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View Diary: UPDATED: Can we take a moment, please? (128 comments)

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  •  Yes, 'high pressure sales tactics' (12+ / 0-)

    is a very good description.  But for me, in the few times I've had to do this, I've had to apply those tactics with levels of persistence and insistence that go far beyond my own boundaries of respect for the other person's free will, so much that I felt I was 'bullying' the other person, even as I kept persisting.

    I've only had to do this 2-3 times for friends and neighbors.  The most difficult one was with an older gentleman (now passed).  He was a very kind man and a good friend; we had frequent phone contact, since it was hard for both of us to leave our houses.  He was legally blind and had long-standing chronic back pain and was (imo) addicted to his (low-dosage) opioid pain meds.  He went away for a long visit with his daughter (an RN!) who sent him home with a big supply of a much stronger opioid med.  Not long after that I was terrified one morning to hear him on the phone -- his word-finding and short-term memory had changed radically overnight.  He would start of with the One Important Thing he had been wanting to tell me, adn then, three minutes later, suddenly 'remember' the One Important Thing' again. and repeatedly 'remember' three minutes later over along call.  Another friend and I kept expressing our concerns to him, urging him to call his Dr etc -- but he would have none of it.  And he told everybody who called him that he was fine, just fine, thanks, can't complain.

    Eventually the other friend and I put several puzzle pieces together, tidbits that he had told one but not both, and this picture came together:  Since his return from his trip, he had several fall -- including two where, from a standing position in the tub, he fell OUT of the tub, toppling like a tree; and, I learned about the additional, stronger meds.

    Around that time, another set of unusual behavior began.  He could call and chatter like a magpie, talking very fast, very jubilant and excited -- like me on too much coffee, but very unlike him.  Worried, I would call him back 20-23 minutes later, and he would be so lethargic that he could barely form words.  I talked to a pharmacist about the two meds, and the pharmacist confirmed my concerns that the jazzed/lethargic thing was an indicator of  'too much' of the opioids.

    During one of these times, the other friend called from his house, scared to death, because he was in the 'lethargic' phase, asking me to come over.  I went -- only two blocks, but hard for me --and spent over an hour on my knees by his bed, using every persuasive technique I had ever learned, asking him to let us call 911, Dr, anybody.  He remained very kindly obdurate, and since he was lucid (although speaking and thinking slowly and laid out on the bed unable to move) I didn't feel we had the right to call for help that he refused.  I did manage to persuade him to let me removed the un-prescribed meds from his house, so that was one less worry.

    Of course, I had no 'standing' and the medical community was obligated by privacy laws.  But I pushed my way through his Dr's answering service to insist that the Dr call me.  The Dr, by law, couldn't even acknowledge whether my friend was, or was not, his patient, so I had to handle the whole conversation as a 'hypothetical'  ie, 'Just in case you have a patient 'Name', I want you to know that Name was given un-prescribed meds (by name) and that we are seeing/hearing him show the drug-related behaviors, and his severe memory problems pone him to the real possibility of accidental overdose.'  The Dr listened, but grumpily.

    My friend continued in this way for several months, while the other friend tried to convince his sister that some action was needed, and we both continued to try to get our friend to open himself to some help.  I was terrified that he would wake up one morning in pain, take his morning dose of the pain meds, then before the meds had kicked in, forget that the had taken them and take another dose five minutes later.  I was terrified that one day, when my neighbor gave me her copy of yesterday's paper, I would find his obituary, already old.

    Finally I bit the bullet and, after telling my friend and our mutual friend, I called Adult Protective Services and badgered them into having them into having the Area on Aging people do an intake interview without my friend's permission.  I was there, along with a third friend and my friend's sister, who was furious at me for interfering.  This was the only way I could find to get my friend into the medical care system, and I knew I was sacrificing the friendship to save my friend (as I saw it).  This intervention led to my friend's being moved into an apartment near his sister, where a younger family member could check on him and help with his day-to-day living, and make sure he ate.  That lasted about a year, then he went to a nursing home and died about two years later.

    I learned, at the last minute, that his sister was at his home supervising the first move.  I got here as quickly as I could, so I could hug my friend goodbye and tell him how much I loved him and what a good friend he had been.  But I knew that would be my last contact with him, because the sister, who felt I had wronged her, was now guarding the door.

    I'm sorry to go on so long, TF, in response to your kind comment.  This loss still grieves me.

    It is such a terrible feeling of helplessness, when one knows that someone needs medical care, but you you are powerless to connect them with that care.  

    Thanks for spending your life being someone who made that connection and brought care to people who needed it.  And thanks for continuing your vocation last night, and being the hands and the voice for so many people, and for sticking with it until BB got the help she needed.

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