It has been another busy week at Charlie's, Monday we had a memory clinic and sat through a long cognitive examination looking at many aspects of the functioning brain and learning where different areas of cognition can be affected in different pathological processes. You can tell a lot about a patient through asking htem to draw the face of a clock and specific times. Its almost like a scene from Alice in Wonderland as each clock can reflect each individual mind and whether they have the capacity to reason and plan how the clock should be...
I had a trip with an ACAT (Aged care assessment team) on Tuesday afternoon and went with a social worker to visit a lady who had been referred to see if she needed more services. She had been diagnosed with gastric cancer last year and 8 months after her surgery she has a wonderful support network looking after her from her local church but needs to get her independence back while utilising other services to relieve the pressure of assistance from her friends. She was a lovely lady and you could see her will to want to live more of a 'normal' and independent life.
Wednesday we followed the DRAC team all over the hospital to assess referred patients as to whether they need transitional care placement or should be in a hospice post hospital discharge. Most patients had poor prognosis and those with a prognosis less than 3 months were usually played in a hospice. TCP allows a few weeks of placement for assessment into relevant care facilities around Perth. I had talked to one lady who had a metastatic cancer in her hip (and a loud systolic murmur i could hear on my stethoscope!!) on Tuesday but we didn't get to see her that day, at least i had a good chat to her :) But we did get sent ahead to find out information on some more patients before the doctors got there so we could have a go at reporting all the relevant information. Unfortunately my patient in the respiratory ward was severely demented with Alzheimer's dementia and most likely had some delirium due to his inattention, but we didn't get very far with the conversation, it was so sad to see him not know where he was, what day or year it is or what was happening around him. Most of my reported information was from the notes and although only a little test a quiet 'well done' from a lovely Reg was enough to make me feel like i passed the reporting!!
I spent that afternoon having an over 2 hour conversation with a lovely 97 year old lady on our GEM ward. I was going to put in my first cannula but since she was a little fearful of needles she preferred the intern to do it instead. But she talked to me about her illnesses and mostly about her life in general. She was quite lonely in the hospital and loved the company, and me being too weak to say i needed to go i gave in and enjoyed chatting to her and finally left the hospital at 6pm. From dawn to dusk i don't think i had a ray of sunlight that day... better get out the vitamin D!
Thursday we finally had a ward round with our GEM team and got to know some of our patients our team of doctors were looking after. This was followed by a multi-disciplinary meeting and a case-study lunch meeting... free lunch for hungry medical students is always a win!! Then after a nice tea-break at the new Santis cafe we set off for an afternoon of lectures.
Friday, today, i spoke to my 97 year old lady who was going to be discharged today but she wasn't ready. Her pain had cleared but she wasn't mentally ready and i reassured her that health is so much more than whether you have pain or not and if she was not comfortable leaving the hospital then she has the right to stay. She is worried about how she will function at her own home where she has been living independently. She has been cleared by the physiotherapists and OTs but in the end it is her confidence which prevents her from having falls and lets her function independently without any mishaps that would lead her into the hospital once more. You really see how age affects you both physically and mentally, it can be such a scary thing and is hard to imagine what it would be like to have to give up your independence and go through your body becoming weaker and slowly dysfunctional with age. It highlights just how important it is to look after your body now while we are young. I would love to reach the high 90's or even make the 100 one day, i want to look after my body the best i can while enjoying all i do. It makes you think what would you do differently today knowing each day is a gift of life and each day gives an opportunity to take to let us live life to the fullest. My time to come old will come i have no doubt, and i can see myself being a grandma who bakes for my grandchildren, still does pilates and goes out in the community still living life in every way that i can. And i want to live it while i am young too, take oportunities, never regret the ones i take no matter how they turn out, always tell those i love i love them and always be true to myself and what i believe in.
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