Choices in Senior Care Blog

Unfixable Problems

Posted by Jen W on Mar 8, 2017 3:12:22 PM
"I'm sorry", the doctor says, "there's nothing more we can do". 
 Everyone has a story and every story matters. When that opening statement is part of the story, it's devastating and definitely a plot twist. When I have heard this kind of narrative from clients/friends/family, though, I also feel gratitude that the doctor was willing to say the hard things. Of course, there are always things we can continue doing to people to keep their hearts beating and their bodies breathing, but when a doctor says there's nothing more they can do, he or she is imparting a kindness, granted a very difficult one. They are letting you know that the next chapter is going to be the last one, or a life-changing one, allowing you to choose the tone of that chapter, if not the outcome.
So, what do you do when you're faced with an unfixable problem? First, take a deep breath. Then take a few more.
And then you begin to ask different questions. Atul Gwande suggests that you list your fears and worries for the future. He also suggests asking what your priorities would be, should time become short. Along with that, I would add naming the hopes and dreams that may no longer be realistic. This brings things out of the shadows into the room so important conversations might impart great gifts. Atul Gwande asks, "what are you willing to sacrifice, what are you not willing to sacrifice?" This is such an important conversation to have, even if time is not expected to be short, but you've experienced a plot twist.
This is the essence of "slow medicine", the art of asking different questions. Instead of asking "what's the matter with you?", perhaps we should ask "what matters to you?" Better questions and therefore better answers, allow people to write their own stories, even with the plot twists. Unfixable problems and difficult situations happen. They are huge and important parts of our stories, but they're not the whole story. And every story matters.

Suggested reading; Being Mortal by Atul Gwande

Atul Gawande (born November 5, 1965) is an American surgeon, writer, and public health researcher. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston, Massachusetts. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and the Samuel O. Thier Professor of Surgery at Harvard Medical School. In public health, he is executive director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit that works on reducing deaths in surgery globally.[2]

He has written extensively on medicine and public health for The New Yorker and Slate, and is the author of the books ComplicationsBetterThe Checklist Manifesto, and Being Mortal.

Maureen Willis, RN, BSN, PAC Consultant

Tags: aging, Alzheimer's disease, caregiving, education, General, Assisted Living, care management, cognitive benefits, communication, friendship, grief, health

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