I was with Ed this week on Wednesday, to attend a class on proper care of the heart. It dealt with diet, how to handle stress, and in the beginning there was a short movie on the inner workings of a heart attack. The film was well done, and the acting was also good. I think it was put out by the Discovery Channel. All in all it took three and one half hours.
While there, my cell phone went off, so I had to leave the room to answer it. It was Rose, our RN, who notified me that Bob seems to be in some sort of trouble. He was unconscious, stiff, and unresponsive; could be very serious. She told me that she called 911 and they were just arriving. She did the right thing of course, but the only complication being that I was the Power of Attorney (POA) for Bob, and I knew what he wanted. One thing was not to go to the ER if he should be in the midst of a possible life threatening situation. He is 88, had a stroke about three years ago, often confused, which is getting worse as time goes on, and has aphasia. However, I often talk to him when he is clear, on what he wants down in case of an emergency. One thing that always comes up is please donít send him to the ER. After a brief conversation with Rose she sent the Ambulance away. Of course if Bob were in extreme pain, and we could not deal with that, then he would have been sent. He knows that, since I try to cover all the bases with him.
He came back from his unconscious state, and seemed to be his old self by the time I got home. We however did put him on Hospice, and the nurse was there when I arrived. While the nurse was there, I had another talk with Bob, since he seemed to be alert and aware, and was able to communicate clearly with me. He was happy that I did not send him to the ER, and in the future to please do the same thing. I agreed, but also made it clear to him that he could change his mind at anytime about this issue, it was in his hands. It would only when he was in a position of not being able to speak up for himself, that I would step in. There was no right or wrong way to handle this, it was always in his court.
ERís are good and I spend quite a lot of time in them over the course of a year. For the elderly however they can be traumatic. They are often cold, and one can spend anywhere from 4-12 hours there while test are being done. The average wait is about 6-8 hours. Also the elderly are not given priority, since ERís are often dealing with car accidents victims, heart attack victims, and with people who are much younger. So the doctors are often very busy, and canít get to some elderly patients for long periods of time. For someone like Bob, who is 88 with multiple health problems, with some confusion, going to the ER can do more harm than good. Also since he is DNR, going in could put him at risk for a lot of trauma if the Doctors on duty choose not to honor Bobís wishes. Which is understandable, since being a doctor is about saving lives, extending life for as long as possible. Though today I doubt this would happen. However from time to time I see doctors, who are hesitant not to all that they can to bring someone back, no matter what their age, or overall health his. It is never easy.
Being a POA, for a friend, or a family member is an honor, but one that should not be taken lightly, since one is bound to honor the wishes of the friend or loved one. Hopefully people are honest enough about their ability to do this when they are asked, and can turn it down if too much for them. There is no shame in that.