No one warns you about falling. Yet so many do exactly that. In fact for the elderly a fall is the most common entry into the hospital/residence home system. It is a sad fact of life that almost any of us who have a severely broken leg will struggle to cope. When you cannot reach things, make your own food and suddenly become dependent on others, it feels like being a helpless child again. All your plans including work of any sort is shelved. Usual routines like housework, coffee breaks, visits to friends become challenging. But however difficult for those who are middle-aged and younger, it is as nothing compare to that facing the elderly in the same situation.
Their responsibilities may well include being a caregiver for an elderly partner. Suddenly, what was a 24-hour job becomes untenable. Often a fracture in an elderly person will not just lead to their hospitalisation but also institutionalisation of the remaining partner. Added to the anguish of pain and medical procedure is is the realisation that the closest person to you has been left vulnerable and taken from your home by the social services. Confusion reigns as the elderly quickly lose a sense of where/who they are when moved out of familiar surroundings and company. Recovery from major injury can take months not weeks and always there is a very real possibility that there may be no recovery.
In many places hospital care has been centralised. This means people are often taken far from their family, friends and neighbours. When they most need support and care, that lifeline is severed by the long distances travelled to receive medical procedures. Waiting time in casualties the world over are now in excess of three/four hours. Even after you see a doctor no one tells you what has happened. For fear of litigation or lack of staff, communication is minimised. So the elderly are left in beds confused as to what injury they have sustained. Not sure what will happen next and completely disorientated by this new and frightening environment. Trained not to complain they endure in silence while others shout for attention. I have visited relatives who have been in hospital for days and they still have not been told what their injury is. Even basic things like fluid intake are neglected. There used to be a lovely little lady in Coleraine hospital who would come around casualty and hand out tea and toast. In the chaos and confusion her smiling face offering hot tea and warm toast was like an angel in a war zone.
Nowadays, she has been replaced by on duty police officers to restrain the many drunks who attack staff and other patients. These officers are really needed. I had a young student friend, John who was in casualty for a broken arm. While awaiting treatment for this injury a violent drunk broke his nose as well. I must confess to losing my sympathy for such violent individuals. It feels as if they have decided to get drunk and in that state injured themselves. Then, when brought to casualties up and down the country they wreck havoc on staff trying to treat them and even other patients sharing the waiting room. It tests compassion indeed when the elderly have to share such spaces with these drunks. The injured elderly are particularly vulnerable to abuse and know it.
Regained mobility is not taken for granted by the elderly. They know like health, mobility can be gone in the crack of a bone. Who you are and how you think about yourself all can change in a single second. The only aspiration becomes regaining what you once had and that seems an epic battle fraught with setbacks and unexpected complications. When they have wrestled and fought to regain normality they cannot easily forget this torment.
So understand when the elderly want to tell you the details of their illness even after they recover. It is a form of post-traumatic stress and having fought on a battlefield filled with pain, sleepless nights and vulnerability they need to retell their suffering. Talk through the trauma and understand their life’s journey has changed. All can play an important role in helping them, take ownership of themselves and their path in this world by just listening. With each retelling the experience becomes more of their past and less of the present. They gain perspective on what has happened to them. Your listening ear provides a recognition of what they have been through. But don't be afraid after listening, to move the conversation on. Your insights and interests are exactly the world of outside hospitals they need to rediscover. It's just for many the hospital corridors have been long and agony filled. It takes time for them to mentally navigate and find their exit.
Parallel universes exist in this earth. There is the life inside hospital and life outside. Two completely different worlds.
