Medical interventions can happen quite frequently when working with the elderly population. Sometimes, they are very necessary. Other times, they inadvertently lead to a really poor outcome for the person.
For instance, my wife and I were planning a natural childbirth, one with as small amount of medical interventions as necessary. Why would one want to forgo the wonders that modern medicine can provide? It was because of the cascade of interventions during labor.
Often, when a woman in labor is not progressing fast enough (as deemed by the hospital), she may be put on an artificial chemical (usually pitocin) that stimulates her body into having contractions. That would be nice if that’s where it ended, but now that she’s on pitocin, the hospital wants to monitor her blood pressure. She will most likely have a monitor for her heart rate and a fetal monitor as well. Now, the mother is restrained to a bed during her contractions, which are more intense now due to the drug. Without being able to move around during labor, many mothers eventually end up asking for an epidural, or rather she is told that one is available. Now, since the pitocin is still active, the baby is experiencing harder contractions, even though the mother has relief from the epidural. Not surprisingly, the intense contractions can cause fetal distress, and if the doctor is feeling uneasy about the infant’s heart rate, he or she may recommend a C-section. At this point in a woman’s labor, if the doctor says, “A C-section is recommended, we wouldn’t want to put the baby at jeopardy,” most mothers will oblige.
The primary medical intervention, induction of labor using pitocin, can send a mother to a second, and/or third medical intervention, usually which are more serious in nature. It is true that at the end of the day, the mother and baby are still alive. But one should wonder about that first intervention, if it caused a falling cascade of further interventions.
This sort of thing can happen when working with the elderly. For instance, a relatively young man who was very athletic was admitted to a nursing home. A few days in, and one of the nursing staff decides he might fall, because he liked to stay active, so she put him in a geri-chair and put the tray down so he couldn’t get up. A few days later, and everyone was making sure that man was in a geri-chair. Within a week or so, this man would probably start losing muscle in his legs through atrophy, and start to cry out because he is in severe pain. At this point, the nurse may ask to bring in the doctor and give him some pain medication, or maybe even a ‘mood-stabilizer’ to keep him from yelling so much. How much longer would a man in this situation last?
Its our job as activity professionals to keep a keen eye out for those we care for. I’m not trying to say that nurses are bad or lazy, but often the reason someone becomes an activity professional is because they are seeing people through their heart as well as through medical lenses. In this case, if the activity staff sees the downward progression and does not act on it, they are complicit in the man’s demise as well.
Be alert, stay aware. Get to know your new residents and members ASAP. Our job is to constantly assess everyone we work with. And watch out for that first intervention, it may very well lead to a falling cascade.
