I had to laugh when I opened the mail today. I received a Christmas card from a local funeral home…….the handwritten note said, ” Hope to see you soon!”
The world has become so advanced with how we communicate with one another, I think we often forget how to communicate. We text, FB, Tweet, Viber, Instagram and Snapchat our way through the day, interacting with those around us….. We share our lives openly by posting pictures on social media, storing precious pictures of life events on a memory stick and on in cloud libraries. Advanced and high tech would certainly describe our society in a nutshell.
But you know, I think we have forgotten how to sit down with someone and talk face to face , without interruption of a ding, bling, chime or musical melody. It is like we need the distraction of an electronic device in our hand to even engage in a social encounter. Follow me here:
One of the places that I love to meet people is airports. I strike up a convo with any nearby stranger and trade stories of where we are going, what the weather is like or going to be at our destination and on and on. Once on the aircraft, I engage with my seatmate about airports, air jams, the beauty of a sunset from our view…
Leaving on my last flight out of DC, I took my seat in the middle of the airport waiting to board. I looked around to see who I could spend a few minutes with .Suddenly I found myself outnumbered by cell phones, ipads, tablets, kindles and some devices I could not identify. Not one person looked up from their devices to acknowledge my asking “ Is this seat taken? ” After a few minutes of feeling displaced, I went over to the food court only to find tall tables with ipads as the center-piece to place your food order, surf the net while you eat and read your email. I scanned the crowds, looking at the countless number of people, all looking down at the device; lost in their own world, unaware of those around them. But they are all communicating with someone…somewhere. Communicating.
Once onboard the plane, I took the window seat as usual. I love to watch the clouds float gingerly by on a beautiful day. For me, flying is a peaceful event; freeing me from phones, ipads, computers and any other device. my seatmates seemed like they would be interesting conversationalist…one appeared to be Middle Eastern and the other, possibly a Greek National. After a few minutes of ” Hi, how are you? Mind if I scoot my bag under the seat” chat, we are airborne.
Within ten minutes the flight attendant announces: ” Welcome aboard, the Captain has turned the seatbelt sign off, so you may move freely in the cabin and you may now use any FAA approved electronic devices. This flight offers WIFI, so feel free to connect and enjoy the internet for this 6 hour gate to gate flight…….. ”
INTERNET? WIFI?? What happened to the peace and serenity of flying? I looked over at my seatmates to discover they both had successfully connected to the www. of life. Connected….. Connected…. Successfully Connected. Hmmmmmmm.
As I sit at my desk today, I listen to a daughter talking to her mother as they go through an old photo album together. “ Mom, this is you and dad, and me and Bobby. It was taken at the old cabin beside grandmas. Do you remember mom? Without expecting an answer, the daughter moved on. “Look at this picture mom. Remember how we vacationed in Big Bear at the lake? Look at this one mom, it’s you and dad at Lake Arrowhead. Look at Bobby in those red pants! Remember mom? Oh here is one of Bobby and I at the church banquet when I was maybe 8. Look at how handsome dad was in that blue suit. You were so beautiful mom in that dress. Here is a picture of Bobby’s graduation from high school; look you and Bobby, Dad and Bobby…..Look mom, here is your and dad’s 50th wedding anniversary picture…..There is Mr. and Mrs. Moore, Mr. and Mrs. Emerson, Mr. and Mrs. Oglen……
Sitting there eavesdropping on the conversation, I realized that it was THAT generation that was truly connected. Just by listening to the daughter identify the pictures to her mother, I could tell that this was a family that spent time together, loved one another and captured their memories in a worn out photo album.
What will our generation have? Cell phone cloud memories? Facebook images? Will we have any captured moments at all since we are so busy snapchatting , vibing, texting and hanging on social media? We never look up long enough and glance away from the electronics to notice the dawn sunrise, the evening sunset or the people around us. Yet the generations before us were more connected than we will ever be. Their memories may not be digitized, tagged and have a thumbs up logo, but what they do have is an everlasting remembrance to a different time and place. A time of fireside chat radio, face to face family visits and time well spent. I call that successfully connected.
Dementia is a unique and interesting thing. It may affect one person one way, and another, the complete opposite. Some days in our line of work, it is impossible to determine if dementia is the culprit to a certain behavior, or was the individual always this way. I understand that not every single 90 year old was not always a sweet, cute ball of happiness , but geez, can there be so many vicious, mean ones?
Let me tell you about Shirley to give you an idea of what I am referring to when I say “mean.” Wow. Shirley is a full packed pistol. This morning as I was walking through the facility, I encountered her or should I say, heard her.
” All of you can go to the pits of hell. All of you belong in jail. I am going to kill you all. You all are Godless heathens who need to go to jail and never get out. Let me get up from this chair and you will find out what kind of person I am. I don’t mess around. I mean it. I will kill you all. You hear me? Answer me!!!!!! Fine, don’t answer. But I tell you one thing, when I get my hands on you, you better get running and hope I don’t catch you….” Shirley continued on and on, and seemed to be working herself up, so i felt the need to visit with her for a while and see if I could redirect her and reduce her anxiety.
” Hey Shirley, how are you this morning?” ( Okay, that was a dumb question. )
“How am I doing? I will tell you how I am doing. You are a heathen. You hear me? I hate you. You are stupid, stupid, stupid, stupid. You belong in the jail. No you don’t. You belong under the jail. you dumb dumb. I wouldn’t feed you a scrap from my table. I will give it to the cow before I give it to you. You hear me? Huh?” Stand there looking dumb ‘cuz that what you are. Dumb.”
Well, goodness. I wonder what re-directional technique would work? Hmmm. Certainly with all of me experience and education I can calm her, right?
Kneeling down beside her, I tried to adjust the volume of my voice to hopefully have her match mine….
” Ms. Shirley, what has you so riled up today? Is there anything I can do to help you……” Before I could finish, Shirley drew back to throw a right hook punch, aiming for my nose. I quickly moved out of the fire.
” Anyone ever tell you how ugly you are? Ugly. You are ugly, ugly ugly.I bet you aren’t even married. Nobody would be stupid enough to marry an ugly thing like you……” She continued on and on with her insults, carefully crafting her next plan of attack.
Without hesitation, Shirley changed gears. ” Who did you say was getting married? Tommy? Well I hope he finally found somebody. He may be son, but he is one useless man. He ain’t worth the dirt he drags in on his shoes. Nothing worse than a useless man. Wonder who is marrying him? I hope it ain’t Patty’s daughter. That girl ain’t got good sense. Maybe they will make a fine pair, useless pair……… She continued for 15 minutes discussing Tommy and his lack of use..
It never ceases to amaze me at how dementia creates a whole new personality that differs dramatically from the who the individual use to be. Shirley, prior to the onset of dementia, was an elementary school teacher. Now, we all know the patience needed to be a teacher, especially an elementary teacher! So how did Shirley go from that person to the one screaming hateful words today?
The brain is a mysterious thing, yet carefully studied by the greatest minds of all times, yet some questions will always remain unanswered. The best any of us can do is to simply try to understand, reassure and comfort.
The key being try. All of the sweet talk in the world is not going to redirect someone who has lost the emotionally connect. The medial section of the brain may shut down, causing a loss for impulse actions as well an emotional balance……… who really knows?
Shirley continued to vent, rant and rave….eventually calming down after the nurse gave her her morning meds. After a few hours, the meds will wear off and she will once again return to her previous state……..until it is time for her afternoon meds……..and the cycle continues.
People who do not advocate the use of psychotrophic meds have never seen the results of an unmedicated dementia resident who has absolutely no impulse control. The purpose to medication is not to sedate or create a zombie, but rather to decrease anxiety, promote a sense of well being and overall sense of peacefulness.
Shirley is sleeping now…….all is well for the moment, and that is a all that matters…….for now.
During my almost 30 years of working in long- term health care, I have encountered residents from every possible walk of life. Rich, poor, black, white, red and mixed race; from the trailer park to Fifth Avenue, with personalities ranging from “precious” to extremely violent. I have sat in my office and listened to the family members summarize the person their loved one was before dementia.n
” Daddy was a hardworking man. He took care of mom at home for 4 years.”
“My mother was always the caretaker in the family; from laundry to lunches, mother did it all. Hard to see her like this.”
” My husband was such a kind man.”
” Pops was a good church-going man. Breaks me down to see him like this”
” My dad was a mix between Hank Williams Sr and John Denver. Just a good ole boy from the southern part of West Virginia. ”
” My mother was the sweetest, kindest, most tender -hearted person I have ever known.”
” My father was the meanest, most evil and abusive man. He tormented my mother and us kids every day of our lives until we were old enough to get out of his house. He was a bastard then and is a bastard now. Now that he has Alzheimer’s he has forgotten to be the monster he was.”
” My mother was not the nicest of people. You could say she was just plain mean. She would cut switches from the tree out back of our house and whip us until we bled. Now it is my duty to make sure she is cared for. It’s harder than I thought.”
” Nevermind what kind of man my husband was back then. He is old an feeble now. Just take care of him.”
I admit, listening to the family describe their loved one from past experiences, can at times, be very difficult. I sense their obligation to the parent or spouse, but also feel their hatred for them. I had one fellow tell me ,” Send me the bill for dad, but don’t expect to see me or anyone else for that matter. He wouldn’t walk across the street to see his own father when he died, so don’t be expecting anyone to come see him. Just bill me. Call me when he dies, after you call the funeral home.”
Tell me how to I should respond to that. A simple one word ” Okay” ? Hmm, that seems too cold, distant and wrong. Do I try to explain that he, himself should try to forgive his father for whatever grudge because his father will die soon?
I simply nod at the son and leave all words unspoken. My job is to care for and insure the wellbeing of every person and not pass judgement on anyone for past present or future behaviors. Yet, I am troubled by the patient who must die alone, without the family he/she once had. It is also hard for us as caregivers to visualize a feeble, confused, incontinent person as abusive, commanding and mean-spirited. We contribute any type of aggressive behavior to the disease process, not personality.
It truly must be difficult to be in the position of the adult child who must care for his/her abusive mother or father. I honesty do not know how I would handle such a situation……..But I do know this; even the most aggressive resident responds to love. The other day, a resident was raging with anger and had somehow ripped a baseboard off the wall, which he was swinging at any staff member in his path. When I arrived on the unit, I never stopped walking toward him….my arms were wide open as I said “Mr. Marks! I am so glad to see you, can I have a hug?” I never took my eyes off of him as I walked directly in front of him. His response?
” Hi baby, sure. You look pretty today.” After a few minutes of hugging and talking I had secured the weapon, calmed him and had him sit in a recliner to watch TV. All it took was a hug. Am I saying that every time a resident become behavioral I rush out and hug them to change the behavior? No. I am saying I use wisdom and always approach with compassion, kindness and empathy. It is my opinion that regardless of the disease process, people can always feel love and will respond to it. Mr. Marks was, according to his daughter, one of the ” worst monsters a child could ever have”. Today, no one visits, no one calls…..he simply exists and rages out of control every so often. I sometimes think that he and others like him, think about the things they have done in life, stewing on the facts until they explode. It is my opinion that dementia does not disable repressed memories….as a matter of fact, I believe the memories can become more active. Here is the problem. How does a person ask for forgiveness when they no longer can hold the memory long enough to remember what they need forgiveness for? The short ” breakaway” memory of being a “monster” is forgotten as the thought changes……So forgetfulness prevails.
The victim will always remember the abuse but at what point does one look deep into their own soul and find emotional healing? Can that ever be achieved? Will the victim ever be able to look at the aged, infirmed, helpless abuser and feel any emotion?
I don’t know the answer. I simply know it is painful to see both sides tormented and know that resolution is more than likely, not ever going to happen.
We all need to remember that how we treat people today, will affect both of us for the rest of our lives. Some things in life can never be undone. So treat everyone in your life well while you can……because one day, it will just be too late.
Growing up as a preacher’s kid our family moved around a great deal; living wherever my father was sent to pastor. My siblings and I had learned the routine of “packing up and moving out” long before we dreamed of being a grown up. I can remember my mother folding our clothes and neatly packing them into boxes, carefully marking each box with our names. She would then collect toys, tricycles, bicycles and skateboards and place them into a heaping pile in the front lawn.
I can hear my mother’s voice as she commanded us kids to do what we could to help. ” Each of you are to go out and make sure you still play with or use the toys in the yard. Anything that is not used, is to be placed in a pile, NEATLY, to be donated.”
Six kids, one pile. We always found a need for every Cabbage Patch doll, teddy bear, ball and glove that was in the heap. We would alert mom to our discovery that every toy was indeed a necessity to our lives. My teddy bear, ” Roy”, had a pull string on his back that would say maybe 3 different things….he was worn, stained and tattered, but he managed to move me throughout my childhood, all the way through college. There really wasn’t anything significant ( that I can remember) about Roy, other than he was was simply mine. I’m not sure when and where I lost Roy; if I threw him out when I left college or if he landed in the trash after I got married.
As an adult, I have packed up and moved many times and found myself to be as methodical as my mother had been. I would make piles of ” necessary”, “trash” and “no clue what this is or why I have it”. Packing was second nature to me. Just load me up with suitcases, boxes and a few trash bags; give me a few hours and I will have everything packable, packed, tossed or piled. This has been true for me, except for two times in my life………
August 28, 2000 was the day my father passed away.The hospital room was filled with balloons, cards, flowers and half eaten bags of food. His well-worn Bible, Sunday School Book and notebook all laid on the over bed table beside him. My oldest brother began the process of packing up the room.
” Jessie, go ask someone if we can get a box or something to put dad’s stuff in, Grab a trash bag too from somebody.Is there any of this stuff that belongs to any of us?” My brother had become the well oiled machine my mother had created so many years ago.
October 26, 2002, my mother passed away. The same drill of packing up her belongings, sorting through what was important,what was trash……. But then came the most difficult challenge of all. Going through the house our parents had called home. Pictures covered the walls…the yearly church Olan Mills family portrait for the church directory took up at least two entire walls.School pictures of each child from 1st grade through the cap and gown senior portrait. The pictures of my siblings who had joined the military, each posing with the American flag in the background. I would say our parents were the proudest people in the world. They celebrated our lives with constant reminders of the children they had raises. The fireplace mantel was adorned with football, baseball and tennis trophies we had earned from little league on up. My father’s study was filled with polaroid instant camera pictures taken of each of being baptised in the Jordan River on one of our trips to the Holy Land. Pictures of us teaching Vacation Bible School, singing in the choir and being in character in the annual Christmas Story church play. On his desk was his another worn, tattered Bible.
We, as adult children stood in the house, unsure as to how to pack up the parents who had taught us everything we knew. Finally my sister spoke up and said, ” This is too much for any of us. Why don’t I bring some guys from work and have everything packed up, put in storage and we can go through it later.” That was the best idea she ever had.
What made it difficult for us was not the chore of packing, but rather, the memories that were etched in every single thing in the house. As I turned to walk out, I looked one last time at my daddy’s recliner. Laying on the arm was the remote to his TV. Without a second thought, I grabbed the remote, stuffing it into my purse. My daddy loved to watch the evening news….and the remote was something he always kept on the right arm of his chair….. My youngest brother turned to me and said ” Did you grab dad’s remote? Are you wanting the TV?” ” No, I wanted the remote to have something of his, something that none of us would fight over….” I replied.
Over the years, I have dealt with families at the facility after losing a loved one. Each would say, “I will clean out the room this week Is there any way I can donate some of the stuff in there, like the clothing and other stuff? Sometimes, packing up after losing someone is just too painful. The old saying ” one man’s junk is another man’s treasure” is so very true in dealing with losing a loved one. Every single thing becomes significant, filled with memories. To help the families, I offer boxes…and a trash bag……and tell them to leave anything they don’t want in a pile.
Growing up in a strict Christian home, I was taught to always address my ” elders” as Mr. and Mrs.. I would have never thought to call Mr Jim Smith ” Jim”. By addressing them formally, it showed respect for their age and wisdom. It was also a sign of respect.
Yesterday, a young marketing representative came into my office and asked to speak to ” Mrs. Steele.” When I say young, I mean she was in her 30’s……. I stood up to acknowledge her and stated, ” Hi, I am Jessi”.
She quickly thanked me for taking the time to speak to her by saying'” It is so nice to meet you Mrs. Steele….”
Mrs. Steele. I don’t think I like the sound of that! I am simply Jessi!!!!!!! I am not that old , am I?????
After she left, I walked through the facility, speaking to every resident I encountered. ” Hi Mr. Jamison, hello Mrs. Davis; good to see you Mr. Mitchell; Hey Rita, you okay today? Good afternoon Toby; Hey Diane, what’s going on?” I continued on throughout the facility, calling each by name.
The more I have thought about it and listened to the staff interact with the residents, I heard things like :
“Come on Fred, you have to go the bathroom.”
“Evelyn, sit back down before you fall.”
“Ivy, drink your juice.”
“Peter, come back to the table”
The staff are simply doing their jobs, but the longer I listened, the more I thought on the importance of how we address our residents. We should never interact with them as if we are running a preschool or daycare center. These are men and women who should always be treated with respect, kindness and dignity. Dementia has robbed them of their identity, their person-hood and their ability to recognize their loved ones or even themselves.
So where is the fine line drawn between addressing the residents with respect, yet reminding them of their own identity?
” Good afternoon Sir”, clearly is not how to remind someone of who they are, yet it is very respectful.
” Good afternoon Mr. Evans” surely sounds better than ” Hey Fred”. But, how many people in Fred’s life addressed him as Mr. Evans?
How do people address you? Brian? Diane? Art? Steve? Barb? Dave? Jim? Your friends call you by name….Not Hey Mr. Hamilton, right? So, as you age into your eighties, how will the 20-30 somethings address you?
You have probably never been addressed as your Mr. or Mrs. name on a daily basis routinely, so why do we do it to the elderly dementia patients?
Respect is so important, an expectation I hold for every employee, but I want to also want what is best for the resident.
Thoughts anyone on this issue?