The Greater Good ?
Stan was a tall, thin, lanky man. He appeared shorter than his measured six feet, because he stood with his shoulders and head bent. He sported a wild whiff of gray hair on the center of his head and a pair of thin wire rimmed glasses that rested precariously on the very tip of his nose. He was quiet and reserved, yet congenial. He interacted with the other residents, but usually only at meals and during special events.
On the afternoon he moved into our community, he rode his bike from his home only blocks away, while his daughter directed the movers. Independent and active, he pedaled his way along the sidewalks and residential streets, through our front door and into our lobby. He showed up ready and eager, in his mid eighties, to become a new resident.
For months Stan rode his bike everyday. He signed out at the front desk right after breakfast, and he would return just in time for lunch. During the summer, the afternoons in Florida were extremely hot, so Stan would find a rocker in the shade by the gazebo, and spend the afternoon staring at the trees and watching the birds. He loved to be outside.
Six months after he moved in, Stan began to suffer from shortness of breath and overall weakness. It became harder and harder for him to pedal his way through the neighborhoods. He still left every morning after breakfast, but the bike remained locked to a post by the door. Stan could no longer maintain his balance while riding, so he abandoned the bike and began to walk.
He walked through the neighborhood, and he walked through the near-by school -yard. He walked to Wal-Mart, and he walked to Chili’s for a glass of ice tea. He would walk back for lunch, but in the cooler weather he would be off again in the afternoon exploring the residential areas surrounding the community.
Then came the fateful phone call. A gentleman found Stan sitting in his yard. He was confused and disoriented. Familiar with our community, the stranger called to inquire if we had lost a resident. “He says he’s forgotten his way home. He seems frightened.” Stan had traveled several long blocks, so I got in my car and fetched him home.
It was a sad day for all of us. We felt that Stan should no longer roam the neighborhoods alone, and we were apprehensive about the huge impact the confinement would have on his wellbeing. My director of nursing and I met with his daughter and explained what happened. We cautioned her about Stan’s vulnerability now that he demonstrated progressive dementia. Although she was concerned for his safety, she was convinced he would suffer more if we forced him to stay inside.
The following day, Stan came to me and begged forgiveness. “Stan, there is nothing to forgive. I’m worried about your safety. What if no one were willing to help you? “ “Walking is my life,” he pleaded. “Please don’t keep me inside – it’s all I have left.”
My director of nursing and I, along with Stan’s daughter racked our brains for ideas. Finally his daughter bought a pre-paid cell phone. She purposely programmed only one number, that of the community, and taught him how to dial if he should become lost again. The concierge also made him a badge with one of our business cards, so that if he needed assistance from a stranger, it would be easier for someone to determine where he belonged. Our staff made sure he never left home without both identifying items.
The cell phone was a workable solution, although not once in the next several months following his first incident, did Stan ever have the need to call. But, it was inevitable that his good fortune would not continue forever. He was at Wal-Mart one afternoon listlessly wandering the isles when a manager spotted him. He identified Stan by the badge we insisted he wear, and called to inform us that our resident had been there for several hours. “He appears lost,” the manager reported. “When I asked him if he wanted me to call for someone to come get him, he didn’t seem to understand what I meant. I think you should have one of your employees come and escort him home.”
That was the end of Stan’s walks. His daughter, refusing to curtail his need to explore, took him home to live with her. She thought it best if she supervised him herself. I agreed with her that Stan would die a little bit each day if he were forced to remain inside, so I suggested that she employ a private daytime companion to accompany him so he could continue to enjoy his excursions.
Stan’s circumstances brought up a disturbing question that haunts many of us in senior care. Where is the fine line that divides quality of life from quantity of life? When does it become cruel to become so protective that a person is removed from all good and familiar ways of being just so that they can remain alive? Those of us in senior living accept that every situation is different, but we frequently ask ourselves those questions. Of course there are no viable answers.
I don’t know what happened to Stan after he moved from our community. I only hope that his life ended outside on a sunny day, and that he was enjoying the way of life he knew and loved.