Shay Jacobson, RN, MA, NMG, LNCC, CLNCP
Martha Kern

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When Donna moved to the big city with her sister as a young woman, eager to leave the farm and small town where she grew up, she never imagined she would one day have strangers at her door, deeply concerned about her welfare.

The adventure had, after all, started with such promise. She sought out the excitement of city living and found it, at least by the standards of the time, and got a job as a secretary at a fairly large company. She also very much enjoyed attending church services and working as a volunteer through the church whenever possible. She never married or had children, and instead enjoyed a life of work and faith.

And now, this. Having survived her parents and all of her five siblings, including the sister who moved with her to the city, Donna found herself losing ground. Managing life’s day-to-day tasks had become burdensome, impossible, at the age of 89. Her ability to keep herself fed, appropriately clothed and current with her bills diminished over time.

Someone, possibly a neighbor, called the police. Alarmed at what they saw, the police summoned Senior Services. Senior Services, in concert with an attorney, called Lifecare Guardianship.

Hello, Please Come In
We first met Donna at the front door of her condo. We were part of a string of unusual visitors she had recently entertained, all very worried about her health and safety.

She was frail, weighing in at just 78 pounds. Her hair was matted and her scalp encrusted with cradle cap. Adding to the poignancy of this picture was a severe incontinence problem that left her covered in her own waste. At some point, Donna had become incapable of caring for herself, and it was uncertain how long she had quietly lived this way.

Given her physical status, living conditions and memory impairment, an emergency petition for guardianship was filed and Lifecare Guardianship was named temporary guardian. Our first responsibility was to call an ambulance and have Donna taken to the hospital.

Donna’s medical condition revealed a fairly complex picture: Congestive heart failure, hypertension, chronic lymphocytic thyroiditis, osteoporosis, spinal stenosis, malnutrition, Alzheimer’s disease and depression. She scored 13 points out of 30 on a Mini Mental Status Exam.

Home Again?
Donna’s home, once cleansed of its sanitation hazards and excess personal property, might make a suitable environment for her in the company of an able caregiver. She was discharged from the hospital on a temporary basis to an assisted living facility with a memory unit where she could safely reside while her condo was thoroughly cleaned.

It wasn’t long before Donna was hospitalized again for an exacerbation of her congestive heart failure. Her primary care physician expressed concern over her 15-pound weight loss during the past year, and the chronicity of her other myriad medical issues.

It was collaboratively determined that Donna should remain safely ensconced in the memory unit where she benefits from 24-hour nursing services, carefully managed medications and three daily meals that may go a long way toward restoring her weight to normal levels.

The Life Story Continues
Though few of us would ever imagine arriving, alone, at the point where we could no longer bathe or care for ourselves, there are thousands of people like Donna who have done just that. They are behind closed doors, and often receive attention only when they wander into the public sphere or otherwise attract attention. Thankfully, Donna’s neighbors took the initiative to call the police and her profound needs were identified and addressed.

It is gratifying to see how much Donna has improved now that she is regularly bathed, fed and engaged in activities. Donna’s primary care physician believes she may have become isolated due to her long-standing depression, so it could prove a blessing in many ways that she can now attend church services at the facility and feed the faith that always sustained her, even as a young woman when her adventuresome heart first brought her to the city.

©Lifecare Innovations, Inc.