There was a new bounce in his step. Mr. Stefani stood a little straighter, and his face expressed an almost smile. Intriguing.
I had treated elderly Mr. Stefani, suffering progressive heart failure, for approximately a year. It was an exercise like table tennis. I told him how important it was to take medications on a regular basis – he kept forgetting. I told him it was important to avoid salt in his diet – he said he was a poor cook and it was easier to heat up instant meals. I told him it was important to get out and be part of social activities – he said he didn’t have a family, and didn’t really care.
“Why care?” he said.
He was sick, and, as he put it,
“What was there to look forward to in the beginning of each day anyway.”
This is a common story. When people develop heart failure, proper food and self-management of the condition is as important as taking correct medications. This may make a difference between being able to manage the disease at home or several hospitalizations in a year, ending up in the nursing home. Elderly patients, especially men, who do not have family support, are faced with a “triple whammy.” There is no-one who cooks proper food for them. Wham! No one reminds them to take their medications. Wham! And no one motivates them to want to live better and longer. Wham! Wham! Wham!
So what had happened to Mr Stefani?
After we went through these preliminaries –
“Have you been more short of breath?”
“How much can you walk?”
“About a block.”
“Are you taking your medications?”
“Are you keeping away from the salt?”
…we finally arrived.
“Yes, much better now,” he announced, “I have a new friend who cooks for me”.
Well, in all fairness he had said, “I have a new girlfriend.” I just interpreted it as a “new friend”. He went on to explain that there was now a young woman in her late 20s living with him, and she had taken over his kitchen and was helping him out in general. Hmmm. I wasn’t sure if I should ask anything further, something along the line of “Where did you find her?” However, Mr Stefani was more than happy to explain.
“I was driving along the road one day, and there she was, standing on the edge of the road. I stopped and asked if she needed a ride. She said she had nowhere to go. I asked if she wanted to come home with me, and she said yes. That’s how it happened.”
My patient seemed happy. His grooming was better. His feet were no longer swollen. I suggested that he bring his new friend to his next appointment.
The next appointment came in 6 weeks. Mr Stefani walked in with a young woman who beamed at me. I started asking questions about his health. Yes, he was feeling a lot better. She proudly presented his medication list. He told me how she was after him to walk every day. She told me how she had changed her Chinese-style cooking to be salt-free. He told me how he helped her look for a job.
There were questions I didn’t ask. Was she really his girlfriend? Was she an illegal immigrant? Was she hiding from someone? What did she get out of this arrangement? Was he paying her?
Looking at the two people in front of me, these questions all of a sudden did not seem so relevant. People at their heart need connections, and those two had found one.
Self-care Tip: Be open to human connections wherever they occur. It may just save a life – yours or someone else’s.
Question: Have you made a connection with a person that was unexpected? Was it challenging? Fruitful? Embarrassing? Eye-opening? Tell us your story.