Today was a day of interesting encounters. The first was of a lady who used to be quite ornery until she declined and became non-verbal. She still wasn't very happy with us today as we moved her around to complete her exam. She is dying, and while she has very loving caregivers, they aren't able to give her medications if she can't swallow. We ended up having to move her into the hospice facility to be able to receive liquid, oral medications for symptom relief.
Next was the patient who just wanted to stay in her room. Her family kept talking about how crazy she was. She was the most sane of the group. She clearly was not in a happy marriage. The nurse and I listened to a sermon from her husband, who then had the audacity to tell her, "you may be good but you sure aren't pretty" when she responded to the nurse's question about how she was doing with a "pretty good". The daughter did not stop talking, and did not want to rescind control of the patient's care.
Then we went to the top of the mountain to see a third patient whose symptoms are worsening as his disease progresses. His wife needed coaching on medication administration, but was kind and present for her husband.
Finally, we had the guy who was actively dying, and had a sweet and doting family who had really helped provide the best care possible for him in his situation. They asked questions about his presentation, if he appeared uncomfortable, and what the best options were for his care. It really was a good end to an interesting day.
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