Wednesday, July 7, 2010

Oscar the End of Life Cat

Making Rounds with Oscar by David Dosa (362.1767 DOS Main)
Reviewed by Jeanne

Not too long ago, the news services and internet sites were all agog over “Oscar the Death Cat.”According to an article in the New England Journal of Medicine, this cat seemed to know which patients were near death and would sit with them until they passed.The article claimed that in some cases the cat’s prediction was more accurate than the doctor’s assessment of how long a patient would live.

Dr. David Dosa wrote the original article which he has now expanded into a book.He is a physician and researcher who specializes in the needs of the elderly. His work often takes him to Steere House, a nursing and rehabilitation center with a large number of older patients, many of whom have various forms of dementia. The staff tries to keep them as comfortable and content as possible.To this end, Steere House has cats to make the patients feel more at home. One cat, Oscar, isn’t exactly a lap cat: he’s independent, permitting petting on his own terms, and not overly affectionate. He swats Dr. Dosa when he tries to pet him and isn’t particularly sociable with patients.

Yet according to the staff, he keeps a vigil over the dying by lying next to them, purring.He seems driven to do this, pacing outside doors, anxious to get in and to do his duty. Some who have experienced such a scenario believe that Oscar is bringing comfort not only to the patient but also to the soon to be bereaved.

Dr. Dosa becomes intrigued and sets out to interview staff and families of those Oscar attended. There are some theories, some interesting stories—such as what happened once when two patients were dying at the same time—but the focus of the book subtly shifts from the mystery of Oscar to a bit of a meditation about the end of life. He describes the various patients and their families. Some are adult children, trying to balance care of their own families with caring for their parents; some are elderly spouses struggling to meet the needs of an impaired partner. Dr. Dosa presents a sympathetic portrait of all concerned, but gently raises questions about what we expect and what we should expect about end of life care. He doesn’t lecture or judge, but he does make you think.

At the same time, Dr. Dosa examines the human/animal bond. Many nursing homes and other care facilities have found that having an animal around is comforting to patients.There are many theories as to why this is so. Perhaps it’s because an animal makes the facility seem less institutional and less impersonal; perhaps it’s because an animal doesn’t ask any questions or make any complicated demands, or maybe evokes memories of earlier times. Whatever the reasons, most people do seem to respond positively.

Part of the book’s effectiveness is that Dr. Dosa discusses his own feelings. He’s relatively young, but already experiencing a few health problems. He’s beginning to think about what he wants for himself when the time comes. He made me think about what I want, too. A patron who read the book said she was inspired to go ahead and take some action to ensure that her wishes are carried out.

That’s a pretty impressive accomplishment for a slim little book.

Much to my surprise, I finished the book with a positive outlook. I’d met a lot of good people: staff, patients, caregivers. I’d met one amazing cat, Oscar. I’d faced what could have been a big, scary, depressing subject and come away feeling empowered.

I highly recommend this book to anyone with an aged relative—or to anyone who aspires to become a senior citizen at some point.

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