While all sorts of aids to daily living are subsidised, there is no assistance to support the presence of a pet
As an avowed and long suffering Western Bulldogs AFL supporter, I am still coming to terms with our magnificent and well-deserved premiership win.
Here was one instance when envy from the wider football public was not a prevailing emotion. Australians love the underdog and the Aussie battler.
After 62 years, it was widely felt that we Bulldogs fans deserved to bask in this glorious achievement. However, dogs are more than merely a club mascot, as I hope the cases below illustrate.
BEA’S STORY
Beatrice (“call me Bea”) was in her early 70s when I first met her. She was a World War II widow in receipt of a widow’s pension and attended our clinic only because the doctor down the road, who had cared for her and her family for 30 years, had retired.
She knew that she had a heart condition, “bronical asthma” and “blood pressure” and presented me with a Tupperware box of pills and inhalers from which I was meant to derive her various diagnoses.
This was not a difficult task, however, I was rather surprised that among her regular scripts was a 500ml bottle of cod liver oil, which I dutifully prescribed on a regular basis. The cost of her medications were covered by the Department of Veteran’s Affairs. I felt that we had more modern concoctions for constipation, but Bea insisted on her regular script for cod liver oil.
On a wet wintery Monday morning I received an urgent call from a very distressed Bea. She was suffering severe abdominal pain and had not opened her bowels for two day, which was most unusual for her.
I did a house call in the knowledge that cod liver oil resistance would not be described in the literature. I was welcomed by a magnificent and rather tame-looking red setter. When I examined Bea, she was febrile, tender in the left Iliac fossa and seemed quite distressed with the pain. Her dog looked on rather sorrowfully as I carried out the examination.
I felt that Bea may have diverticulitis and that hospital admission would be essential. I suggested that she take her medications with her but she could leave the cod liver oil at home.
I commented in passing what a beautiful dog she had and wondered who would look after him if she was in hospital. Bea suddenly became tearful as she replied: “Jack, my son, will look after the Lawrence the dog, but that’s not why I am so upset. I have to tell you doctor that the cod liver oil that has been prescribed all of these years was not for me but for Lawrence. You noticed what a fine coat of hair he has. It’s the cod liver oil.”
Bea made a rapid recovery and a week later was home reunited with her beloved Lawrence. On reflection, I felt continued prescribing of cod liver oil was warranted. I have no doubt the cost-benefit equation in relation to Bea’s wellbeing was very much in favour of such action.
JENNIFER’S STORY
Jennifer was aged 90 and her long-standing aortic stenosis was beginning to take its toll.
She was becoming short of breath with very little exertion and had three hospital admissions over a six-month period for heart failure. She also suffered from COPD, which appeared stable over this period of time, and generalised osteoporosis.
Following her last hospital admission, she met the cardiology team who advised her to have a transcatheter aortic valve replacement. She came with her daughters to discuss the pros and cons of this procedure.
Fortunately I knew a little about it. A family member had undergone this procedure at a similar age and it had added five symptom-free years to her life.
I had also recently attended a cardiology conference where papers were presented on the success rate of inserting a new aortic valve through a femoral or brachial artery approach.
I strongly encouraged Jennifer to have the procedure.
Jennifer was a widow but did not live on her own. She had Rufus, her 16-year-old labrador who had been an integral part of the family and a vital part of Jennifer’s life. Her main concern was who would look after Rufus. He was losing his hearing and had arthritis in his hind legs.
Jennifer had gone on short interstate trips with her friends, and at the age of 88 went on a Pacific cruise. Her daughter Vanessa had looked after Rufus during these times and was prepared to do so again. So Jennifer agreed to have the procedure.
Five days after the procedure I had a message from the hospital that the procedure had gone well, Jennifer had made a wonderful recovery and was ready to be discharged home. I phoned the daughter and was met with the tragic news that Rufus had died. He had developed a skin infection, which resulted in septicaemia, and within 24 hours he was gone. Vanessa was devastated and was preparing to go to the hospital to break the news to her mother.
Jennifer came home, but was inconsolable. Vanessa stayed with her for several days and although the doctors reassured her that her mother was now fine, this was not the way she appeared. Jennifer still complained of shortness of breath, had no energy, was tearful and could not sleep at night. She blamed herself for Rufus’ death.
It became clear in the coming weeks that Jennifer was depressed, was having a grief reaction, and was struggling to cope on her own. Previously fiercely independent, she ultimately agreed to go into a residential aged-care facility The cardiac procedure was a technical success, but the patient did not recover.
There is plenty of evidence to support the benefit of pets to the lives of their owners, particularly when those owners are elderly and live on their own.
Loneliness is one of the greatest afflictions of the elderly, especially widows or widowers. While all sorts of aids to daily living are subsidised, there is no subsidy to support the presence of a pet in the life of an elderly person. Perhaps it is time to rectify this.
Leon Piterman is Professor of General Practice at Monash University and has been in clinical practice for almost 40 years
Do you have similar professional experiences you would like to share? Please email: grant@medicalrepublic.com.au
