her frequent hospital admissions and declining health, her social circle gradually dwindled. Apart from her husband, Mrs. S has no other relatives to turn to - her son was killed in an accident many years ago, and her only sister had recently died. When I saw her in hospital, she was admitted for bone mets, under palliative care. I recalled her being somewhat deflated, overwhelmed by everything that has happened to her and was tearful at the end.
"You should have seen me during my hey-days. I was at the top; I was once in control.... I don't know what to do now...."
I cannot think of a particular patient at the moment, to illustrate my latter statement. There are however, numerous people I've met in the past four weeks, who were once so competent, now being exploited by many (mainly where finance is concern) because of their cognitive impairment.
Sigh.
In my rather immature frame of mind, being old sure sounds hard to me. I do need to consider, however, that what I've seen in health-care settings is just a glimpse of a certain cohort. There are others out there in the community - active, fit and well - perhaps even healthier than I am..... =P
Labels: Medicine/Hospitals/Medics, Random thoughts
