Opiates and the Elderly

Eyelids flutter as the needle pricks the skin, no reaction after that, daughter and son sit close, expectantly, waiting for their mom to come around.

She was okay an hour ago, they tell me, talking, walking, a little depressed, but alive. She had fractured her pelvis in August, and had been in rehab ever since.

She’s still alive, just not responding. I reassure them. Her vital signs are excellent, her blood glucose level right where it belongs, and her heart is as strong as mine.

But why won’t she wake up, they ask, imageslooking at me for an answer. I have none. I’m racking my brain, looking at the EKG, rechecking the blood pressure, pressing her nail bed firmly with my pen, but nothing happens.

I think she might hear us, I think she knows what is going on, I think she’s just tired, I say, and run the line.

I’m at a loss. She’s eighty-nine, by all accounts thriving, ate this morning, went to physical therapy, took her medications and was getting ready for lunch.

Instead of lunch, she went to bed, and stayed there, not moving, not responding, not getting ready at all.

I kept an eye on things, the ER was close by, and her pulse was strong and steady, but her son and daughter were not.

I hate it when somebody dies, and somebody else asks how old, and the answer is up there, and they nod, knowingly, as if that makes the pain less to bear. I hate hearing how she had a good life, and it was her time, and how she’ll be happier.

The people watching their mom dying don’t see things that way, not at that moment anyway, they see the woman who made them sandwiches, and washed behind their ears, and laughed with them on Christmas morning, and scolded them when they were fresh. They see the woman who loved them. Loved them for eighty-nine years.

I transferred care to the people in the ER, and they listened as I told my story, and made mental notes of my findings, and saw for themselves that she wasn’t responding, and looked at my numbers, and thought for a moment, then administered 2 MG of narcan through the IV that I had established.

I wish I had thought of that. Even eightynine year old lovely old ladies can OD.

Mom was back a few minutes later, and daughter and son get to spend some more time with their mom.

 

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