As a mobile veterinarian, I have visited several elderly clients in assisted living facilities, or living alone in their homes with their pets. One such client, Collette, lived in a memory nursing unit with her cat Chaminou. Collette was originally from France, and moved to the United States decades earlier with her husband. Unfortunately, she no longer had any immediate family members still living, and she would share her personal story each time we visited her. It was heartbreaking to hear her retell how her son suffered and later died of cancer. She came into my life through one of her nurses, Kathie, another client of mine. Kathie was Collette’s guardian angel, and my co-conspirator in caring for Chaminou, and keeping him in Collette’s company.
Not all Collette’s stories were sad. For instance, she would greet us each and every time with the same joke about Chaminou. She would say that he spoke three languages: English, French, and cat! We laughed each time as if it was the first time we had heard that joke, and as if it was the funniest joke ever told.
Chaminou originally had some gastrointestinal issues, occasionally requiring laxative treatments. The nursing home allowed cats, but when it came to keeping medication for a pet, the rules were strict. Collette was not allowed to keep cat medication in her room. Her memory issues made it a valid concern that she might become confused and accidentally self-medicate. When we first tried hiding them in her bedside drawer, to avoid letting the main nurse’s station know about it, we ran into trouble because Collette continually forgot where we had hidden the medication. So we devised a plan to have Kathie treat him during her shifts.
With time, Collette’s memory deteriorated, and Chaminou’s health declined. He was an elderly patient, and developed chronic renal failure. Treatment now involved more medication, diet changes, and occasional fluid administration. Kathie would smuggle in fluids, and collectively, we did all that we could.
When. Chaminou’s health status became terminal, we were faced with the impossible decision of how to approach Collette with the bad news. Her memory issues caused her to forget entire conversations about his disease. She became noticeably more easily agitated. She misplaced her wallet often, and became very upset during the visits looking for it. During one visit she began yelling at a nurse, accusing her of stealing her wallet, only for us to locate it in a purse minutes later, where she had hidden it in her closet. She would call me in tears relaying episodes of Chaminou being too weak to get up to eat. We would visit and discuss with her that he was dying, and she would understand, cry, and seem lucid. Yet the following week, it was as if the conversation had never happened. It was painful to revisit the diagnosis with her repeatedly, and see her visibly crumble with the “new” reality.
Kathie’s and my biggest concern was that Chaminou might die with Collette alone in her room. The thought of that kept me awake at night,. We discussed that it was best to intervene and humanely euthanize him, knowing that she would be there to witness it, and hopefully not find herself, weeks later, frantically searching for him after he had passed. Yet, each time we would come up with a plan, she would seem to have forgotten it, so it took several visits to make sure that she understood what we were intending to do. And, to make it worse, she seemed to be visibly physically declining as much as he was. I feared what would happen to her without her best friend to keep her company.
The day ultimately arrived, and my nurse, Kathie and I dragged our distraught selves into her room. Collette was aware and crying upon our arrival. We gently, and respectfully, sedated him, and then administered the final medication. She knew at that time, what was happening and wanted to spare him of worsening or dying in her presence. It still was so incredibly difficult for all of us. When he peacefully had passed, my wonderful nurse, who happened to speak French, whispered to Collette what translated to “alas, he is gone.” She quietly sobbed with us for several minutes.
I cried every time I drove by her building for weeks. I am tearful now just remembering it. For a month afterwards, I communicated with Kathie to see how Collette was the weeks and months afterwards, and if she was confused. She had been at first, but soon understood, and evidently remembered us coming and him passing. Sadly, as I suspected, Collette herself passed three months after our visit. I find peace and comfort picturing them all together now… Collette with her son, husband, and of course, Chaminou.
Dr. Dawn
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