Peer Reviewed
Reflections: innocence revisited

What my patients have taught me (Test clone)

Dr Dee
Abstract

A GP reflects on work in an aged-care facility and on learning not just about chronic disease management, palliation and dementia care but also about humility, acceptance, pride and positivity, grace, faith and resilience.

Sigmund Freud said, ‘One day, in retrospect, the years of struggle will strike you as the most beautiful’. 

I was privileged enough to work as a GP in an aged care facility for two years. Being the resident GP meant that my patients became my family. I would see them at their bedside, learn about their lives and meet their families, who became mine. It was the most difficult period in my working life – dealing with death, palliation, dementia, bureaucracy from government agencies and demands from families. Admittedly, sometimes these demands were warranted but at other times impossible. My days were filled with ear syringing and managing falls, urinary retention and skin tears. Then there were the team meetings and case conferences between care providers and families. Resident medication reviews and health assessments thrown into the mix made it interesting but difficult and time consuming.

I learnt about palliation and dementia care as a GP. My chronic disease management improved, as did my acute care for the aged. On the flip side of that coin, my confidence took a beating every time a patient died or a family member complained about the care provided. And slowly, like a sculptor chiselling away at the obstinate stone, I waited for the day that a beautiful sculpture of a brilliant aged care physician would emerge. Unfortunately, the time waiting for that to happen took its toll and after months of tears over losing yet another person, empathy for the slowly progressing dementia patient, fear of complaints and brain overload with complicated chronic disease, I decided to step away. However, I did so having grown as a doctor and also as a human being.

I learnt about humility from my patients, such as the 90-year-old who always thanked every staff member for their care, especially care of her toileting needs.

I learnt about acceptance from the gentleman who succumbed slowly to Lewy body dementia. He was a pilot with the Royal Australian Air Force during World War II and knew he was declining. His words to me were always, ‘Why fight against or worry about what cannot be changed? I accept my fate’. 

I learnt about pride and positivity from the 86-year-old nurse who battled metastatic pancreatic cancer with a smile on her face, makeup in place and beautifully coiffured hair.

I learnt about grace from the sons of a scientist who watched their dad fade away from Alzheimer’s disease. They visited every day, held his hand, took him shopping and massaged his feet, all the while thanking the staff and chef for all the care.

I learnt about faith from the 98-year-old florist who attended church services in the aged care facility every Monday until the day he was found in his final sleep with a hint of a smile on his face.

I learnt about resilience from the 72-year-old emphysema patient on oxygen. Her family neglected her, yet she found joy in her plants, her knitting and her ‘book club’, which conveniently took place during happy hour.

So yes, Freud was correct that, ‘One day, in retrospect, the years of struggle will strike you as the most beautiful’. I have been lucky to provide care for the aged at a time when they were most vulnerable. I hope that I did that with the respect and dignity they deserved.     MT

 
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