| there's a sheet in the front of the charts, or near the front, that's called the minimum data set or something like that. the nurses fill it out. it's this huge questionaire and it covers absolutely everything you could possibly want to know about a nursing home patient, as well as a lot of things you really don't want to know about yoruself.
a lot of the items on the questionaire are fairly straightforward-- does she need help toileting? eating? bathing? getting up out of a chair?-- but there are other parts. there's a depression screen in there, which makes sense. we were having a lecture on depression and i was leafing through my patient's chart-- i thought we'd decided she was depressed and luckily there was this neatly scored checklist right there. but there's a section right after it called "psychosocial" or something and the items are more like: strong attachment to previous life role, difficulty adjusting to new routine, loss of previous social ties and/or role in the community.
and i'm walking past the room where there's a group watching a movie together. my patient is never there. and i'm walking past the courtyard, which is pretty nice, and my patient is never there either. she's always behind her curtain with the tv on and she's always so happy to see me and she always tells me to drop by more often.
and she smiles. she's very pretty. and she's pleasant to be around. her memory's shot, but you'd never notice over chit chat. i have these fleeting thoughts about taking her home like a stray cat, about coming home to her and sitting by her bed while she makes pleasant conversation, a genial hostess holding court. it could be worse.
but it couldn't. her family doesn't want her around. and it's not like she screams through the night or hits the staff or smears feces on the walls or even does little things like wander the halls, the sorts of things that scare you. she just sits there.
but she needs help. and we're busy. i'm busy, too. she's my little cactus-- hardly needs any care at all, so easy to forget she's even there, just sitting there, pretty and quiet, no trouble at all.
and she invites me to come back more often, reproachful but gently, politely so. and i nod and smile and shut the curtain behind me knowing that, yes, i will. in two weeks. |
