Patients that Changed My Life: Carol

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

In one of my first ever nursing jobs, I worked in a facility specifically for Alzheimer’s and Dementia. I didn’t really know what to expect, but I found that I loved working with them. They kept me guessing, and usually laughing. We had this one lady, who I will call Carol. She was active, even though she was declining rapidly. She used a merry-walker, which kept her safe when she would suddenly get tired and need to sit down.

She had almost no short term memory. You could have a conversation with her and seconds later, she wouldn’t remember it.

That doesn’t mean that she didn’t remember anything.

She had an issue with me almost immediately. No matter what I did, she got angry, and she would scream at me. It wasn’t that unusual, since she had a temper, but she did seem to single me out more often than not. I had no idea why until a few months into the job when she said something that surprised me.

“Get off my husband!”

I wasn’t sure how to respond, but I let her know that I wasn’t on her husband. Over time, she kept making comments that made me believe that her husband must have cheated on her with an Asian woman. Comments like:

“Get out of my house!”

“Get out of my husband!”

“They’re my kids, not yours!”

“Tell me it didn’t mean anything and you didn’t enjoy it.”

Most people don’t really think about it, but it’s the emotionally traumatic events that seem to stay with Alzheimer’s patients. They may not remember that they just ate, but they remember how people made them feel. Those memories stick with them longer than anything else, even if they don’t even know my name.

Just because they’re confused, it doesn’t mean they aren’t there, and that they don’t notice what’s going on around them. 

Patients That Changed My Life: Jimmy

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won't use real names, but I want to tell you their stories.

To read about previous patients, click here

In one of my first jobs as a nurse, I had a patient whose name was Jimmy. He was an active guy, and because of his dementia, he wasn’t able to sit still. He would pace the hallways for hours, and even during meals, he couldn’t sit down long enough to eat. The more stimuli he had, the more agitated he would get.

I think one of the reasons why I connected with Jimmy was because he reminded me of my dad. He was obviously a hard worker, and he usually thought that he was our supervisor. He would come up to the nurses’s station, go through the clipboard and then nod his head and tell us to keep up the good work. He loved it when we asked him for help or advice.

One of the things that I realized about Jimmy was that he did really well with personal, one on one interaction. He was definitely confused, and he didn’t make much sense when he talked, but he craved the human interaction, and not just being in a room full of people. He needed to make a connection.

I started saving his meals at dinner, and put it in the fridge in the kitchen. Then, after everyone was asleep, I would take him in the dining room, heat up his food, and the two of us would sit and talk. While he had the human interaction, he was able to sit. He was able to be distracted enough to relax, and he was able to eat something.

Even after he lost his memory and his home, he still was Jimmy. He never lost his identity, no matter what the disease did to him. Yes, there were moments when his personality would change, but as I got to know him over time, I realized that he was still the man he was his whole life. He was a supervisor, he was a father, and he was a friend.

Why I Like Working With Alzheimer's Dementia Patients

When I first decided I wanted to be a nurse, I knew I was going to be a geriatric nurse. I knew that was where I was meant to be. My first job as a caregiver was in an assisted living that was specifically for Alzheimer's and Dementia patients. It was my first time dealing with those who were confused, and at first, I didn't know what I was doing. Orientation consisted mostly of explaining where the supplies were, what the assignments were, and what was expected of me during a shift. I didn't have any expectations coming in as to how I would have to deal with the patients and their disease.

To my surprise, and probably the surprise of everyone, I loved the job. it was an amazing experience, and I found that I connected with these patients. I became fiercely protective of them, and a lot of it was because they couldn't protect themselves. I was their advocate, and I took that responsibility very seriously.

When I first became a nurse, I started applying for jobs in different skilled facilities, but there was one in particular that just felt right to me. It was a facility that was specifically for Alzheimer's and Dementia patients. It was probably one of the best jobs I've ever had, and the company itself was wonderful.

Whenever I talk about my time as a nurse or caregiver in those facilities, I'm met with surprise that I actually enjoyed my time there. people don't understand why I would want to spend time with people that are confused, and who don't remember who I am, even if I saw them a few minutes before.

After working in rehab and in the hospital, I can say that the reason why I love Alzheimer's so much is the clean slate. I go in and talk to the patient, and no matter what, it's wiped clean. They don't remember. Now, that may not seem like a good thing, but for me it is. Nurses have to deal with a lot of cranky patients. And sometimes, we get cranky back. But when I work with Alzheimer/Dementia patients, they forget. If they get mad at me for making them change out of their dirty shirt, five minutes later, we can go back to having a happy conversation. If they threw their food against the wall because that's what they felt like doing, I have a much easier time ignoring the behavior because I know that they can't control it. There's also no point in getting mad, because they won't remember it anyway.

Even with their forgetfulness, they can remember aspects. They can remember how you made them feel, even if they don't remember your name. And sometimes, knowing them well enough that I can make them smile is all I need to have a good day.

Patients That Changed My Life: Jessie

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

I want to tell you about Jessie. She was ninety years old, and had Alzheimer’s. By the time we met, she’d lost basically all function and sat in her high back chair day in and out. Every once in a while, she would say something, but not very often. In this facility, almost every single one of our patients were feeders, which mean that we had to spread ourselves out to feed everyone on time. I would take a whole table of patients, usually 3-4, and each CNA would take the same number.

When I first started, the nurse before had sat at Jessie’s table. I found pretty quickly that she wouldn’t eat. I tried everything I could, but I couldn’t get this sweet lady to eat. It took several months before I realized that she would drink. She liked the small cups, but if I took my time, she would drink close to 600 ml of supplemental health shakes.

I sat with her for over a year and a half, feeding her every night. We grew a very special bond. There were some nights that would be difficult, when she would clamp her lips together and refuse to eat. Then there were nights that she would drink. I talked to her about random things, about my own life, about what was going on. Whenever she was having a good night, she would give me the brightest smile when I talked. Every time I saw it, my entire night went well.

That’s all she gave me. She never spoke, she never said anything profound. She just smiled, but I still remember that smile, even years after it happened.

Sometimes, a smile really can change a person’s life.

Patients that Changed My Life: Billy

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here

I know I talk about this a lot, but I love working with Alzheimer patients. There’s something so special about them, especially when you can find a way to connect with them.

One of my patients, Billy, was a mechanical engineer. And he was a pretty impressive one at that. He’d gone to school at some Ivy League schools, and had his PhD, and had many, many patents out there. Unfortunately, as always happens with Alzheimer’s, his mind left him, and when I met him, he wasn’t the same man he once was.

That didn’t mean he stopped being himself. He liked to follow our maintenance men around and tell them what they were doing wrong. Sometimes during dinner, he would stare up at the ceiling, watching circuits the rest of us couldn’t see. As he became more confused, he became more vocal, yelling for help constantly.

One night, I was sitting with him, and he started screaming for help again. Every time we asked him what he needed, he didn’t know. Finally, I went into the maintenance closet, pulled out a screwdriver, and handed him that and a broken hole punch.

“Billy,” I said, once he took it in his hands, “I need you to fix this for me.”

And he set out to do just that. He spent hours on that thing, tinkering as he finally had a purpose. That was all he needed. He needed to feel useful again. He wanted to know that he wasn’t just sitting in a chair, watching life pass by.

It’s so easy to see behaviors, especially when they disrupt other people, as something that needs to be silenced. But more often than not, it’s a call for help. It’s a request for someone to see them, and to fulfil their need.

I hope that we’re all listening, instead of trying to silence them.

Alzheimer's is not Amnesia

Today, I want to talk about one of my biggest pet peeves in literature. Movies, books, tv shows, all around the board, I’ve seen this, and it needs to stop.

There’s a perpetuated misconception about Alzheimer’s, and it actually harms the treatment and the attitude toward the disease.

Alzheimer’s is not just memory loss. It’s not some kind of selective amnesia, or amnesia where the person just forgets everything about their lives. Alzheimer’s affects every single aspect of the brain. Think about it. What do we do that isn’t affected by the brain?

Right now, I think that Alzheimer’s has become romanticized to some extent through media, showing us this disease where someone just forgets their loved ones. It’s beautifully tragic, and sad. But what they don’t show is that half of the time, other memories are lost as well.

When I worked in a facility specifically for Alzheimer’s and dementia, every single one of my patients were affected differently. Some of them forgot how to walk. Some of them forgot how to use silverware, and some forgot how to talk. It’s a disease of regression, where they slowly lose all of the memories they’ve gained over time. The short term goes first, but soon, all of the rest of their memories go with it.

Which memories go last? The ones that are affected by emotions. There’s a reason why a patient may not know where they are, what they ate for dinner, but they still remember the name of their husband, their wife, their mother, and their children. There’s a reason why one of my patients, who couldn’t feed herself, who couldn’t remember how to speak, or how to use the toilet, still got a huge smile on her face whenever her husband of thirty years walked through the door.

It’s not amnesia. It’s a disease of regression, and the last thing to go is the things that are most important to them. Which is why, when I read a book or see a movie where an Alzheimer’s patient can play the piano perfectly, eat perfectly and never has an accident can’t remember the name of their spouse.

Alzheimer’s is messy, and it’s not romantic, not at all.

Therapeutic Lying

Alzhimer’s is not an easy disease to deal with. I remember watching my Great-Grandfather, confused, throwing out accusations at nurses and family. It’s hard on the caregivers, and you’d better believe that it’s hard on the person who has it. Alzheimer’s isn’t the same thing as the romanticized version in books and movies. It’s painful, exhausting, and often taxes emotion and mental emotions more than anything else.

I had the privilege of working with Alzheimer patients from the very beginning. I was a CNA at an assisted living specifically for Alzheimer and Dementia patients, and from there on out, it became one of my passions.

I’ve talked to many people over the years who have some issues with one of the recommended therapies for Alzheimer’s patients: Therapeutic lying.

Therapeutic lying doesn’t mean lying to the patient about their cares or about the situation. In most cases, the patient (or family member) doesn’t live in our reality necessarily. I’ve had many patients believe they’re sixteen years old, or twenty, or even five. They think they’re a mother, waiting for their kids to come to school, or an engineer, directing the maintenance department.

As odd as it might be for caregivers or family, their reality is as real to them as ours is to us. How would you feel if you were talking to a husband, a brother, a daughter, and every time you said something, they’d argue? Telling you that you’re crazy and that what you’re seeing, what you’re feeling is wrong?

Let me give you an example:

One of my patients, Carl*, was admitted at the same time I started working in the facility. He was a vivacious man, happy, energetic, and he loved to flirt with the female staff. He loved to laugh, and he always had a smile on his face. I loved working with him, to feel his energy. He had Alzheimer’s, and he was confused. During the day, he would ask where his wife is. I’d been taught that for Alzheimer’s, you step into their reality. Something like:

“Where’s Deborah?*”

“I don’t know.” Glance at watch. “It’s about three o’clock. Do you think she’s out picking the kids up from school?”

“Oh, yes, you’re probably right.”

Conversations like this help to calm the patient down. It helps them believe that they’re not missing someone, or that something bad hasn’t happened. Carl’s family, however, did not approve of lying to him, and they insisted we always tell him the truth. I overheard a conversation between Carl and his family, and it about broke my heart.

“Where’s Deborah?”

“She’s dead, dad.”

“Dead?” Carl began to sob, long, loud tears. “How? When did that happen?”

“A year and a half ago. You were there, remember?”

No, he didn’t remember. It’s part of the short term, the first thing that goes when someone has Alzheimer’s. He remembers his wife, how much he loves her. He does not remember she’s dead. As staff, we weren’t allowed to use thereptuic lying, and each time I had to tell her she’s dead, it broke my heart even more. His family even went so far as to hang signs in his room, over the phone, by the door.

“Remember Carl, Debora’s dead. You can’t call her.”

In three short months, Carl became depressed. I know what you’re thinking. He’s confused, he doesn’t remember. So why would he get depressed? Here’s the thing I’ve learned over years of working with Alzheimer’s patients.

They don’t remember events. They don’t remember names or faces, but they do remember how they feel. They may not know why they feel angry, or sad or confused, but it lingers. The longer a person is depressed and upset, the more it sticks with them. Poor Carl was reminded, over and over again about his wife’s death. He grieved each time like it was the first time he’d been told. Soon, he stopped walking, and then he stopped eating. Finally, he refused to get out of bed.

His family blamed us. They said we weren’t doing enough for him. He was removed and put into a different nursing home.

The lesson Carl taught me was a powerful one. Each experience we make for our patients, each word we speak, is going to make a difference. They may not remember in the distant future, but they will remember how you make them feel. It’s the reason why some patients naturally bond with certain nurses and CNAs. They don’t remember why, but they know that they can trust that person.

As terrible as it sounds, therapeutic lying is necessary. They don’t always live in our reality, and we don’t live in theirs. But that doesn’t mean we can’t help them make sense of what they’re living, and what they’re experiencing.

For more information on therapeutic lying, go to: Alzheimers.net

*Names have been changed

What I Learned From Finishing My NaNoWriMo Novel

Remember that novel I started in November?  I finally finished it today! 

The first 50,000 words were easy.  Probably because I was on a deadline.  November, I had my writing group, I was motivated, and the writing sprints made it even easier.

Then December came along and all of the ‘life’ I put on hold came back.  Like cleaning the house and doing laundry.  And work got a little chaotic as well. 

But I did it.  Three weeks later than I was hoping, but I made it!  This is novel number 5 that I’ve written from beginning to end, and it’s unique in several different ways.  All of my other novels are YA Fantasy with magic and romance.  There’s none of that in this novel.  It’s a modern day story of a woman whose dad gets diagnosed with Alzheimer’s.  I knew it was going to be hard to write, and even knowing that, I’m still amazed by the work and effort that it took to finish. 

It’s a good idea to try something new every once in a while.  We all get into ruts, and unless we push ourselves, we’ll never grow and learn.

So here’s what I learned from my newest novel, the Purple WIP:

1.  I can write adults.  I’ve never had a main character over the age of about 25.  Jen is almost 40 with three kids, and her oldest is 15.  I know how to think like a teenager because I’ve experienced it.  Putting myself in the mindset of someone older than me was foreign, though we figured each other out by the end.

2. It’s really tricky writing ambiguous endings.  My other novels had a clear cut ending.  They achieved their goals, they overcame their obstacles, and they lived happily ever after.  I’m a huge fan of HEA.  But with Alzheimer’s, that’s not really an option.  One of the reasons that it took me so long to finish was because I didn’t know where the story ended. 

3. Writing in two languages is harder than it looks.  Jen is married to a Hispanic man, and they are asked to help a Spanish Congregation of their church.  She doesn’t speak Spanish, but there’s constant Spanish around her.  Trying to write a conversation between her and some of the sisters in her congregation was almost impossible, though probably very accurate.

4. It’s a lot harder to write real places.  When I make up a setting, I can decide where the cities are, what the weather’s like, and the history.  Not so much with real life fiction.  Though, I did learn how to spell Milwaukee, so that’s a plus, right?

5.  I enjoy writing YA Fantasy.  I think this was the biggest thing I learned.  It was a great experience, and I’ve been wanting to write an Alzheimer’s story for years now, but I don’t know that I’m going to branch out to write more of those kinds of novels.  One is good enough for me.

A Tribute to Past Patients

I love being a nurse.  I love the interaction that I have with my numerous patients, though, as I’ve stated before, I’ll always have a soft spot for those with Alzheimer’s. 

I honestly can’t even count the number of patients I’ve had that have touched my life.  Starting as a CNA, I began to realize how much these people influenced my life.  They made me look at life in a whole different way, and they gave me perspective.  Since it's the day after Thanksgiving, I thought I'd say thank you in the only way I know how.

So here’s to the older couple that taught me true love.  The husband always held his wife’s purse and oxygen while she pushed him in the wheelchair.  And they always ordered a dessert to split because they were just as in love as they were as newlyweds.

Here’s to the Doctor who always respected me because I was a nurse.  Even though he was technically my patient, he never failed to tell me that his career wouldn’t have been so successful without his nurses.  He showed me what a true relationship between Doctors and Nurses should be.

Here’s to the sweet lady who reserved her most brilliant smiles for me when we sat together for dinner.  She taught me the importance of slowing down and really enjoying every moment. 

Here’s to the man who believed he ran our facility.  He believed I was part of his staff, and he always told me how much he appreciated me, and he always offered to help me with whatever I needed.  He taught me what a true supervisor should be, and I try and follow his example now.

Here’s to the man who reminded me of my own father.  He made me realize that each one of my patients are related to someone else, and that each of them deserve the respect I would want my family to receive.

Here’s to the woman who told me stories while she ate.  I loved hearing them, even when they were the same stories every meal.  It makes me want to remember the important moments in my own life so that I can pass them on someday.

Here’s to the Engineer who never stopped fixing things.  Even when he couldn’t walk, he still knew how to use a screwdriver.  As someone told me the other day, “If you do something, you’re good for something.  If you do nothing, you’re good for nothing.”

Here’s to the little old lady who spoke to me in English although it wasn’t her primary language.  She was willing to learn and speak a foreign language, and she loved to teach it.  She taught me the importance of respecting culture, even if it’s from the same country.

Here’s to the older woman who fed her cat so much that he got fat and his extra dandruff gave her asthma.  She taught me that those cat ladies do exist.

I wish there was room or a way to acknowledge each one of them.  I wish there was a way to tell their story.  Because as I got to know each one of them, I realized that their disease had an even more devastating effect than most of the others.  They forgot who they truly were, what they’d accomplished in their lives, and they lost the ability to tell their story.

How about the rest of you?  Want to give a tribute to someone you knew with Alzheimer’s?  I’d love to hear their stories!

The Strain of Caregiving

I’ve been exhausted this month.  Not normal exhausted.  Not I’ve been writing every spare moment exhausted.  I’ve been feeling tension and stress more than I have in a long time.

At first I thought that maybe it was work.

Then, a few days ago, I realized what it was.  I was exhausted because of the novel I’m working on this month.  It’s about a family who’s dealing with a grandfather who has Alzheimer’s and hasn’t been diagnosed yet.  It’s exhausting to write: not just physically, but mentally and emotionally.

Working with Alzheimer’s is unpredictable, and when you don’t know what’s causing the strange outbursts of the odd behaviors, it can cause high family tension.  I’ve seen it more times than I can count.  I feel that in my time as a nurse with Alzheimer’s and Dementia patients, I’ve seen families fall into usually one of two categories.  Either they’re very involved, and constantly vising their family member, or they rarely visit and are difficult to get a hold of.

I honestly can’t imagine what it would be like to experience it firsthand.  I’ve seen it through the eyes of a caretaker, as a nurse.  I know that it’s painful and difficult for everyone, and they all respond to the disease differently.  For some, it’s showering their parents with attention, for others, the change is too painful, and they withdraw.

I’m only experiencing it secondhand from a fictional character, and I’m emotionally and mentally drained.  Trying to keep up, sort through the accusations, the anger, the behavior… it’s exhausting.

It’s amazing how much of an impact that Alzheimer’s plays in our lives.  Did you know that it’s one of the top ten diseases and it’s the only one without a cure?  Think about that.  That means hundreds of thousands of people deal with it every day without any hope of improving. 

If any of you are experiencing it right now, I hope you know how much I respect you for what you’re going through.  Please make sure that you have a good support system – one that can take care of you as you care for your loved one.

Provided by the Us Against Alzheimer's Foundation

Why Do People with Alzheimer's Have So Many Behaviors?

When I first became a nurse, I found a job at what I still call ‘the best job I ever had.’  I’d already discovered my passion for Alzheimer/Dementia patients, and this was a private, skilled nursing facility for Alzheimer and Dementia patients.  I could honestly go on and on about the amazing features of this place, along with increased number of staff and the activities, they had round the clock music therapy and art therapy.  How many places can say that?

One of the things that really stuck out to me was that they had 3 full days of ‘office’ orientation.  You know, the boring stuff where you go over policies and procedures, expectations, handbook, etc.  Anywhere else I’ve ever worked had 1 day.  There was a reason why they had 3.  They spent the first day on the normal stuff, but then they took two whole days training us on what to expect with the Alzheimer’s/Dementia population.

There were many memorable lessons I gleaned in those two days, but they had us participate in one activity that just made me rethink everything I knew about nursing, care, and nursing homes.  I know I’ve mentioned this before, but it was so incredible, I think I’ll repeat it again.

We were given six slips of paper and told to write down the things most important to us.

I honestly don’t remember what I put all those years ago, but sitting here right now, here’s what I would put:

1.       Family

2.       Church/Religion

3.       Chocolate

4.       Colors

5.       Music

6.       Somewhere safe to live

We were then asked to fold our responses and mix them up.  Then we were asked to pick one of the cards out of the pile.  Once we’d picked it, we were told that we could no longer have that one particular object.  It was no longer a part of or life, and we’d have to learn to live without it.

I can’t tell you how devastated I felt.  It was something so simple, and I still had 5 other cards, but losing that one particular item made me want to cry.  Then they asked us to pick the second card.  You can probably see where they were going at this point.

They wanted us to see what our residents were giving up when they move into a facility, or even if their children have them stay with them.  Suddenly, they don’t have the independence they once had, and everything has changed.  Maybe they don’t have easy access to a piano anymore, or they can’t get the food they used to eat at home.  Any drastic change like that can throw anyone off, but when you already have difficulty adapting to new environments or maintaining a grip on reality, it can be even worse.

Most Alzheimer’s patients who move into facilities are going to have increased behaviors.  It’s a natural reaction to the upheaval their life has just endured.  They may not understand what’s going on.  I know that my Great Grandpa believed he was in a gas station.  Others have thought that they were at the store, waiting to be picked up by family. 

Imagine how you would feel, if you woke up and you didn’t recognize anything around you.  And then when you get out of the room, a bunch of (hopefully) friendly people tell you that this is your new home.  You don’t know where your family is, and the food they give you doesn’t taste like home.  How would you feel?

Scared?

Angry?

And if you can’t properly communicate, the only way to let them know is by acting out.  Maybe you just scream for several days, hoping that someone would hear you and rescue you from these strangers.  Or maybe you think that they’ve kidnapped you from your home and you start attacking them.  Or you could try to escape, checking each door to see if they’re actually locked.

Unfortunately, this natural, and really – understandable – behavior can cause families and healthcare workers to get impatient.  Instead of looking at the situation from the perspective of their residents/patients, they might punish them, perhaps by not letting them eat a dessert, or by forcing them to stay in a chair.  But the person with Alzheimer’s doesn’t understand why they’re being punished.  It may cause even more behaviors because now they’re even more angry or scared.  It’s a vicious cycle that can’t be broken with the person who has Alzheimer’s. 

It is something that needs to be broken by the people who are there to take care of them – whether that be their family, nurse, CNA or doctor.  They have to realize that they won’t always be able to vocalize their needs or their concerns.  They need someone who can look beyond the physical obvious action and realize the reason behind it.

It can be exhausting, and it can take weeks, maybe even months to find what the patient needs.  Families should not try and do it on their own.  Burnout and exhaustion can often lead to impatience and anger on the part of the provider.  Make sure that you have a good support system, and make sure that you voice your own needs when they arise.

Why I Became a Nurse – Part 2

So last week, I talked about the first time I ever doubted my decision to become a nurse.  The second time was when I became a caregiver at an assisted living that was built specifically for Alzheimer’s/Dementia.  I wasn’t quite sure what I was getting into.  I knew that I wanted to work in Geriatrics, but I hadn’t really decided anything beyond that. 

When I started, I quickly realized that all of the clichés – the confusion, the behaviors, everything else… was all true.  But that didn’t mean that it was miserable or that they were difficult to work with.  In fact, it was just the opposite.  I LOVED my job.  I loved working with my residents.  They made my day so much happier.  Most of the days, I couldn’t wait to get to work. 

I think the one thing that I loved about it was that it was almost as though their disease – as devastating as it is – stripped away all of the false shows that we as humans tend to show.  They were completely honest, even if at times they said something offensive, I knew that everything they said was true in their reality.  I loved the job so much that I began to wonder why I’d even gone into nursing school.  Because in the Assisted Living, I never saw the nurse.  She didn’t work the floor, she didn’t see our residents on a daily basis. 

The whole reason that I’d become a nurse was because I wanted to help others, I wanted to take care of them.  Suddenly, I started to wonder if I really wanted to become a CNA and not a nurse.  I started to really doubt my career path.

And then I met Joe.  Of course, his name wasn’t really Joe.  According to HIPPA, I’m not allowed to tell his real name, but it feels funny not to give him a name at all, especially since he influenced my life so much.  He was a chipper, happy, bubbly man who arrived in the facility around the same time that I did.  He was always quick to make everyone feel better, and he always made me smile. 

Over the course of several weeks, I began to notice a definite change in Joe.  He started to become depressed, he stopped eating.  By the time I left the facility, he refused to leave his bed.  His family threatened to take him out and put him somewhere else because they thought we were neglecting him or abusing him.

But I knew exactly what happened.  His family, because they didn’t understand his disease process, felt it was important to bring him back to reality.  They reminded him of things he forgot.  Which wouldn’t be so bad, if the reminder he constantly received was that his wife had died the year before.

  

One of the things that many people do not realize about Alzheimer’s is that it affects different areas of the brain, which includes the memory and reality perception.  Their reality does not always become ours.  Very often, a person with Alzheimer’s begins to ‘regress,’ which means that they slowly move backwards in time.  They talk more and more about their deceased husband/wife, their mother, brothers and sisters.  They may remember their kids, but they remember them as small children, not as grownups with children of their own. 

The absolute worst thing to do is to tell someone with Alzheimer’s that their reality is wrong.  How would you feel if you experienced that?  Someone came up to you and told you, ‘No, the president isn’t Obama, it’s President Tanner, and the year is 2045.  Not only would you be confused, but you’d be upset because you’d think they were trying to pull one over on you. 

Joe’s family didn’t understand that.  All they knew was that he was confused, and they wanted to fix it.  They hung signs in his room, by the phone, on the bathroom door, everywhere, that said, “Dad, remember that your wife, Debora is dead.” 

Joe didn’t remember his wife was dead.  That wasn’t in his reality.  So every time he read a sign, every time his family reminded him, he went through the grieving process all over again.  Though he didn’t always remember exactly why he was sad, the feelings remained with him.  He became depressed.  And wouldn’t you?  If you experienced your significant other’s death for the first time nine or ten times a day, it would be devastating or exhausting.

As a CNA, I couldn’t do anything for him.  I couldn’t talk to the family.  I couldn’t make a difference.  That’s when I realized why it was so important for me to become a nurse.  I wanted to be his advocate.  He couldn’t express his feelings, and he needed someone to do it for him.

That’s why I became a nurse.  And that’s why I focus so much on Alzheimer’s and Dementia.  Did you know that they’re the only disease who can’t speak for themselves?  If someone has breast cancer, they can tell their family and friends, they can join help groups or donate to the cause.  Most of those with Alzheimer’s don’t even realize what’s happening to them.

And that’s why I think that awareness needs to be raised.  Alzheimer’s isn’t a period of forgetfulness, and it isn’t romantic like the movies show.  It’s a devastating disease that affects every aspect of life.  And unfortunately, right now, the only cure is death. 

I know this was a long post, but it’s an important one.  Please spread the word.  If you want to learn more about the disease, there’s a book called the 36 Hour Day which is just fantastic.  Read it if you get a chance.

Anyone here with personal experience with family or friends with Alzheimer’s?  I would love to hear your story!

Why I Became a Nurse

My great grandpa was diagnosed with Alzheimer’s when I was very young.  I don’t remember very much of it, but I do remember the way that my grandma and her sister would keep all of us updated.

“He thinks he’s in a gas station and that the nurses are holding him hostage.”

“He keeps fighting because he wants to go home.”

These are things I remember them saying.  Whether or not that’s what they actually said, I’m not sure.  I was only six or seven at the time.  I do remember visiting him once and thinking that something was different about him.  He wasn’t the same man that I remembered.

I also remembered watching the nurses who took care of him.  They were all very pleasant.  Very happy.  They made me want to do the same thing as them.  I wanted to take care of people when they got old. 

I remember the moment that I decided my career path.  At the ripe old age of seven, I knew what I wanted to be when I grew up.  I was going to be a nurse for old people.  My parents didn’t discourage me, but they did make me learn how to say geriatric instead of old. 

I grew up convinced that I wanted to be a nurse.  I used to unbend paperclips and stick them in stuffed animals and dolls so that I could practice giving shots.

There were only two moments that I ever questioned that decision.  I want to tell you about the first today.

A few years after I decided I wanted to be a nurse, my dad took us to see the musical Oliver!  During intermission, my little sister began swinging around my dad’s legs and fell, splitting open her chin.  Blood gushed everywhere.  I’d never been so terrified in my life.  For the first time, I began to wonder if I’d made the right decision.  Because of the amount of blood, we were all rushed backstage where they tried to patch her up.  When they couldn’t, my dad drove us all to the hospital where my other sisters and I waited in the waiting room while my sister went into the emergency room.

It took me years to overcome my fear.  I was convinced that I was afraid of blood, which is a slight drawback to becoming a nurse.  Despite all of that, I was still convinced that this is what I wanted to do. I wanted to be a geriatric nurse.  Years later, when I did go to nursing school, I realized that it wasn’t a fear of blood.  I was afraid because I didn’t know what to do.  I was afraid of not being able to help her.

Looking back almost twenty years to that decision, it was the best one that I ever made.  Geriatrics is one of the best fields in the world, and I had the advantage of being able to work in multiple facilities focused on Alzheimer’s.  I love the field, and I love all my patients.  They’ve taught me so much about myself and about life.

Becoming a nurse was the best decision I ever made.  How about the rest of you?  Do you have anything you’ve done that you’d never change for the world?

November

November is finally here!

For those of you who don’t know what that means, it means that writers across the world are frantically writing as fast as they can, trying to up their word count before time writes out.  It’s the time to forget about sentence structure, and about precision and accuracy.  It’s about getting those words onto the page.

Friday night, our NaNoWriMo group met at 11:30pm in the only place in our tiny little town that stayed open past midnight: McDonalds.  We met, talked, ate and then anxiously waited until the fateful time when we could begin writing.  Last year, this McDonalds was brand new, and it was a ghost town.  Not so this year.  I’d never seen so many people crammed into one space. 

Our group did a countdown to midnight, and the rest of McDonalds joined in, probably expecting something exciting to happen once we hit zero.  And something spectacular did happen.  Nine or ten different worlds opened up at midnight.  New characters came into being.  Stories that might never have been told began. 

Too bad those in McDonalds couldn’t see it.  All they saw was that a large group of people on computers counted down until zero and then began writing on their laptops like nothing happened.  I did get a pretty big chuckle out of their confusion.

This year, I’m trying something very different.  Writing is always about the journey, about trying something new.  Last year, I finished my fourth YA Fantasy novel, and I’ve got to say, it’s probably the best one that I’ve written.

This year, I decided to try something new.  I’m used to writing teenagers, love stories and fantastical worlds full of magic and danger.  I wanted to push myself to a new level.

This year, I’m writing about a woman in her 40’s.  She’s married and she already has three kids, one of them being a teenager.  She’s dealing with life itself, that after “happily ever after.”  One of the reason why I decided that I wanted to focus on this was because I wanted to write a book about Alzheimer’s.  It’s such an important topic, yet I keep seeing it romanticized. 

Alzheimer’s is a devastating disease, on all accounts.  It’s a change in personality to the point that when you’re interacting with that person who has Alzheimer’s, you’ll never get them back – not completely.  There may be moments that they seem to come out of their fog, but that moment becomes less and less common.  They slip into their own world, leaving those behind to learn to deal with the loss.

In the first two hours of November, I was able to write just about 2,700 words.  Almost immediately after, I went to sleep.  When I woke up, I saw this on my twitter feed.

How appropriate is that?  November is National Novel Writing Month and Alzheimer’s Disease Awareness Month.  I feel like the two of them are converging into my novel. 

That being said, I’m going to use the month of November to give you updates on how my novel is going, and I’m also going to be sharing my own experiences and knowledge about Alzheimer’s.  I would love to hear any of yours!  The best thing we can do to take care of those with Alzheimer’s is to advocate for them.  They’re the ones who don’t have a voice.

Happy November!