Thursday, July 18, 2013

Dementia



How is she now?
Asked the relative of the fragile old lady who has in her late 80s and was operated for hip replacement.

She will be discharged tomorrow...

My short response was not taken very positively by the relative, I felt he wanted her to stay there for some more time, may be get into some complications and stay at the hospital only! I was surprised by my own thoughts and my getting so involved with this patient

The blank stare on both patient and her relative lingered  around the room and my thoughts...

Oh!
Came as a very Calculated response from ten relative. He certainly wasn't sure how to handle the discharge and this news!

Can this be extended by a couple of days...he was very slow, calculating, and wanted to be very safe while asking this question.

Why?!!! My very sharp reaction and tone bothered me too!
Nothing specific... He smiled sheepishly and said I need to make some arrangements at  home ...

He left his sentence and the counter mid way....his answer!


Life as hospital attendant is very demanding and challenging and one always comes across various aspects of family life, drama even in such situations. Having witnessed fights between brothers, spouses and kids about who will take charge of the patient to who will pay the  all the bills ... Have left so many scares .. That I wonder at times how and why wounds heal!

This old lady was a patient of dementia for last 10 years and her situation was worsening every year. Some three 4 or 5 years  ago she was at the our hospital for fracture near elbow and that time her family members were not so insensitive I guess. This is my 15th year at the same hospital and ward and I don't think that I will ever get promoted beyond my current levels!

I had checked records from previous admission and that time it was stated that her son who took her back home.

The gentleman I was talking to, certainly was not her son.... My be was her grand son? Or...

A different and unique curiosity forced me to make a  dig at this situation... But he was now where to be seen! Patient was all alone

I announced for his name from PAS and Waited for him to arrive...but he did not appear! I too got busy with some other administrative work and it did not occur to me that patient was all alone without any relative for more than 10 hours now.

As i went to report this to this senior administration for filing a report with police for abandoning a patient, I saw him seated with hospital administrator and he seemed distressed...

The old lady was his maternal  grandmother. For all these years she was the most loving and caring mother, mother in law, grandmother, neighbour and any other role that she must have  played. No one from the family remembered that she ever had raised her voice or had any major argument with anyone ever! It was  some years ago when the old age caught on her and she had these episode of forgetting things, names, places, situations and connections. Family took all this with pinch of salt and was protective about her. Last two years she had lost all connections and did not even recognise her own son, daughter!
All she had was memory of her childhood, memories of her parents, siblings and of time when she was 16/17 and some memories from near past.

After the last hospitalisation some two years ago, things were worsening, she forgot if she had meals, taken bath, and at times lost control and family found it strange when she started shouting , abusing and screaming for seemingly no reasons. She was not aware of death of some close family members and  after death of her son, her daughter took her to their home.

It was since last 2 years that she was with them. At her daughter, and her family was adjusting to her style, temper tantrums and it was getting difficult every day.

Twist came in last fortnight, when a friend of this grandson visited the family. they both studied together at college and he came for the first time to this house.  every-time someone visited the house, this old lady would ask about who the visitor is! this usually was true for family members too! she would kepp asking questions to her daughter about who she is, why is she here in her house, how long will she stay and so on.... most of the time situations were hilarious and frustrating . as soon as this person entered the house, she smiled, as if she recognised him! Her daughter asked her if she actually had!

She very confidently said yes!

There  was a different kind of glow on her face the regular lost expression was gone,she  than started of, how when she was 17' she liked a boy in the neighbourhood and how they had managed to some time everyday for themselves and eventually she fell for him and they had relationship. This certainly was not socially acceptable to her parents and they married her off  to a boy from poor family.
She said the young man who had arrived was her "friend's" grandson! She knew exactly that time, the name of  her friend, which city he arrived from and rattled exact address, all this matched with the details of the visitor and the name in fact was visitors grand father's name!

She said this very proudly that she loved this man all her life very secretly and it was due to social mirror and pressure she married a different boy and to fulfilling wishes of her parents she continued to be a good daughter after having hurt them!

She continued with  specific details of her meeting with that man, his looks, his house, his family, his acceptance and craving for her!

There was pin drop silence in the room.

No one knew exactly how to act including the guest, who had come for the first time to this household, and the eerie silence prevailed.

The old lady was excited and was in a different frame and kept on asking questions about grandfather of this guest!

All of this must have. Lasted for 10 minutes, the glow, disappeared. She was her original self again, lost and asked the visitor.... Who are you?

No one responded this time, they needed some time...

Old lady got excited and stood up started walking, before everyone realised what was happening to her... She fell down and ... Now was in hospital Afro hip replacement... There were no other complications medically...

Dementia, whatever you remember is always correct and your subconscious brings it out for you,

It created a different kind of burden for all. Family needed sometime time recover from this shock! They wanted to forget this before she was taken home  and they needed some time to be normal self....

 Doctors were discussing impact of dementia

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