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Old 10-26-2014, 06:38 PM
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Question Please help, how to help my patient keep his dignity intact?

How can I help my patient and his dignity?
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. I must tend to him.*
Also I am the only adult figure in his life that is tender and close to him. (Situation with his parents will be unmentioned.) I am the person he sees when he wakes up and when he goes to sleep, and I'm the only person who really sees or talks to him on a daily basis. The most he's seen other people is when we are on outings, we are around hospital areas, or the time last year when I was helping a student get experience and education. I think it's hard, especially because of his family situation. Also due to it being inconvenient for him to be around society, it seems difficult for him. He's kind of a loner but I still feel bad once in a while.
Other than that, it's his pride.
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. 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 dressing him. For his comfort, an outfit contains a sweatshirt with long cuffed sleeves or a cotton t shirt, lounge pants with cuffed ankles, and socks that are changed at bathtime or when he gets seeaty or uncomfortable and an incontinence diapering that is changed every known soiling and checked by default every 2 to 4 hours.
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 will drool or have saliva conflicts, due to malfunctioning digestive system, but I don't make a big deal.
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 enjoy outings. I buckle him into a wheelchair and help him put shoes on and we are off- downtown, sights at the park, walks 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.*I once in a while sit and have a gut ache anout it.
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? How can things be easier? We are both comfortable but there are still bad sides all around. Please help.
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