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May 3, 2011

1

Aged Care Staff … if you don’t laugh about it, you’ll scream.

by Prue Miller

On the afternoon and then evening of the Royal Wedding, I was working in a, small and not to be disclosed health facility, taking care of four lovely ladies – whose combined age made them older than the royal carriage that carted the happy couple away post vows.

It certainly added a bizarre twist to the event, as three of the four ladies were in various stages of dementia. Caring for dementia sufferers, in a professional sense, is particularly tricky. Especially for someone like me who comes into a situation with no prior knowledge of how whacky these dear souls are; what will set them off into an abusive tirade, what will scare them witless and what will calm their dreadful fears. You just sort of feel your way for the first half hour, then leap in, hoping you’ll think fast enough on your feet to keep everyone at least safe, and if you’re lucky, happy.

A distraction such as a Royal Wedding can as easily be a godsend as much as it may also be a problem. Distraction can add to the background noise of the disease, and agitate rather than soothe. But a Royal Wedding? I thought I was onto a sure thing, and was doubly thrilled to discover that the coverage started at 4pm and would last my whole shift.

One of my charges was a woman possibly in her seventies of such grace and beauty that to call breathtaking was to understate her presence. Elegance personified, beautifully spoken and, to use a great expression of my dear mother, as warm as toast.

She was very happy that she was to be involved in a good evenings entertainment, and she told me that as soon as she “put the ponies away”, she was hoping to have a wine and settle down to watch it. With that she wandered off to the bathroom to reapply her lipstick, returning moments later prepared for the work at hand – she had slipped on a pair of gumboots located in the shower room. Pajamas, lipstick and gumboots – it was quite a sight. I let her keep them on, it seemed to me that gumboots were something with which she was familiar, so why not?

Another cohort was convinced she was dying. Now this is not unusual in older patients, but somehow this particular woman had a way of expressing her imminent demise in such as way as to make it entirely funny. Not long after I arrived she declared in a strong, clear voice. “I have just taken my pulse, and I don’t have one. I am dead.” It seemed she was challenging me to prove her wrong. I dutifully took her pulse and announced her very much alive. “And in any event”, I told her, “if you can speak there’s a good chance you’re still with us.” She tut tutted at my ignorance of such things, and snatched her wrist back from my grasp – I was not to be trusted with her pulse it seemed.

I looked across at the third patient, who was about 80 I imagine. She had several mismatched layers of clothing on, topped off with a hospital gown, and over one arm she had a large handbag and she asked if I could get her the phone. She had the prettiest little face, sort of translucent – not wrinkled really, with clear but fearful eyes. She wanted get home to her mother’s house, as she was sure her Mum would be worried about her. After reassuring her that her Mum knew where she was and she wouldn’t get into trouble, her pleas changed – now she wanted me to call her son. She didn’t know where she was, but was absolutely sure her son would come and get her, if he only knew where she was. Her fears were escalating and I redirected her to get ready for the Royal Wedding on the television. She said she didn’t have a television, didn’t own one. I redirected her again to her TV and wondered if, perhaps she would be more comfortable if she took off at least one layer of clothing. “No!” she said “I have to be ready for when my son comes.”

At that point the Pony Lady called out to us, “Oh good! Is he coming to watch the wedding? That will be fun!” she said as she sat on her bed, and crossed her gumbooted legs – managing to still appear remarkably elegant. I wondered if she had been part of the polo set? “I might stay and watch it here” she decided. Which, as we were in a locked ward seemed a good attitude to adopt.

Our fourth companion for the evening was not demented, but had become so ill that she had lost many talents, including speech. So I had to keep an eye on her to see that she was not gesticulating that she was in need of a bed pan or CPR, or whatever.

The daughter of the Not Really Dead patient arrived, looking harassed and a touch cross. She had in her hands a range of small cartons boosted from the chiller section of a supermarket: custard, crème brulee, jelly, pureed fruit. Before she’d even made it across the room her mother shouted at her “I’m not eating ANY of that. I don’t know why you got that. You know I don’t like that. Take it back. I won’t touch that,”

“But Mum…”

“No. You are just stupid. You know I can’t swallow anything. I’m choking. I’m choking right now.”

“Mum, you’re not choking.”

“I AM! I am choking. I am going to die right now.”

“Whose Mum is dying? ” called out Fearful Lady “Is it my mum? She doesn’t know where I am. And she’s dying!”

I assured her she wasn’t dying – and she knew where she was and not to worry. Pony Lady sashayed across the room to help calm Fearful Lady, the gentle scuff of the gumboots on lino seeming entirely correct for the room. “Now what are you worrying about? No one’s dying here.”

“I’M DYING!” called out Not Really Dead Lady.

“Oh Mum you’re NOT dying. Anyway the wedding is on tonight and you wouldn’t want to miss it – here have some custard.”

“This is a very nice hotel,” commented the Polo Lady as she scoffed down all of the sandwiches left on the Fearful Lady’s tray table. “ You really should just relax. Come over and have a wine with us this evening.”

“Do you have my son’s phone number?” Fearful Lady asked, “If you could get my son’s number we could call him and he could come and get me.”

“No my dear,” said Polo Lady “But let me see if I can help.” And with that she sat down on the edge of her new friend’s bed and, using her ever present lipstick, started to write on the nearby serviette, left bare by the ingestion of the sandwiches. “Now what’s your son’s name?”

I stepped in and swapped the lipstick for a pencil.

“Oh thank you my dear, this will work much better. Now, where were we …oh yes, what’s your son’s number?”

“I don’t know – you should know.”

“Oh should I? Let me think.” And she walked back across to her side of the room and rummaged about in her purse and came out with a Woolworths receipt. “Is this his number sweetheart?”

“Yes! Oh thank you. That’s all I needed. His number. Have you got a phone?”

“No, but I’m sure of you ask this lovely waitress” she said, waving toward me with a huge warm smile, “she could find one.”

“Excuse me,” asked Daughter “Have you seen Mum actually drink any fluids today?”

“I CAN’T drink – I’ll choke,” snaps the Not Really Dead Lady.

“I’m not asking you Mum, I’m asking Her!” barks Daughter.

“Well don’t ask her, she doesn’t know anything. She can’t even take my pulse.”

“She took your purse?” asked Fearful Lady of The Not Really Dead Lady.

“No” I say, “she says I can’t take her pulse.”

“You took MY purse too!” says Fearful Lady accusingly as me. “It’s not here. You took it!”

“No truly I didn’t.”

“You did! I saw you.”

“And my watch is gone!” chimes in Not Really Dead Lady.

“Oh Mum! That watch has been gone for ages. Look I’ve brought in this new one for you.”

“I can’t wear THAT watch. That’s not my watch.”

“It is Mum I bought it for you – look we’ll put it on.” And with the daughter tried to put the new watch, on the old mother.

“I hate it.”

“Mum – really? You haven’t even got it on yet.”

“I don’t have to get it on to hate it. I don‘t know why you buy all this stuff. And you can take all that food with you too. It’ll just choke me.”

And at that moment, the Royal Coverage of the Wedding began. Kathy Lette and Lisa Wilkinson appeared on the TV sets. Pony Lady kicked off her gummies and reclined on her bed, staring up at the screen. Quiet.

Fearful Lady couldn’t bring herself to sit down, but rummaged around behind her bed and found a suitcase which she carried over to Pony Lady’s bedside, where she stood for quite some time, alternately staring up at the screen, and watching the doorway.

“Mum look!” says Daughter, “The wedding is on.”

“I can’t see any bride. What’s wrong with my television? I don’t have a wedding on MY television” barks Not Really Dead Lady.

“It’s not actually on yet Mum, they’re just talking about it.”

I went over and put on the television for Sick Lady, who didn’t react in any way and I slyly watched to see if she was still breathing, which she was.

It was all-quiet for ten minutes.

Then Frightened Lady’s telephone rang, and I leaped for it hoping it might give me some information to help calm the Fearful Lady. It was her son, calling from Brisbane. Her face lit up as she took the phone. “It’s Mummy here! When are you coming – are you on your way?” and I braced myself for how the conversation was most likely going to resolve itself. I had been witness to this conversation countless, countless times. I watched Frightened Lady’s back curve over, and saw her shoulders heave. I went over and rubbed her back as she berated her son. “You are so mean, you are so mean, mean, mean to me! Come and get me out of here!,” actual tears started running down her cheeks, as I rubbed and cooed to her that it would be alright, we could watch the Royal Wedding together, just ‘us girls’.  But she was desolate and desperate and frightened. All of which she unloaded on her poor son. I gently took the phone from her and talked to the son, who was himself dreadfully upset.

“Are you okay?” I asked him.

“Christ! This is just so awful – every day I call, this is what happens.”

“Do you have someone with you? Can you call someone?”

“Thanks. Thanks for asking – no. There’s no one here. Maybe I should call later?” asked Sad Son. But that wasn’t going to help anyone, so I gave him the permission he sought to not call, to go and have a life, to go and watch the wedding with some friends at some noisy pub and to give himself a free pass on the guilt, for just one night.

“Thank you, thank you so much,” he whispered between sobs. And then he was gone.

I wiped away the tears from Frightened Lady, made a cocoon of her pillows, lay her down and placed the blankets over her and calmed her until she finally closed her eyes for a little pre dinner nap.

The PEG feed on Sick Lady suddenly fell out of her line, and spewed coffee coloured protein mix all over, and by the time I cleaned that up Not Really Dead Lady had had enough of not really watching the wedding, and decided to continue to pick on Daughter who finally had enough, picked up her bag and started to leave,

“You can’t go!” said NRDL “You can’t go! You are wicked if you leave now. I haven’t had any dinner!”

“But you said you wouldn’t eat anything, cos you’d choke!”

“I never!”

“Mum, you did. Here then,” said the dog tired Daughter  “Have a few mouthfuls of this puree…”

“I’m not eating that, I’d choke!”.

Daughter picked up her handbag, wished me the best of luck for the night and leaves. “You’ll need more than a Royal Wedding to keep this lot happy!” she laughed as she walked away.

The night went predictably, people getting up to leave, demanding bus fares, telephones, their home addresses while wearing a variety of clothes, or no clothes at all. I was barked at, then hugged, thanked and shooed away. I was called Hey You, Sister and Girl. I walked a hundred kilometers in a room of 35 square metres. For my half hour meal break, I walked in the rain to a deserted section of the facility, raided the vending machine and ate a Mars Bar for dinner in front of yet another television, as Katherine walked down the aisle.

It was an odd night, and despite all the hard work involved I really enjoyed the company of these unique women, as we shared the Royal Wedding.

They say dementia numbers will triple in the not too distant future, and odds are it will one day be me dressed in my pearls and wellies, demanding a sparkling white wine with my puree cottage pie.

I do hope I get a kind waitress to look after me.

1 Comment Post a comment
  1. Amanda Buckworth
    May 3 2011

    Can we have adjoining beds? I’ll bring my pearls too

    Reply

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