A dignified and peaceful release

A dignified and peaceful release

A DIGNIFIED AND PEACEFUL RELEASE On July 21, 1987, my father celebrated his 95th birthday in fairly good health--getting around with the aid of a walk...

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A DIGNIFIED AND PEACEFUL RELEASE On July 21, 1987, my father celebrated his 95th birthday in fairly good health--getting around with the aid of a walker. In general, he was quite independent, even going up and down stairs by himself. On Sunday, August 9, I arrived home at approximately 11:40 pm after working the 3:00 to 11:00 PM shift. As I drove into the driveway, I noticed the lights on in my father's bedroom. This was unusual, because after he watched the news and had his snack, he was in bed by 8:00 PM. When I got into the house, I read my sister's note and went upstairs to find out why my father was still up. "Hi, I'm home, what's wrong?" He said that he was taking a couple of Tylenol because his knee was aching--he suffered from osteoarthritis of the left knee, thus the reason for the walker. I said, "Okay, if you need me, call," and I went to get ready for bed. Once in bed, I could still hear him making some fuss, so I went to his bedroom door. The light was out and he seemed to have dropped off to sleep. Even after returning to bed though, I still felt uneasy because he once again was stirring. At about 1:30 AM, I went back to his SAY "CHEESE" room and asked him if anything was Thank you for the article, "The Cam- wrong. He now was sitting up in bed era as a Nursing Tool," in the May/ with the light on and said "I don't feel well." I asked, "How do you really June 1987 issue of Geriatric Nursing. I have been working as a senior ser- feel?.... I feel like I'm going to die," he vices coordinator for the past 10 years replied. "Father, maybe you are." I checked his pulse, which was quite and have photographed some beautiful faces. It can be wonderful therapy! irregular. With that I woke my sister Why not start a section showing one and told her I thought father was dy"ward winning" photograph for each ing. She went to his room while I called issue? I'd be glad to submit a few right the doctor and told him about my father's condition. He said I could send away. him to the hospital, but I thought it Keep up the good work. LINDA LAISURE better to wait a while. The doctor Venice, CA agreed, but said to call if I needed Editor's note: At this time, we cannot him. I then called my brothers and sisdevote an entire section to photographs, but we wouM be happy to con- ters--there are seven of us--and my sider photographs submitted for use in nephdw, Dennis, who idolized his GN, depending on the space available grandfather and often sought his advice. I also called our pastor. and the subject matter.

A JOB WELL DONE Thank you for publishing the wellwritten and thoughtful article, "Urinary Incontinence Among Nursing Home Patients: Issues in Research," by Marjorie R a m p h a l (Sept.-Oct. 1987). Dr. Ramphal provided a succinct review of the factors contributing to urinary continence and incontinence and an equally succinct overview and critique of studies done on incontinence of institutionalized patients. Her discussion of interventions and outcomes reflects her ability to address an issue, relate data to a clinical situation, make a judgment, and recommend further action and study. I hope that the appearance of this article means that Dr. Ramphal has a research project underway concerning nursing interventions and outcomes for diminishing urinary incontinence and for maintaining continence. This very complex and difficult clinical issue needs the considerable clinical and research expertise she conveyed. MARILYN J. HOWE, RN, MSN, FAAN Assistant Researcher Centerfor Health Systems Research and Analysis University of Wisconsin Madison, WI

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14 Geriatric Nursing January/February 1988

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adequate Care of the

Elderly.

A Health Care Perspec-

tive on A b u s e a n d Neglect. T. Fulmer. and T. O'Malley. Presents guidelines for handling vital aspects of care such as understanding and assessment of elder abuse, case management and support programs. 192pp / 1987 / $21.95

A Nurse's Guide to Caring

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Brue. Topics i n c l u d e p h y s i c a l changes, as~;essment of aging, nutrition, and psychosocial aspects of care. 240pp / 1987 / $20.95 soft

Exercise Activities for the

Elderly. K. Flatten, B. Wilhite, and E. Reyes-Wafson. A handy resource for those working directly with institutionalized and home-bound elders. Illus. 240pp / 1987 / $19.95 Recreation Activities for the Elderly. In this guide are simple crafts that utilize easily obtainable, inexpensive materials and recommended hobbies for homebound and institutionalized elders. Illustrated 240pp / 1987 / $19.95 2 Vol. set, $35.50 N-1 Springer Publishing Co. /

LETTERS Soon after, I began wiping my father's head with a cool cloth because he began to perspire. His pulse rate was about 40 to 4 4 - - v e r y erratic. By 2:30 AM everyone had arrived. As each spoke to him, he opened his eyes and recognized and spoke to each o f them. There were bits o f idle conversation and, when the subject o f p l u m b i n g u his t r a d e - - c a m e up, my father made some witty remarks. The pastor then told him that he was going to say a few prayers. My father understood and answered to the prayers in a clear, audible voice with t h e rest o f us. As the family gathered around his bed, I knelt by his side, gently squeezing his hand. I said to him, "Father, everyone is here now; everything is going to be o k a y . . , so it's okay to die and go home to mother. She's waiting for you." Though the night outside was gloomy and wet, inside was far differ-

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li./eal eria frie Uurse Methodist Hospital,

long e s t a b l i s h e d a s a r e n o w n e d r e s e a r c h ,

teaching and referral center with many technological "firsts" to its name, offers an enthusiastic and experienced clinical geriatric nurse the opportunity to join our new Geriatric Medicine Program. You will play an integral role in our newly remodeled Geriatric Assessment Clinic, a referral center that targets the major problems of older patients. We offer you the flexibility to design the position to your interests and abilities, while participating in an interdisciplinary approach. You will also use your specialized geriatric training as an RN to obtain histories, perform exams, and counsel patients. Experience in acute or long-term care required; expertise in geriatric issues, and a Master's degree or nurse practitioner, are preferred. As Indiana's leading health care facility with 1120 beds, we will provide you with an excellent salary and benefit package that includes relocation assistance, on-going educational opportunities and exceptional challenge. Please call Patricia B. Brown, RN, Employment Representative collect at 317/929-3547, or forward resume with salary requirements to: Methodist Hospital of Indiana, Employment Office - PB, 1701 N. Senate Blvd., P.O. Box 1367, Indianapolis, IN 46206. An Equal Opportunity Employer.

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16 Geriatric Nursing January/February 1988

ent. At 4:50 AM, a man was allowed to die in dignity, in the house he h i m s e l f built, in his own bed, with his family gathered around him. He died as he lived: peacefully and with dignity. E. T E R E S A H A R N E Y , RN, BSN

Paxton, MA

A POINT OF CLARIFICATION In "Nursing H o m e Reform Bills and Hearings Focus on Staff Preparation and Improved Survey Methods" (News Watch, Sept.-Oct. 1987), it was stated that the bill, H R 2270, would require nurses aides to have state certified training and that unlicensed aides must either have completed or be enrolled in a state approved program. I would like to point out that aides are never licensed. The article should have referred to them as "uncertified" not "unlicensed." Certification merely indicates that someone has met the requirements o f a particular program. Licensure implies much more, including the right to practice according to standards set by a licensing board. And if the practice is not carried out according to standards, licenses can be withdrawn. Interchanging licensed and certified in this instance is not only incorrect, it further erodes the standing o f health care providers who pass licensure examinations and continue to maintain standards ofpractice. L A U R I E J. B R O B E R G , RN, BSN

Yarmouth, ME

Editor's note: Thank you for picking up on our using the terms licensure attd certification interchangeably. You are correct; they are not the same. I only wish licensed nurses understood that difference when they encourage and allow aides to carry out nursing care. CORRECTIONS: In "Irving Kleinman: Music M a n " (Nov.-Dec. 1987), sentence 5, paragmgh 10,p. 346 should read, " A n d he says after victory in World War II . . . . "Sentence 3, paragraph I I, p. 347 should read, "Now that the Grey Panthers are the American agency for FIAPA . . . . " Our Nov.-Dec. cover is a photo o f t h e Philadelphia Electric Company not the Four Seasons Hotel as was stated on p. 287.