Another symptom of heart or lung disease is shortness of breath. Coughing, or the smallest physical activity, can make the patient gasp for breath. This causes great distress. The physician may prescribe oxygen that can be used effectively after a bad bout of coughing or rapid physical movement.
The patient’s strength and personality may cope with pain in a surprising manner. However, incontinence of urine and feces is a humiliation few can tolerate. The situation requires immense care and tact, as well as tolerance, from those nursing the patient because they must cope with the physical and psychological misery that incontinence produces. It is important that, despite the unpleasantness, the family should not let the patient feel that he or she is an intolerable burden. Incontinence must be accepted with sympathy and understanding.
As the patient becomes physically weaker, the physician administers more drugs. The mental state of the patient changes for an alert, realistic individual, to one who is often confused about time and place. This confusion varies, and periods of normal discussion fluctuate with moments of drowsiness and loss of reality. Often the patient is aware that he or she has been confused and is apologetic for the trouble caused.
Visitors should come for only a short time. It is best if they know the patient well and can remain peaceful and silent. If necessary, they can just hold the patient’s hand. This physical contact is a form of communication that can produce peace and contentment.
During the patient’s deterioration, the appetite is usually lost. Offer the patient small amounts of his or her favorite foods, jellies, or soups. Serve small portions of food frequently.
If at any time the family feels that they cannot cope with the situation any longer, discuss the problem with the physician. It may be that the time has come for the patient to be hospitalized and it is wise to accept the physician’s advice on this.
