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DocuDrama: The Nursing Home Series

Cheryl D. Ring kept a diary of her time observing the nursing home Ahlzeimers ward where her grandmother was moved to after a failed attempt to leave her assisted living community. Suffering from dementia and acclimating to her new surroundings Bubie was facing the end of her life. Cheryl documented events and behaviors that bring awareness to what happens near death and the end of life.

Friday, January 10, 2014

Nursing Home or One Flew Over The Coo Coo's Nest? 10-05-2011 at 10:38 AM OMG!!!!! I have never!!!! Never been to a nursing home, at night, in the wing where the Alzheimer's residents live. The sundowners exhibit a range of behaviors—something that is not usual for the person. That can range from being restless to striking out, and these behaviors statistically occur during the transition between daylight and darkness. Imagine being around 10 people who are all having a sundowners episode AT THE SAME TIME! Yesterday evening, we moved my grandmother, who I call Bubie, into a nursing home. She just turned 92 with mild dementia. They secured her in a wing where they lock the doors around the clock because of her attempted escape from her retirement community.

She had a studio apartment in assisted living and had a wish to go home. When she left her room on the assisted living floor she rode the elevator to the main lobby and scooted herself on her walker out of the main entrance of the building. The community leaders asked the family to move her out, suggesting she needed 24-hour supervision in a nursing home.

She didn't drive anymore but said she would take a cab to get to her house. A house she didn't have anymore. Her once well-kept three-bedroom ranch home on Indian Meadows Drive, where I spent much of my childhood with my siblings and cousins, sold many years ago. There was no way to reason with her. The family had to move her somewhere and made the hard choice to put her where she would receive the care she required. As I walked into the secured wing to visit only 4 hours after her move I saw her being wheeled down a hallway by an old lady wearing a dress. I didn't know who she was until an aide stopped her, took her by the hands, and walked her back to her room. I realized the elder lady was not an employee when I heard the nurse tell her, " Now come with me. You shouldn't be doing this. Let's go back to your room now." It turned out the old lady had trouble walking and Bubie just happened to be in the right place at the right time in her wheelchair. The case of the runaway Alzheimer's patient going nowhere fast. Then, I walked into Bubie's room and saw another aide helping a woman up from her chair. She said, "You're in the wrong room, sweetie. Let's go back to your room now." Then Bubie began to get agitated and was ready to leave to "go home" wherever that was in her mind. If I had the means and the space I would have taken her home with me where she could be around familiar faces. As we tried to calm her, suddenly there was yelling coming from the hallway. There was a woman having a terrible case of sundowners. She was cussing at the staff, saying "Get the fuck out of my room", and, "Leave me the fuck alone". I felt bad because the roles had reversed and I couldn't protect Bubie on her first day there. I couldn't blame her for wanting to "go home". Then, I stepped into the hallway and saw a lady standing at the door with a wheelchair. I asked her if she was Bubie's roommate. She giggled at me. I asked her again. Again, she giggled at me. Shortly after that, Bubie's roommate showed up. An aide brought her to the room because she didn't know where her room was. Once there, introductions were made. We thought maybe having someone to talk to would be a distraction for them. Until the roommate acted " funny". She kept going in and out of the bathroom, chanting, and stating she didn't know what to do and needed help. I went to look for help and after I found someone on the floor, I assured her someone would be in to help her shortly. In the meantime, Bubie is very upset and becoming more agitated continuously stating she wants to leave and doesn't know why she is there. "I am sorry I came here, ", she said, and then she looked straight at my mother and said, "What did you do to me". These were the last words my mother needed to hear, the eldest of her siblings, and the one continuous caretaker in Bubie's life. The roommate continued to act "funny" as someone with severe dementia. When I asked her a question, she told me, "I remember nothing. I'm confused". Then, as the roommate continued to make statements, chanting, Bubie looked up pointed her finger at her, and said, "I gotta live with this?"

Everyone in the room, including Bubie, broke out in laughter and the nurse's aide had to leave the room because she burst out in laughter and couldn't contain herself. It was a pleasant break and nice to see Bubie smile and laugh, even for a few minutes. But it didn't last all night. Bube was still insisting she wanted to "go home". Mom and I could not bear to see her in distress and felt helpless. It was time for us to leave. I later learned that Bubie's agitation turned to aggression and fell as she was getting up from her seat. As we walked down the main hallway of the ward, we could hear residents calling out for help, unsure of where they were supposed to be or what they were supposed to do. It was sad and disturbing to hear. Did we do the right thing? A place to depend on and trust to take good care of our loved ones solved one problem but created more problems. Today is a new day. I am looking forward to seeing how the same people I encountered the night before act during the afternoon hours. I hope to see my grandmother engaged in activities with a smile on her face.

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