Lori

This is the story of Lori. Lori is in her mid-to-late sixties. Lori's husband James died of cancer during a recent Spring. Lori and John married late in life, lived in Illinois and were devoted to each other. They had no children. Although Lori has a few nieces and nephews out of town, she is really "alone in this world." Within a few weeks of her husband's death, Lori fell and broke both her hip and pelvis. She was admitted to a hospital for a hip pinning. She also had a halo brace put on her pelvis, and was then transferred to a nursing home. When Lori emerged from anesthesia, her mental status was very poor and she was not able to make her own health care decisions. A lawyer has been in charge of her affairs since her surgery.

I became involved in this story in early June. Initially I had lunch with three or four of Lori's high school friends, who were aware of her situation and wanted to be involved and be advocates for her. They contacted me, yet were not immediately certain what they needed me to do. I hoped to work with these friends and the lawyer to inquire about DNR (Do Not Resuscitate) issues, financial issues, and placement issues. Lori's friends saw me as someone who could give Lori help in what they thought were the last months of her life.

At my next meeting with Lori's friends, her lawyer was involved. The goal of this meeting was to figure out "who is doing what" for Lori. At this meeting, I attempted to link the lawyer, the medical doctor (who did not come to the meeting, though he was invited) and Lori's friends. An open dialogue between all parties would give Lori's friends a chance to learn about Lori's end-of-life options and to make a decision. Lori's friends were concerned about her advance directives, (her living will and her power of attorney for health care), and so was I. During the meeting, it was clear that the lawyer had total control of Lori's life and was not willing to share that control with Lori's friends. By the end of this meeting, which was difficult at best, the lawyer agreed to let me visit Lori ten times during the summer. This was a reluctant agreement. However, the lawyer refused to relinquish any information about her advance directives.

After the meeting with the lawyer, Lori's friends realized that Lori had to regain her mental competence if they were to have any say in her care. If she was able to regain her mental faculties, then I could present her with a new living will and power of attorney for health care, which she could sign. In the weeks after this difficult meeting with the lawyer, Lori slowly recovered. She began to walk with assistance, her hip was significantly better, the doctors took the halo brace off her pelvis, and she prepared to go home. She was very aware of my involvement and the reasons why I was involved. I was involved in order to facilitate meetings between Lori, her friends, her doctors and her lawyer. I also was involved in order to assess her spiritual condition at that point. Although Lori became disoriented at times, she understood the desperateness of her situation. I used more and more of my nursing skills in Lori's care as she improved physically and mentally. I essentially became involved as a case manager, and made some arrangements prior to Lori's discharge from the hospital. Lori recovered from her ailments and was discharged back to her home. Her mental status improved 99%.

The Role of the Center

The Center's Director...

1. Visited Lori in the hospital;
2. Met with Lori's friends in order to discuss their wishes and hopes for Lori's care;
3. Met with Lori's lawyer to obtain information about Lori's advance directives;
4. Facilitated discussion between Lori, her friends and her lawyer in order to create a cohesive support network for Lori;
5. Made arrangements in preparation for Lori's return home.

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