"Boy of Steel"
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THE NIGHT SHIFT
30 November 2005
I have such an increased admiration for people who deal with Alzheimers patients, and for my cousins, who have been dealing with Barb all this time.
The day before Thanksgiving, my mother received a call saying that Barb was in the hospital. They had diagnosed pneumonia and the doctors were saying it "didn't look good." It seemed to come on her so quickly and it seemed unbelievable to think that she might actually die.
The encouraging thing was that my cousin Kathy (her daughter) said that "Mom gets pneumonia every year around Thanksgiving."
Thanksgiving morning the call came that her fever had broken and that things were looking better.
Because she is in a hospital and not in her familiar environment (though, with Alzheimers, even the "familiar environment" sometimes seems strange), she has required round-the-clock supervision, so the family has been working in shifts--her two daughters and their spouses, my cousin Peach and her husband. My mother was added into the mix yesterday and when they discovered that men are not allowed to be in Barb's room after 9 p.m., now that she has a female roommate (for legal reasons--it's unclear to my cousin's husband, the least threatening man in the world, if there would be legal restrictions against a woman being in a room with two male patients!) they called to ask if I could work a shift as well. I readily agreed. I love this woman and would love to be part of her family care team.
I was assigned the 10 p.m. - 4 a.m. shift Sunday night. Bob, my cousin-in-law, met me at the front door and walked me through the maze of the hospital security system and deposited me at the door of the wing where Barb was, saying he was not allowed to go through the doors.
Peach was there and was very happy to see me, gave me sketchy instructions and was out of there in a matter of seconds. I realized why later. By 2 a.m., I was already counting the minutes until my cousin Kathy came to relieve me.
I had an easy night. Two nights before, Barb was combative, fought to remove anything she had attached to her and threatened to kill her daughter. A nurse finally tied her to her bed, which angered the whole family. The doctor agreed the nurse had been out of line and replaced her the next day.
But my day was an "I love you" day, where everyone who came in was greeted with hugs and kisses and told they were wonderful and she loved them. She didn't know me, but then she never does. She called me "lady" and told me I was the most wonderful person she had ever met.
Even with it being an "easy" night, it wasn't easy. She doesn't want to be in the bed and when Kathy came to relieve me at 4, I told her that I had become expert at getting her to bed, since I'd done it a couple of hundred times over the previous four hours. It always went the same. She'd sit up and say she wanted to get out of bed, I'd tell her she couldn't, she'd ask what she was supposed to do, I'd tell her she should lie down and go to sleep, she'd ask me where, I'd show her the pillow and she'd ask if she should put her head on that. Then she'd lie down, I'd cover her with blankets, she'd close her eyes and 10 seconds later she'd be up and we'd do it all over again.
It wasn't that she wasn't tired because when she sat up, she would close her eyes and appear to be asleep. But when she would finally lie down, then her cough would wake her up. It seemed to calm her if I would stroke her hair, but that never lasted too long.
At one point she insisted on getting out of bed. When she stood up, I realized that she had soiled her diapers, her nightgown and her bed pad. I called for someone to bring clean supplies, since I couldn't leave her to get them myself, but it took about 20 minutes before anyone came. I was standing there holding this heavy diaper with nowhere in sight to put it. The person who finally came to help me get her cleaned up was not her regular nurse and we did a poor job of getting her into a fresh diaper, but at least she was clean and then she actually went to sleep for an hour and a half, at which time the nurse came in to check her vitals, start an antibiotic drip, and draw blood. At 2:45 a.m. After that was all over, there was no getting her back to sleep at all.
She is also convinced she is going to die. Of course, she's been saying that for years, so this is nothing new, but when she told me that she was going to die this time, she began to tremble all over, from head to toe.
It's interesting trying to figure out what her mind is doing. I suspect that if I were around her more, I might be able to get clues from the way she behaves, much the way I get clues about dog behavior from watching Sheila interact with the various foster dogs.
The one thing she did consistently throughout the evening was to read the visitor pass which was pasted to my chest. Interestingly, sometimes she could read the words "Visitor Pass" just fine. Other times she would laboriously sound the words out, and other times she didn't seem to be able to read it at all. Even if she could read it, sometimes she seemed to almost understand what it meant, other times she didn't have a clue.
And her hands. She examines her hands like a baby who has just discovered something attached to the end of its arms. I wondered if she was examining the bruises on the backs of her hands, where she has been attached to various tubes, or whether she was looking at the very thin, wrinkled hands and wondering whose they were because they couldn't possibly belong to her.
She was forever asking me what she should do, as she fought to get out of bed, and if she could walk out into the hallway, which she could not. I had to struggle with her to keep her oxygen tube in place and to keep her from ripping out her pic line.
But I had an easy night and I only had one night. The rest of the family on her care team has been dealing with her for several years now, since she entered the Alzheimers facility, and for the past week-plus that she's been in the hospital. I only had one brief 4-hour stint, so I have a renewed appreciation for anybody who devotes themselves to caring for Alzheimers patients, or who is dealing with a loved one with Alzheimers.
She may be able to return "home" (the facility where she has been living for these past several years) today, if her blood test comes back OK, so I may not be called upon to take the night shift again, but I do feel blessed that I was able to do even this little bit for her.
Some of it may have rubbed off on me. I left the hospital around 4:15 a.m. and had driven all the way to Folsom, several miles in the wrong direction, before I realized that I'd made a wrong turn somewhere and had to retrace my steps. I didn't get home until after 5 a.m.
But I can still read the words "Visitor Pass," thank goodness.
PHOTO OF THE DAY
I FOUND THEM!!!