I recently needed to use that phrase in a way I had hoped never to have to use it. No, my husband did not need CPR, but he was unresponsive. He lost consciousness while being moved using a ceiling transport device. Slipping out of the harness, he fell four feet from the lift equipment, landing first on his shoulder, then hitting his head on the floor, followed immediately by his head bouncing up and slamming into the door jam on the opposite side of the door.
Can You Hear Me?
After hearing the thud and his caregiver’s cry of alarm, I ran to their location to find him unconscious. His breathing pattern looked like someone having a seizure. Though his eyes were open, they were unseeing. I attempted to determine if he could respond by shouting, “Can you hear me?” “Can you speak?” However, he gave no sign he could be aware I was present.
Do You Know Where You Are?
I pressed his rescue alert button to call for help and continued to monitor his vital signs and level of consciousness. As he regained consciousness, I checked his mental awareness. “Do you know your name?” Check. “Do you know where you are? “ Check. “Do you know who I am?” Check. “Do you know what happened?” Not exactly. At first, he answered questions correctly. He even managed to refuse transport to the hospital (against my better judgment) because he wanted to finish cleaning up for the morning. He insisted he was fine.
Change in Mental Status
As the rescue squad gathered their equipment to leave, I followed them out the door. I told them to expect a call from me if I noticed the slightest change in his mental status, allowing me to take authority as his power of attorney and take him to the hospital against his wishes.
Encourage Self-Decisions
I walk a fine line with Lynn regarding his life decisions. Though he often tries to push decision-making back to me, I try to encourage him to make as many decisions about his self-care as I can. I strongly feel that he needs to maintain control of his life for as long as he can.
Mental Independence
As a functional quadriplegic, Lynn has lost control of most of his body. With almost no voluntary movement, he must rely on someone else to do nearly everything for him. I don’t want to take away the one area of his life he can still control — his mental independence. I serve as his power of attorney for his convenience because he cannot sign documents. Since his hands don’t work and he isn’t flexible enough to hold a pen with his mouth, I sign everything. However, the decision must still be his.
Deciding About Ventilator
Last year, we were confronted with the need to decide about putting Lynn on a respirator during a life-threatening event. Without it, he would die. However, I knew that if he went on the ventilator, he might not come off after the acute condition healed due to his weakened diaphragm and lung capacity. I knew he did not want to live the remainder of his life connected to a respirator. However, I also knew he was in excellent physical health apart from the acute condition presenting itself at that time. Therefore, I felt that if anyone could come off the respirator through hard work and determination, it would be Lynn. My inclination, therefore, was to allow them to put him on the ventilator and take the risk. However, I felt this decision had to be Lynn’s.
Left Decision Up to Lynn
I told the surgeon I would not sign the consent until I explained the risks to Lynn in a way, I knew he understood and allowed him to make his choice. I knew he only had minutes to decide, but he had to have that minute. They agreed, and I quickly explained the risks and options to him. He agreed to the surgery and ventilator, if necessary. I signed the consent, and the surgery went well. As I expected, he was able to come off the respiratory without difficulty and is doing fine now. The best part, however, was that he made his own decision and felt he had some control of the situation.
Difficult to Make Decisions
I often have a tough time letting Lynn make his own decisions. It’s very frustrating to me. I have a medical background and can objectively see what’s in his best interest. I like to know the facts of a situation and face it head-on, decide, and get on with it. On that front, Lynn and I could not be more different. He will delay a decision until the decision no longer has to be made by him. Instead, the decision becomes someone else’s responsibility.
Drives. Me. Nuts.
Won’t Discuss
He won’t talk about it, doesn’t want to hear about it, won’t read about it, doesn’t want to see me reading about it—total denial. He knows I’m going to research it anyway. He knows I’ll thoroughly check it out; I’ll advocate for what I think is right and step in where I think it’s not. He trusts my decisions to be right, but he doesn’t always go along with them. He admits he’s probably wrong in refusing my recommendations but says he needs to try it his way first to know that the other option wouldn’t work. I try to respect that choice and hold my tongue at those times because it’s his life, after all.
Can You Speak?
So, sometimes, when I ask, “Can you speak?” I’m asking for a medical assessment to see if his speech is present, garbled, or makes sense. At other times, I must remember to ask myself if I have allowed him to speak. Have I ensured he has been heard by those around him who may only listen to my voice speaking for him? When that happens, I must remember to turn to him each time and say, “Can you speak?”
This article originally appeared on Multiplesclerosis.Net by Health-Union, LLC, and has been reposted with permission.
