Real-Life Decision Making
An 82-year-old woman named Mrs. Hopeless is transferred to the west wing of Sunnyvale Center in January. After her stroke in November, she spent about six weeks in the hospital. Her insurance company requested that she be transferred to a facility that could rehabilitate her for less money.
Sunnyvale was carefully chosen by her two sons. Although both like to personally nurse their mother, the round-the-clock care is more than either can handle. Both work long hours at their jobs, as do their wives.
Mrs. Hopeless lost the use of the right side of her body on Thanksgiving. She spent the last month in the hospital being fed at first intravenously, then by hospital aides. She had made little progress since her stroke.
Mrs. Hopeless sometimes refuses to eat and never walks. Her doctor at Sunnyvale tells her the aides would be happy to take her around in a wheelchair. That way, she could meet other people in similar circumstances. She looks at the doctor with her blank blue eyes and shakes her head from side to side.
Mrs. Hopeless never smiles at any of the workers or the other patients. She doesn't see the point. Last winter, she lost her husband of 55 years to pneumonia. She thinks she will soon join him.
As a physical therapy assistant, you are assigned to Mrs. Hopeless. On your first morning together, you walk into her icy private room, pull the curtains aside to let in the warm sun, adjust the heat in the room and introduce yourself. As you explain what you do and rattle on about the weather, you notice your patient hasn't said a word.
You plod along anyway. "Together, in the next couple months, we're going to get some movement back in that arm. I'll be in on Tuesdays and Thursdays. I work closely with Jane Bone, who is your physical therapist. I will report back to her and keep her updated on your progress. She consults with your primary doctor. We're all a team."
You lean closer to the patient, who is sitting up in bed, not paying the least bit of attention. Mrs. Hopeless is unresponsive. As is her custom, she is staring blankly, this time at the TV, which isn't even on.
"Do you have any questions before we get started, Mrs. Hopeless?" you ask.
With every bit of muscle left, Mrs. Hopeless opens the left side of her mouth. "Go away."
The words reach your ear clearly. What do you do?