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When
Meals Are Carted With Care
By
Christine Contillo, the For a few years I delivered Meals on Wheels twice a month to homebound
adults. They were ill, blind or unable to shop and cook for themselves. I
brought my toddlers with me because I wanted them to get a sense of living
in a community, and because I knew that the elderly people we visited
loved seeing them. I'm a public health nurse. These people weren't really my patients, but
I think nurses anywhere will agree that the observational skills we learn
in training can never be turned off. We're always looking closely at that
mole, listening to that cough or noticing that tic. The first patient was crotchety. She always had a lit cigarette in her
hand, and her health suffered accordingly. She had emphysema and was
chronically short of breath. She coughed explosively, her skin was
wrinkled, and her hair and nails were yellow and brittle. The windows in
her crowded home were covered with greasy film, and she had piles of old
newspapers and magazines stacked everywhere in every room. Complaining constantly about the hospital food we delivered, she
frightened my children. On top of everything else she had a snappish
German shepherd dog. I always tried to get in and out as fast as I could. But one hot day in August she stopped me to tell me about the rain.
Although we were in the middle of the longest dry spell of the decade, she
claimed to be unable to sleep because of the constant rain. She said that
it had puddled in her yard, brought her gutters down, tapped on the roof
during the night and made her feel sad all the time. She held me
spellbound with her description, even as I realized that something must be
very wrong. Because she had no family, I placed a phone call to the local health
department. Someone there sent a nurse out to assess the situation. Within
the day, it was determined that a virus had left her dehydrated. Deprived
of adequate fluids, her medications had become concentrated and toxic in
her slight body. After a few days in the hospital with IV's running she
came home, right as rain, ready once again to complain about the food. The second story is more sinister. Fully aware that all too often our clients were unable, physically or
financially, to maintain their homes, I approached a gloomy house,
conspicuous in its disrepair, to deliver a lunch. This house, though, seemed unnecessarily dark. Each window was shaded.
When I rang the bell, a suspicious-looking young man, obviously not the
intended recipient, came to the door. He motioned for me to place the food
on the floor where uneaten meals from previous days were already stacked. I tried to peek inside but the dim light was such a contrast to the
sunshine outside that I couldn't see anything. I had no doubt that there was a problem; the more immediate concern was
what to do about it. Unable to determine that the meal client was safe, I
decided to phone the police. As officers do with complaints like this, they came out with the local
public health nurse, and then a psychiatric nurse was called in to help. It was soon determined that the young man, who was the client's son,
was listening to voices that only he could hear, telling him not to feed
his ailing, frightened mother. Starving, she could see the food rotting in
the hallway but was unable to reach it in her wheelchair. Thanks to our intervention, by dinnertime both mother and son had been
admitted to a hospital. What I learned from these cases was that what sometimes looks like
dementia or Alzheimer's can have an identifiable and treatable cause, and
that we must not confuse eccentric behavior with the truly bizarre. Today more and more of the elderly are isolated, with families flung
across the country. Mental health exists on a continuum. We cannot always
know what is normal, but we must be prepared to ask for help. If we do, these people can find crucial support through a crisis. If we don't, they will be the strangers we read about over coffee. Copyright © 2002
Global Action on Aging |
