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Our Patients. Their Stories. Genevieve McKee

Our Patients. Their Stories. Genevieve McKee

Genny’s care was beyond anything we could have expected.

Deborah McKee, Genny’s daughter-in-law, Thetford, VT

For the last fifteen years of Genevieve (“Genny”) McKee’s life, her September birthday became the perfect opportunity for a family reunion. Her adult children and grandchildren, nieces and nephews, traveled from as far away as Oregon and Indiana to celebrate the tireless grace and sparkling presence of a woman whose life could be defined by her boundlessly generous heart.

Yet in those last years, Genny’s heart presented a number of health challenges: vascular disease, congestive heart failure and atrial fibrillation—an irregular heartbeat. Genny recovered from six arterial bypass surgeries between 1992 and 2009.

Nevertheless, as she reached her 80s, now also exhibiting signs of onset dementia and of diabetes, her son Glenn McKee and his wife Deborah, of Thetford, VT, were concerned about her growing vulnerability. “With all of her health issues,” Deborah says, “it had gotten to the point that when she had another hospitalization, it wouldn’t be deemed safe to discharge her back to living alone in her apartment.”

The McKees, after agreeing that Genny’s last years should be secure, safe and with family, decided to invite her to live with them in Vermont. Perhaps the most important part of the transition would be moving Genny into a new care community. Their experience establishing her in elder care at Dartmouth-Hitchcock (D-H) could not have been smoother. They helped Genny set up her myD-H account and search the provider database, and she chose Daniel Stadler, MD, as her primary care provider. “She liked Dr. Stadler’s picture,” Glenn says.

“That we were able to get her plugged into her care network before she even relocated, not in a crisis mode, turned out to be pretty significant,” Glenn notes, especially since one week after her arrival, Genny was stricken with Legionnaire’s Disease, a life-threatening pneumonia that was met with quick diagnois and treatment at D-H. After three weeks of inpatient care, Genny was glad to return to her new home in Vermont.

They were even more impressed with Stadler and his team’s compassionate approach to outpatient elder care, always acknowledging that Genny had a voice in her care decisions, including advance directives, and recognizing the value of her opinion. “So much of her life was out of her control,” Glenn says, “from losing her mother at three years or age, then as an adult finding herself the sole caregiver for four kids and then in her last years losing the ability to live independently. For Dr. Stadler to listen to her and empower Mom in her health decisions was huge.”

About a year into Genny’s stay with Glenn and Deborah, she suffered a heart attack at home. After she was admitted to Dartmouth-Hitchcock Medical Center and stabilized, her cardiologist suggested the need for a stent to be placed on the occluded artery. But given her vulnerable condition, Genny was conflicted about having this procedure done. A thorough consultation with James DeVries, MD, in Cardiovascular Medicine, who would place the stent, helped her weigh the risks and benefits, and together with the patient the decision was made to not pursue stent placement based on her values and goals of care.

Next, with Stadler, she explored alternatives to surgical intervention. Glenn recalls, “Dr. Stadler explained that choosing to stay home in the event of another heart attack would not mean she would die painfully. We would do all we could, equipped with pain medication, to keep her comfortable.”

In addition to monitoring her health, as Genny’s live-in caregivers, Glenn and Deborah discovered the challenges of preserving her sense of independence, encouraging her to find community in Vermont, while constantly seeing to her safety. Deborah is grateful for the wisdom and guidance she received from the Caregiver’s Support Group at the D-H Aging Resource Center.

Because caregiving can be an immensely taxing responsibility, the McKee’s had others step in as Genny’s caregiver for a few hours or even a few minutes at a time, to give them a much-needed respite. “We would work out times of day when it was a good time for someone to call and talk to her,” Glenn says. “Anyone who’s done caregiving knows how important respite is, a break from having to focus.”

Up until her peaceful final day, while in respite care at a nursing facility as Glenn and Deborah took a short vacation, Genny maintained her deepest gratitude for family and friends, for Stadler and the wider D-H network of care. Everyone brought her not just safety and security, but strengthened her sense of self. Genny died with a smiling heart.

Genny’s Gratitude

She listened to reminders swimmingly,
until we echoed the timer’s stale signal
that twenty minutes had passed since the last
time Mom reluctantly stood up to heal
her pressure sore. She’d plead, “It’s getting better!”
We’d answer, “That’s because you’re getting up!”

A different story would unfold when you
would make my mother’s showers possible,
or telephone Social Security;
when we’d make crucial breakthroughs with a puzzle;
fulfill our whimsies at a restaurant;
or we three laughing with Mom’s Doctor Stadler.
You, patiently chaperoning prescriptions,
inviting Mom to weekly med box dances;
my offers to clean her glasses, to find
them all smudgy from sleeping with them on.
Outfitting: wardrobe encouragement; your
hands conquering the challenges inherent
in every single zipper and necklace;
my parking lot magic act that delighted
the lady, once more turned into a driver;
fun steering her loose photos into albums;
the toenail trimming, serving one who served;
or counting out the buttons of the phone.

Mom gratefully received the things we brought,
unless we had just placed her evening meds
adjacent to her dinner plate, provoking
her exclamation of “Too many pills!

Not so, when we’d bring her a tall glass full
of water clinking brightly with ice cubes;
a cup of hot tea—morning, noon or night;
your meals, inspiring Mom to say, “Oh, Boy!”
Subsequent marvels at dessert, each taste
once dreamt by this daughter of the Depression.

A highlight reel would feature Monday tuned
to Antiques Roadshow; American Pickers
on Tuesday; Thursday Pawn Stars (unashamed
lover of the yard sale scene). Want to go
out? You know it! Out driving, we’d encounter
loud cows or wary horses wishing us
to pull over and coax a dialogue,
or gliders lifting off the airport grass.
Back home, excitement on the deck when sighting
assertive, buzzing hummingbirds, or feisty
nuthatches or the businesslike woodpeckers;
bring up an inchworm from the yard, and she’d
adopt and fuss about her crawling friend;
repeated Youtube replays of “You Raise
Me Up”—the only version—Mom endeared
to the crowd on that rainy Holland street,
enthralled how Martin Hurkens brought that song;
then, Buddy Ebsen dancing like she knew.

We could have cultivated more delight.
The opportunities came every day.
Another chance to prize Mom’s gratitude
became, inevitably, memory.

Glenn McKee - 2016