Love Thy Father

We bought our first dog when I was about nine years old. He was a big, beautiful border collie, and we called him Jake. Earlier this year we put him down - he was about fifteen years old. Although he'd had a long, good life, he was really struggling at the end. He was deaf and plagued by cataracts in both eyes, and had arthritis in all his legs and struggled to stand up and lie down again. He struggled with his continence, and on almost a daily basis we'd have to clean up the presents he'd left us during the night. He lost his appetite, and lost a lot of weight with it. In the end, we thought maybe putting him to sleep was the kindest thing to do. We looked after him well even in his old and somewhat annoying age - he got all the same yummy snacks our other two dogs did, I walked him for as long as he could still manage, he slept inside until the very end, and we kept him clean and tick-free. I think we did the right thing by Jake.

A few weeks ago, whilst I was on call one night for Family Medicine, I met an old man who was far worse treated by his family than our dog was by ours. Mr J was 79 years old, and had been brought in by an ambulance earlier that day. When I asked him why he'd come to hospital, he said he wasn't sure - that his son, with whom he was living in a fairly well-to-do suburb, had sent him in because he couldn't walk and wasn't eating properly. These symptoms had progressed gradually over the course of a few months, and there had been no acute turn for the worse that day. I asked him what was bothering him specifically, and he said that he couldn't really move even to roll himself over, and that he was a bit troubled by some bedsores. I asked him about any chronic medication, and he said that even although he knew he was supposed to take lots, he hadn't taken any in the last few weeks.

The examination of Mr J was heartbreaking. He was lying on his right side, and couldn't roll himself onto his back. Even in his wasted state he was far larger than me, and I couldn't roll him myself, so I made do with this position. He had pressures sores on every bony prominence of his legs: the malleoli, the tibial prominences, the iliac spines. The worst were below the large diaper he was wearing, which was full of urine and faeces. His buttocks were a bright, hot pink, with areas of ulceration and slough. I asked the man if his son and daughter-in-law were looking after him properly, and if they came to help him turn regularly. He replied that they were rather busy and that they did their best. I then asked if he'd like to stay in the hospital for a while, and after some hesitation, he said yes.

'You know,' he went on, 'it would just be nice if someone could help me in the night. The other night I managed to get to the toilet but then fell on my way back to bed. I called and called for my son, but he never heard me. I lay there for hours.'

When I left the patient to go and discuss his case with the doctor, a sister in the room gave me a letter that had come with the man when the ambulance brought him in. It was from a private GP in his area, requesting that we obtain social assistance for the man, and stating that she was reporting his family to the authorities. Apparently, his son and daughter-in-law had been keeping him in the car garage on a bed that consisted of a plank supported by some bricks. Next to his bed was a row of bottles of water, already yellow with age. There was also a pile of plates with old, decomposing food on them. There was seldom anyone to help the man attend to his toilet needs, and when somebody did attend to him, they didn't clean up the soiled bed before putting him back into it. He hadn't taken any of his medication in weeks because nobody had given it to him.

I always swore I'd never let my parents go live in a nursing home, but after this, I've changed my mind. If the time comes when my parents are unable to look after themselves physically, and I am too busy or don't have the skill to do it myself, I will pay for them to live in a place where someone can give them the constant care that they need. I can't understand how anybody could treat any other human being, let alone one that had given life to them and cared and supported them for decades, in this fashion. This was the most horrific case of social neglect I'd seen in my life, and it was from people who were from the same socio-economic background as myself: educated, and reasonably well off.

In high school our headmistress once read us a story about a couple who built a wooden trough for their aging father to eat out of, because his clumsiness and messiness at the table was so offensive to them. One night, the mother came home to find her small son trying to glue some pieces of wood together.

'What are you doing?' she asked him.

He replied that he was building a trough for her and his father to eat of when they were old and came to live with him. His mother took the wood away from him, burnt the grandfather's trough, and invited him back to the dinner table.

I hope that one day the people who treated that man like that are put into a cold dark room by themselves and are given scraps to eat and soiled sheets to lie on. I hope that they are treated worse than the way we treat our animals, because that's what they deserve.