View Full Version : Help, please. It's about my patient's dignity.

10-26-2014, 10:50 PM
This is long but I seriously need help. I've tried many sources.
How can I help keep my patient's dignity intact? Someone please, please help.

I am nurse and caretaker to a partially mute male, 14 years old. He has failure throughout his body, including problems with digestive and nervous and vital systems, and I must tend to him.
He has good skills and intelligent and mentally independent however has issues that leave him in need of care. So I am concerned for his dignity.
He already has issues with family. I am basically the only one who is tender to him and sees him on a daily basis. So I try to balance it out, with not just medical care but also bonding time and such. But I don't know if things can be balanced.
Any help?
I massage his belly to bring about eructation (burps) and flatulence and to improve digestion. I also massage him daily to help with digestion and circulation and to soothe him.
I handle hygiene and perineal care. I give him physicals or check ups once a week. I bathe and groom him regularly and take good care of his skin. I diaper him since he dislikes bed pans or catheters. I change him when I notice he is soiled, otherwise every 2-4 hours I check him by default. Not to mention he does have sexual insecurity, even with puberty, so it is even worse on that part. I occasionally administer enemas or laxatives also. I am fair with dressing. To his comfort, I dress him in either a cotton T shirt or a sweatshirt with cuffed sleeves, lounge pants with cuffed ankles, and socks, which are changed every bath or if he is uncomfortable due to sweating or etc.
We've agreed that it is acceptable for me to spoonfeed him, since he has poor coordination. Often he can feed himself but requires assistance and supervision. Although I do respect him and I assure meals are satisfying. Often he does drool or spit up because of digestive malfunction but I don't make a big deal out of it.
He has good skills and intelligent and mentally independent. He can do and enjoys doing puzzles or hand activities, but can only do so much due to low coordination. We can do acitivities but it is limited to things such as puzzles and I read to him. We also like outings. I help him get shoes on, I get his wheelchair, and we are gone for a stroll- downtown or the park for fresh air or down a peaceful trail where flowers fall from trees in the spring.
He understands language and he can make noises that resemble words, however cannot speak much. He prefers to make sounds or be silent. I think getting him to speech therapy would rile up his emotions and pressure him too much. He accepts this, since are close and I understand what he likes and needs, and as long as I am kind to him.
I do talk to him kindly and considerably. I communicate with him and make sure I know what he needs or what he wants me to know, even though he has difficulty replying or talking. He cannot communicate easily but he is very intelligent and he has a very active mind. Even though his body cannot function correctly, his mind and feelings are still working fully. So I am concerned.
He does enjoy the care. He likes massages and such. He knows he can trust me and that I can help and comfort him. He knows I will respect him and do what he needs.
However, things can be too overwhelming, like my "full control" or his overdependence. I feel as if I invade or put too much pressure on his will.
Please help me. How can I keep his dignity intact? How can I help him yet allow him to not feel like he goes by nothing? Any help, please? I am begging!