Don is 91 years old and a retired military veteran of WWII. He loves classical and organ music, which has been the center of his life from a very early age. After retiring from the military, he studied music at Lewis and Clark College in Portland. He then became very active with the American Guild of Organists, where he helped design and install a number of organs in the Portland area. He worked as a music teacher and organist until late in life, up until he could no longer climb the stairs to the organ loft.
Don also is a bachelor with no children. When his health started failing, he was lucky he could turn to his nephew, Steve Daggett, for help. Steve, a nurse with Providence Health & Services, became his power of attorney, helped him equip his home with assistive devices, and get his will and other papers in order.
Don had always been fiercely independent and preferred his quiet, no-fuss lifestyle. Steve knew it was difficult for Don to accept help, just as it was difficult for Steve to watch his uncle’s rapid physical and cognitive decline.
Steve remembers a time shortly before joining Providence ElderPlace when Don developed a life-threatening gastrointestinal bleed and was in a hospital intensive care unit. As part of his care, Don was given an angiogram that Steve learned about afterward.
“I knew it was not what my uncle wanted,” Steve said. “He wanted to just fade away.”
Instead Don achieved stability, but at a lower level of functionality than ever before.
When searching for a safer living situation for his uncle, Steve learned about ElderPlace and signed his uncle on with this innovative program. With the help of the ElderPlace intake team, Don was moved into the caring environment of Claudia Dobre’s adult care home. He was placed on a PACE at Home care panel where he could get his care in the privacy of his own home. Don’s doctor, nurses, social worker, dietitian, physical therapists and other care team members all made house calls to provide Don with the care he needed. Interruptions were disruptive to Don, and getting him out of the house was even more stressful. Home visits from his medical team members, whom he slowly grew to recognize and trust, made a big difference in helping maintain a soothing environment for Don.
Steve has been pleased with the care his uncle is receiving. As a nurse himself, he recognizes the challenges in caring for his uncle—Don has severe cognitive decline and is reluctant to come out of his room, entertain visitors or comply with treatment instructions. Steve has been particularly impressed with Don’s nursing team members and how they earned his uncle’s respect. Don actually began looking forward to their visits.
Heather, one of his nurses, talked about how she and her colleagues helped to penetrate Don’s shell. “We just talked to him. We gave him choices and allowed him, as much as possible, to direct his own care,” she said. “If he was being short and withdrawn, we kept our visit time to a minimum. If we could engage him in recounting stories of his days in the army, or playing the organ, we knew he would tolerate our presence longer.”
Sometimes there was even some playful teasing. “Don’s sister ended up moving into the same adult care home,” said Jennifer Travis, another of his nurses. “So when Don was being particularly stubborn, I would threaten to tell his sister on him.”
Soon, the teasing went both ways.
When Jennifer asked if she could visit Don weekly to care for his wounds, he would reply, smiling, “I guess I’ll try and deal with you.” And, when asked if he had children, Don would usually exclaim, “Not that I know of!” Jennifer described how it delighted him when he asked in return, “Do you have kids?” She would mimic his reply, “Not that I know of!”
Don currently is in palliative care stage I. The focus of his care is in managing his pain and other symptoms and keeping him as comfortable as possible, both physically and emotionally. Providing home care with a team Don has grown to recognize and trust has helped tremendously towards accomplishing this goal.
Everything seems to be working smoothly, says Steve. “I, (and certainly Don would be too if he was cognitively able) am so appreciative, calmed, and reassured by the care that Don receives from Claudia and Ileana [of Claudia Dobre’s adult care home], and the whole ElderPlace team.”