Oscar
the cat was born in 2005. He was adopted as a kitten from an animal shelter and
grew up in the third-floor end-stage dementia unit at Steere House Nursing and
Rehabilitation Center in Providence, Rhode Island, USA.
When
the care home was originally being built there was a stray cat on the site who
refused to move. The staff eventually adopted him as a therapy pet and called
him Henry after the benefactor Henry J.Steere who had initiated the building of
the facility. When Henry died, Oscar was one of six cats adopted as part of the
home’s pet friendly policy.
The
41-bed unit treats people with Alzheimer’s, Parkinson’s Disease and other
illnesses, most of whom are in the end stage of life and are generally unaware
of their surroundings.
Oscar
came to public attention in July 2007 when he was featured in an article by
David Dosa, a geriatrician and assistant professor at Brown University, in the
New England Journal of Medicine.
According
to Dr Dosa, Oscar appears able to predict the impending death of terminally ill
patients. After about six months, the staff noticed that Oscar, just like the
doctors and nurses, would make his own rounds. But he never spent much time with
the residents —until they are in their last hours. Then, as if this were his
job, Oscar curls up on the bed, and begins his vigil.
Dr.
Dosa was aware that cats and a few other animals lived on the premises, and had
seen many of them, including Oscar. However, he did not officially meet Oscar
until Mary Miranda introduced them one day. Mary Miranda is the day shift nurse
in the third floor Safe Haven Advanced Care unit, She brought Dr. Dosa to the
bedside of Mrs. Davis, a woman about 80 who had been diagnosed with terminal
colon cancer about three months earlier. Although Oscar was sleeping quietly on
the bed next to Mrs. Davis, he saw nothing unusual.
Even
after Mary told him that Oscar had accompanied a few other patients lately who
had died in his presence, Dr. Dosa was skeptical and even more so after Oscar
scratched him for trying to pick him up. When Mary called him later that
afternoon to tell him Mrs. Davis had died with Oscar beside her shortly after he
had left, it made him wonder. Sometime later, Mary called again to tell him that
Ellen Sanders, another patient had died and Oscar was there, even though the
ward personnel had no reason to expect her imminent passing.
One
of the first cases involved a patient who had a blood clot in her leg that was
ice cold at the time. Oscar wrapped his body around her leg and stayed until the
woman died. In another instance, the doctor had made a diagnosis of impending
death based on the patient's condition, while Oscar simply walked away, causing
the doctor to believe that Oscar's streak (12 at the time) had ended. However,
it would be discovered later that the doctor's prognosis was 10 hours too early:
Oscar later visited the patient, who died two hours after.
As
of January 2010, Oscar had accurately predicted approximately 50 patients'
deaths. Oscar's accuracy led the staff to institute a new and unusual protocol:
once he is discovered sleeping beside a patient, staff will call family members
to notify them of the patient's (expected) impending death.
Most
of the time the patient's family has no problem with Oscar being present at the
time of death. On those occasions when he is removed from the room at the
family's request, he is known to pace back and forth in front of the door and
meow in protest. When present, Oscar will stay by the patient until they die,
then after death will quietly leave the room.
In
consulting with families when Oscar has been present, it has been a universal
theme that he has been a source of companionship to the patients and has proved
a great comfort to the family at this difficult time.
The
book takes us through the thought processes of the doctor and his initial
cynicism about Oscar's importance and the feelings of relatives of the deceased
about Oscar's visits.
In
2010 it was announced that the story was going to be made into a film but I
can’t find any more about that. There is a 5 minute clip from Fox News, The
Rhode Show on You Tube.
Dr
David Dosa is a geriatrician in Rhode Island and an assistant professor of
medicine at the Warren Alpert Medical School of Brown University. Dr Dosa has
published in scientific peer-reviewed literature in the areas of nursing home
quality improvement, delirium and end of life care. He lives in Rhode Island
with his wife and two children.
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