Wednesday, March 10, 2010

Tu necesitas cantar conmigo!

This morning I arrived at the office around 9:15am to meet our social worker, a nurse, and HHA. The four of us left to go see a new pt who lives in a rather dangerous neighborhood (conveniently located about 4 miles from our office...) There is on-street parking there due to the high vandelism and theft rates. We all piled into the CHHA's minivan and off we went!

When we arrived, the RN pointed to an obese man riding on a mobility scooter down the street. "That's him!" she said. We met the pt on the sidewalk and walked with him to his home. He is renting a room in a rather filthy apartment. Since he only has that one room to call his own, he has a stove, microwave, full sized bed, table, chairs, dresser, and piles of medical equipment all shoved into this hardly grandeur bedroom. The pt plopped down on his bed, and the four of us gathered around him, trying to create as little of an overwhelming environment as possible. The RN and social worker took turns asking him questions as the HHA occassionally translated into Spanish for him some of what they were saying. Spanish is his native language, but he was able to converse pretty comfortably in English. The RN asked the pt that if his heart were to stop, would he want them to do CPR to try and revive him? The pt agreed to the CPR, fearful of the alternate... he was a very pleasant and kind man in a real tough situation, which breaks your heart. As someone who helps and cares for people day to day, it breaks your heart when someone is in so much pain or in a situation that just plain sucks, and you can't make it all better for them. I mean, we do what we can, but we're human, and there's limits...

The RN decided to change the pt's dressing on his left leg, which was covered in ulcers (his toes looked like lumps of dead tissue about to fall off...) I watched the HHA as he gently washed the wounds on the pt's leg... even though the HHA took care to be as gentle as humanly possible, it still must've hurt like hell. Still, it had to be done, and already it had made a difference according to the RN! Music was requested, so I got out the guitar and asked the pt what kind of music he liked. He said country -- Where is Katelyn King when you need her! I flipped through my songbook and found a song by Willie Nelson that I remember the MT at my last practicum singing. "Hey good lookin', whatcha been cookin? How bout cookin somethin up with me!" Unfortuantley that was the only part I knew, so the Willie Nelson part of the visit was severely short-lived. I continued to search through my songbooks, but, to no avail -- I didn't have any other country songs I knew. I came across "Hotel California" and hoped that he would like it. I asked if he liked The Eagles, and he said yes. I was a bit nervous singing the song since it's not every day I rock out to The Eagles, but I think it went well enough that he was at least able to recognize the song :) It ended up being good timing, since I was able to sing for him while the nurse was putting the new dressings on his leg. Hopefully it distracted him a bit from any pain he felt...
This pt had been receiving in-home care from another company (not hospice) and they refused to stop treating him. On top of that, the pt was told that he was put on hospice to die. All in all, the pt came onto our services with his previous caretakers refusing to leave, and in a mindset that our company and staff are out to kill him. The poor pt needs a lot of comfort, care, support, and constant enforcement that we are there to make him comfortable and pain free and NOT to kill him or speed up the dying process! Also, if his health improves, then that's wonderful! and we will gladly graduate him from our services and hope that he finds a cure. (The pt is young, but is severely obese and has highly progressed heart disease. A truly sad case...)

I met the MT, our ED, and a HCC at a new facility around 12:30 to observe a marketing in-service and try to take notes so I can give the music therapy spiel by myself next week at another in-service!

Afterward, the MT and I went to see a pt in the town where I play softball. She was an elderly Russian lady the MT knew well. However, it was my first time seeing this particular pt. She had a caregiver there who stayed and listened to the music with all of us. The MT had me bring in her little keyboard to play for the pt, just to add some variety. I have a lot of trouble making the keyboard sound good and am very easily frustrated when playing on it. I think I'm turning into a piano diva! When I play, I want nothing short of a nice Yamaha baby grand! :-P Diva, diva, diva... but anyway, after about a half hour of music, the pt said she was tired. The MT asked if she wanted one more song and then some time to rest, but the pt said we could stay all day. The MT had just received a call from one of our nurses saying that a pt was actively dying, so the MT left to be with that pt while I stayed and played some more piano for the pt. The pt kept insisting that her caregiver learn piano so she can play for her when the MT and I weren't there. I tried to teach the caregiver a simple song, just so the pt knew that she was being heard and understood, and that we were trying to follow up with her request.

After I played my last song, I said to the pt, "Well are you gonna help me carry this stuff out to the car or what?" I was just kidding of course, but she actually did it! (so cute!) I handed her a book that she could carry on her lap, and her caregiver wheeled her outside to my car. (Hopefully this made up for us refusing her coffee earlier -- people like to feel like they're being good hosts, no matter what physical condition they're in -- pretty understandable, right?) I thanked her for helping me and letting me visit her at her home. We said our good-byes, and the caregiver wheeled the pt away for a short stroll up and down the street for some fresh air.
Sorry if my blogs seem to be suffering this week... I'm starting to have to do more documenting, and I'm still learning the system, so it takes me quite a bit of time to do it, giving me less time to blog! But enough excuses... I guess I'll just have to kick it up a notch :)

And sadly, the MT got their just after the pt had passed... BUT, she was there to support the family, which I'm sure was wonderful!

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