Of the many new patient referrals to our palliative care service, this man was described as having only weeks left to live. He had been diagnosed with kidney failure and a number of other conditions including Type 2 diabetes. A month or so prior he had been placed into a rest home from hospital to die. He had chosen not to have dialysis and was unable to care for himself at all.
Some weeks later he was mobile and active again, feeling out of place in the rest home, like a fraud and definitely not dying. He no longer had his own home but wanted to be discharged.
When I met him, he was boarding in the spare room of a friend. He was again in bed and had been for days. He was weak and fatigued all the time, had poor balance with regular falls and was emotionally given up. Generally looking like he was dying this time hence the referral to palliative care.
He had no pain or discomfort, was sleeping most of the day only getting up around 5 in the evening. He wasn’t eating much but was drinking. He had a water bottle by his bed. Nothing suggested to me that he was in fact dying but I couldn’t at that visit put my finger on what might be going on.
I asked him to have a review with his GP.
The next time I saw him he was up in the lounge, dressed, very smartly I might add, and was bright and cheerful, enjoying engaging with me and the friend who’s home it was. He was a totally different person.
What had happened?
What had happened was that his friend had noticed over time that he was requesting and drinking an enormous amount of fizzy orange drink in a day, and also that he was rarely taking his medications. She remembered he was a diabetic and put two and two together.
She got him ‘off the juice’ which immediately lowered his till then ‘off the charts’ blood sugar readings and also supported him to be consistent with his medications and now he was functioning normally.
He was walking in to town every afternoon to catch up with mates, going to football games on weekends and very much alive and embracing and enjoying life. Instead of thinking, as she had admitted to me at my first visit, ‘What the hell have I got myself into here and how am I going to deal with this man’, his friend was enjoying their reconnection.
How lucky he was to have her.
He had improved in the rest home because he didn’t have the same access to the sugary drinks and also admitted how cavalier he had been about taking his medications, he said he hadn’t really cared that much about himself and admitted to being addicted to the drinks. He said he knew they were giving him some false sweetness in his day whilst destroying him at the same time. He very honestly admitted that he had given up responsibility for himself.
This change was beautiful to witness. He was now taking responsibility for, and more evident care of, himself with the support of his friend. She didn’t intrude or berate, but also didn’t let him off the hook if he took steps away from that care. She basically empowered him to empower himself. He was engaging in life again, and definitely not dying.
I saw him again a couple more times and because he was doing consistently well, I had the rare pleasure of being able to discharge him from our service as he had no palliative care need whatsoever.
It was lovely to experience the unfolding connection between him and his friend. She was amazing with a practical and down to earth no nonsense approach to life. There was no sympathy or enabling behaviour from her. She simply saw what was happening and shared it with him. It was then up to him.
It is not always the nurse or the doctor who arrives at the correct realisation or has the answer to what is going on.
