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 Scenario 4
Scenario 4 Elderly Person and Bereavement Maeve Donnelly is a 78-year-old woman born in County Cork Ireland, the oldest of 8 children. Maeve came to England at the age of 24 to seek work and obtained a job as a chambermaid in a west London hotel. It was here that she met her husband Patrick, a porter at the hotel, and they settled down in the suburbs. To their distress, they never had any children. Maeve worked her way up to the position of deputy manager of the hotel and stayed there till she retired at the age of 60. Patrick, who could not come to terms with having no children, eventually migrated to America 20 years ago and Maeve has not heard from him since. Maeve lives alone in a three-bedroom house and she has paid off the mortgage. However she has very little savings and finds it hard to make ends meet on her state pension and a small pension from the hotel. Apart from occasional telephone calls Maeve has very little contact with her family in Ireland. Maeve has been finding it increasingly difficult to carry out the activities of daily living due to steadily worsening arthritis in her knees and hips. The anti-inflammatory drugs she has been prescribed reduce the pain slightly but she still finds stairs and sustained walking extremely difficult. She has told her doctor that she does not want to have an operation on her hips or her knees. Her best friend is Joyce, aged 70 years, who was born in Scotland of Irish parents and came to England 50 years ago. Joyce met Maeve at church 25 years ago and visits her regularly, about twice a month. She suggests to Maeve that she should apply for the Attendance Allowance. Maeve does not want to accept something that she views as a ‘state handout.’ More recently she has found it difficult to get up the stairs to the toilet. To her mortification she is occasionally incontinent and is also constipated due to her medications. Her doctor, aware of the latter problem, had advised her to take a laxative daily but when she did it resulted in diarrhoea and she has not taken them since. To compound the problem she can no longer get into the bath and says she feels ‘smelly and dirty’. Maeve has never told anyone about this and due to her fear of disgracing herself has stopped making her regular attendance at church despite the offer of a lift. Maeve has also become dehydrated due to reducing the amount of fluid she drinks in an effort to stop her incontinence. Her arthritis has affected her food intake. She had been used to ‘a good Irish stew’ but now finds it hard to prepare vegetables and her diet consists mainly of sandwiches, tea and cakes. When her doctor suggested a home help she refused, saying that she wanted ‘no strangers in her house’. Joyce sometimes brings a casserole for them to share but Maeve discourages her from bringing too much because she knows that Joyce is on a limited income. One day Joyce did not turn up as expected and Maeve, worried about this, finally rang Joyce’s daughter Kathleen to be told the news that she had died of a heart attack the week before and had already been cremated. Kathleen said she had thought of ringing Maeve but had been somewhat overwhelmed with all the funeral arrangements and was under the impression that Maeve was quite disabled. Maeve is devastated by this news and becomes ill the next day. She rings her doctor who comes to the house and finds Maeve very tearful. She finally swallows her pride and tells her doctor of the incontinence problem. The doctor says he will send the nurse round to ‘sort her out’. The nurse arrives to find Maeve still grieving and feeling that life is not really worth living. She is also quite angry about Joyce’s death and when the nurse suggests ringing the Priest, Maeve says prayer never did much for her and that she thinks God has deserted her. Learning activities Main issues the Scenario addresses:
These issues will be explored through the following statements/questions:
The following learning activities will provide student or tutor opportunities to engage with:
The following resources will support the learning activities: Books Bartlett, H. (1998) Cultural perspectives on ageing. In: S. Pickering, S and J. Thompson, J. (eds) Promoting Positive Practice in Nursing Older People. London: Bailliere Tindall. Chapter 2, p.22-38. Ginn, J and Arber, S. (1993) Ageing and Cultural Stereotypes of Older Women. In: J. Johnson, J. and R. Slater (eds.) (1993) Ageing and later life. Buckingham: Open University Press. Chapter 13, p. 60-67. Herbert, R. A. (1999) The Biology of Human Ageing. In: S. Redfern, S and F. Ross (eds) (1999) Nursing Older People. 3rd ed. London: Churchill Livingstone. Chapter 4, p.55- 77. Kelleher, D. and Hillier, S. (1996) The health of the Irish in England. In D. Kelleher and S. Hillier (eds.) Researching Cultural Differences in Health. London: Routledge. Chapter 6, p.103-123. Le May, A. C. (1999) Communicating Challenges in Old Age. In: S. Redfern and F. Ross (eds.) Nursing Older People. London: Churchill Livingstone. Chapter 11, p.183-193. Narayanasamy, A. (1998) Religious and spiritual needs of older people. In: S. Pickering and J. Thompson (eds.) Promoting Positive Practice in Nursing Older People. London: Bailliere Tindall. Chapter 8, p.128-151. Neuberger, J. (1999) Dying well: a guide to enabling a good death. Hale: Hochland & Hochland. Norton, C. (1999) Eliminating. In: S. Redfern and F. Ross, (eds.). Nursing Older People. 3rd. ed. London: Churchill Livingstone. Chapter 24, p. 395-412. Scrutton, S. (1995) Bereavement and Grief. Supporting Older People through Loss. Buckingham: Open University Press. Scrutton, S. (1995) Bereavement, older age and ageism. In: S. Scrutton (ed.) Bereavement and Grief. Supporting Older People through Loss. Buckingham: Open University Press. Chapter 1, p. 1-21. Articles Costello, J. and Kendrick, K. (2000) Grief and older people: the making or breaking of emotional bonds following partner loss in later life. Journal of Advanced Nursing, 32 (6), 1374-1382. Govier, I. (2000) Spiritual care in nursing: a systematic approach. Nursing Standard, 14 (17), 32-36. Martsolf, D. S. & Mickley, J. R. (1998) The concept of spirituality in nursing theories: differing world views and extent of focus. Journal of Advanced Nursing, 27 (2), 294-303. Narayanasamy, A. (1996) Spiritual care of chronically ill patients. British Journal of Nursing, 5 (7), 411-416. O’Gorman, S. M. (1998) Death and dying in contemporary society: an evaluation of current attitudes and the rituals associated with death and dying and their relevance to recent understanding of health and healing. Journal of Advanced Nursing, 27, 1127-1135. Videos Waiting for the Telegram by Alun Bennett, with Thora Hird. (LRC) Loss and Grief – Part 1 & 2 (LRC) Useful web resources
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