I recently watched the absolutely stunning four parter ‘Exile,’ on BBC TV. Jim Broadbent’s brilliant portrayal of a father with alzheimers should win him a BAFTA at the very least. It got me to thinking about when I worked with people with dementia whilst studying to be a pyschiatric nurse and how much I loved the job. Of course I wasn’t a daughter looking after an elderly parent on my own, so I have no idea how frustrating that is or what bloody misery it can bring. No, I was in the fortunate position of having a team of nurses around me, so there were always at least two people to assist someone to get dressed in the mornings, two people to assist someone to eat their breakfast and two people to coerce someone into taking their medication, even when it was fairly evident that some individuals did not wish to do so.
The ward I worked on was an assessment ward for mostly older people in their seventies and eighties although surprisingly there were one or two people on the ward who were only in their fifties. Their dementia had been brought on by chronic alcohol consumption and I had no idea at that time, about this particularly devastating effect of long term alcohol abuse.
I met some wonderful characters on the ward. My favourite man was called Fred and he was resident with his wife Connie who was also dementing. We were working hard as a team to try and identify a care home where they could go and remain living together, they had been married over fifty years and we didn’t want to part them. Connie was an absolute sweetie but if Fred didn’t take his medication he could become very agitated and often aggressive, hitting out at anyone who approached him. I believe that people like Fred do well in a one to one relationship with someone they trust, however, on the wards there simply aren’t enough people to offer this kind of support and so Fred was encouraged to take his medication. It was a powerful anti-psychotic and Fred made it clear he hated taking it, it stultified his unique presence and gave him a peculiar gait. Sometimes the nurses would hide it in his food which is appalling practice and probably illegal. Sometimes he would hide the pills beneath his tongue and I would later find them stuck to the wall behind his bed.
One morning I went into work, it must have been about 7am. Lots of people with dementia find it incredibly hard to sleep, it’s a result of how their brain is operating, coupled with various medications. So it was not unusual to find a number of residents awake and in the lounge, waiting for their breakfast and for the morning shift. Some of the patients believed that the ward was a hotel and would treat me like their own personal maid which I didn’t mind a bit, it made me smile and I used to think better that, than the reality.
When I arrived, a few residents on the ward said hello to me. Something wasn’t quite right though – it was strange, everybody had a slightly different air about them and I couldn’t quite put my finger on it. It was only when I later sat down at the table to share breakfast with everyone that I finally worked out what had happened. No-one could speak clearly to me and several people were dropping their food as they tried to spoon it into their mouths. This was not as a result of their dementia, oh no! This was because during the night, one of the patients had decided that someone had stolen his dentures. In the ensuing fracas, (all of which had presumably taken place whilst staff were occupied with their night-time duties,) the patients had swapped each other’s dentures around. Gazing at me with leery grins they slurped their cornflakes down. It took me a fair old while to sort their teeth out and after this, we had everyone’s dentures engraved with the owner’s initials.
Another of my favourite patients was a lady called Edna. She was a statuesque woman and a diabetic. At every opportunity Edna would try and sneak into the kitchen to steal food and because of this, we had to keep the kitchen locked at all times. One day we must have forgotten because I found Edna sneaking off in a guilty fashion down the corridor to her room. I could see quite clearly that she had lots of things hidden underneath her jumper so I asked her what she had put there and turning to face me like a caught child she said to me, “nothing.” I took her to her room where beneath her jumper I found twenty two cut sandwiches, half a dozen jam doughnuts and several pots of fruit yoghourt.
Working with dementia can be incredibly poignant. I was nursing a man who prior to his retirement had been the head teacher of an eminent grammar school. Most of the time he was off in his own world but occasionally, like lots of people with dementia he would have moments of great clarity. One time he turned to me and out of no-where said, “it’s devastating you know.” I asked him what it was that was devastating and he replied, “this bloody alzheimers, it really throws you, you know,” and then he was off again and away from me…..
So very well done Jim Broadbent, for your compelling and utterly convincing portrayal and I’m looking forward to part two this evening