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.
