I am writing to you to commend your unit for providing exceptional care to my mom while she was hospitalized and ultimately died. She broke her hip, was admitted, and underwent a right cephalomedullary nail placement to correct it. Exams were gentle (as much as possible, given the pain). Her preoperative visit for the Orthopedics service was excellent. He explained the procedure clearly and laid out the plan after surgery. He answered all of her (and our) questions patiently and we did not have the sense that she was "just another hip" to him, but rather a beloved mom. The nursing care before surgery was also excellent. I am not sure I have all of the names. The transfer from the ER was smooth. Care was taken to move her as gently as possible. She was positioned to prevent skin breakdown and she was turned, and her skin was inspected regularly. When she would put on her light, someone answered quickly, and medication was given as needed, with applesauce to help swallowing. Her necessary care was given, working around her pain. The nurses were firm in that they needed to perform certain tasks, but they were kind. Many times, two people teamed up to be able to get something (linen change, position change) done more quickly to decrease her distress.

On the morning of her surgery, she went down with a "thumbs up" and a smile on her face. Postoperatively, the careful attention to nursing care and pain relief continued. The Orthopedic PA who saw her postoperatively also explained everything clearly, gently changed her surgical dressings, and patiently went through the next steps, caring about her as an individual. Her postoperative care continued to be excellent, both nursing and tech. Everyone who had contact with her made sure she was comfortable, kept positioning to avoid skin breakdown, trying to get tasks done in the times she was most comfortable. Pain medication was given, and the nurses contacted the doctors and got quick responses if changes were needed. The day after surgery, Physical Therapy began. They were able to help Mom sit up on the side of the bed. She was in a lot of pain. They understood that, but also made her understand that this was necessary to recover. They were kind and caring. She also had a Speech Therapist who came in and evaluated her swallowing. She recommended nectar thick fluids, using Simply thick thickener. This, along with using applesauce to take her pills like she did at home, helped. The next day, PT returned. With a lot of gentle cajoling and bribery (using baby pictures), she got up in the chair. She sat, comfortably, for a long time. She returned to bed via a Hoyer lift. She told me "I flew!".

The next day, her demeanor changed; she appeared withdrawn and did not interact with the staff as she had been. The PT came in to help with therapy. Mom was not interacting with her, was not willing to perform the movements she was asked to do. She asked me if Mom had changed because the previous therapists had not said anything about this behavior. I confirmed that, indeed, she was different. Later that day, when my sister and I were both with her, we talked about what was going on with her. She told us that she just could not do this. When we talked further, she expressed her desire to stop treatment and go into hospice. Her nurse contacted the doctor, who came in and talked to us. She made sure this was what Mom wanted and set the wheels in motion. She changed her level of care to Comfort Care until hospice placement could be obtained. She told Mom she would not get medications, except for paint/comfort, no blood draws, blood sugar checks, vital sign checks, and no more PT. (She got a big smile with that!). She made sure Mom understood this and that my sister and I did too. Mom agreed, and we began Comfort Care and a search for a hospice. This is the point where your team moved from excellent to exceptional care. We are aware that yours is an Orthopedics unit, and this situation is rarely encountered. We could not have asked for better care. Without exception, the nurses and PCTs were respectful, caring and non-intrusive. Our call lights were answered quickly, and medication was given regularly for comfort. They also checked on the family's comfort, offering water, pillows, or blankets. One day, 10 of mom's grandchildren came in, to say goodbye. Mom was able to finish this business, as were the grandkids. There was no censure from staff, just the freedom to finish this life task. After that, she withdrew almost completely. The nurses would address her by name and tell her what they were doing, even though she did not respond. They were respectful and caring. We felt they cared about her as a beloved Mom and Grandma and Great Grandma, not just another patient. This was a gift they gave us.

When she died, the arrangements for Gift of Life were initiated. She ended up donating skin but also participating in research to train those harvesting organs in the correct techniques, using her organs to learn. Even though they couldn't be used for donation, she was able to help. When the time came to prepare her body, my sister and I were able to wash her face and hands, respectively. This allowed me time to recognize, one last time, the work her hands did throughout her life. This was meaningful for me. I have kept the names of all the nurses and PCTs who cared for her. I am sure there were some I missed since I wasn't with her 24/7 during this time. I want to recognize Genevieve for their particular compassion and a true sense of care both for and about Mom. I felt like they were caring for her as they would their own parent or grandparent. That is unusual and special. I am grateful they could share their gifts with us. I don't think there is any way they could know how much this touched our hearts. Thank you.