I've been thinking through my hydration dilemma with my mother...
...and I believe I've hit upon my personal solution regarding how to tell if it is time to put aside Water Torture. My mother is "famous" for almost never losing her appetite. The last time her appetite lagged was when she'd been at the intermediary care home in late May while I was "respiting" (yeah, right) for five days and decided she didn't want to eat. This is soooo unusual for my mother. Turns out, she simply didn't want to eat when I wasn't there. My mother has an appetite even when she's sick. Sometimes her appetite may not be as robust as usual and, certainly, over the last few years, "robust" has come to mean two meals a day instead of three, which isn't odd, really, considering how prodigious her sleep habits have become within those years. I can remember times, some fairly recently, when she's awakened from her nap and tells me she doesn't want to eat. Since there are a few of her medications that are best absorbed with food on the stomach, I usually cajole her into eating a piece of toast and drinking some ginger tea at these times. Invariably, as she eats the toast, her appetite returns and she either asks for more toast or inquires, "Do we have something more substantial in the house? Now, don't go to any trouble..."
    Even when she's seriously ill and in the hospital, she never refuses a meal tray and usually cleans it. When she had the flu early this year her appetite flew nowhere.
    So, I think I've got a reliable formula. If my mother loses her appetite and is refusing liquids, this would be a good time for me to consider abandoning Water Torture. This, of course, assumes that she has not lost her appetite due to a systemic problem and/or an illness that can and should be addressed.
    Mind you, I'm not recommending this formula for all caregivers to Ancient Ones. Slight imagination tells me that the formula will be different for different people. I wanted to mention this, though, because I think it's important to stress that, well, "for everything, there is" a solution; a point of observance that may very well hold pertinent clues in how to treat the very old. Here's the thing, folks: We must remember that, as I've mentioned before, the older we become the more individuated we are from our peers. Thus, Mrs. A may be refusing fluid because she's actively dying. Mr B, though, may be refusing fluid because he's forgotten what it is to thirst, but he hasn't, also, put aside his thirst for life. Cee may be refusing fluid because of a distaste for the form in which it's delivered. Thus, allowing Mrs. A to dehydrate is appropriate. Allowing Mr. B and Cee to dehydrate, though, is, actually, in our society, anyway, and many others, besides, a violation of what we have come to think of as a human right, the right to live. It requires specific focus, something for which institutions (and, sometimes, institutional workers, even in one-on-one situations) are not designed. Reminds me of something I was thinking, yesterday, while driving on an errand: If we persist in ignoring our individual elders, we can be sure that when we are elders we will be ignored as individuals. At a time in the span of a human life when individuation is the key to definition, ignoring can be tantamount to pronouncing an untimely death sentence. We need to be very careful and acutely aware when dealing with elders. If we are, others will learn to be the same and maybe, just maybe, when you are old, someone will be appropriately aware of you.
- posted by Gail Rae @ 17:40   email  this post