Nursing Insights: The Experience of a Chronic Illness as a Series of Subtractions
Illustration by Janet Hamlin for AJN. All rights reserved.
Chronic illness is often experienced by patients as a series of subtractions. A progressive illness like Parkinson’s reveals this process vividly as the ability to move, speak, care for oneself, all gradually disappear or diminish.
The grief of lost freedom, lost abilities, lost agency, lost avenues of communication is easy to overlook. But it’s real, and can come out in uncomfortable ways. Here’s an excerpt from the start of this month’s Reflections essay in AJN, “A Room With a View.”
David was in his late 50s and had been diagnosed with Parkinson’s disease several years previously. Following a lengthy hospitalization, David’s wife agreed to a placement on the subacute/rehab unit in the facility where I was the instructor for nursing students during their older adult clinical rotation. . . . Although ravaged by the disease, David seemed to like having students provide his nursing care. . . .
One of his favorite activities was sitting by his room window, which overlooked the facility gardens and a play area for the preschool next door. For several weeks, I discovered a nursing student and David sitting by the window watching the outdoor activities in companionable […]
A colleague once remarked, “Isn’t it strange that the universal response to hearing that someone has gone into a nursing home is ‘Ugh’?” As nurses, we might hazard a guess as to what kind of care the new resident may receive. But is there a way to reenvision the care that we provide in nursing homes?
