Yesterday I met a lady with dementia. The referral was for ‘escalating behaviours and aggression’. Staff have been pushed and shoved and yelled at, and are having trouble helping her with personal care.
I knocked at the door and asked permission to enter.
She was in her chair, in the dark, in a dressing gown.
We sat side by side in her room which was empty except for a bed, a chair, and a few scattered photos. Her wardrobe door was open, and it was empty. She had no clothes.
According to her, she is 92 and 1/4 (we counted the months together on our fingers).
I asked about the photos and spent over an hour listening to her tell me her life story. She is incredibly sad that she was an only child, so she begged her husbend for two children as a condition of marriage.
She feels lucky she had twins, and named them after their grandparents.
She loves music and dancing, and acting in plays. Her favourite musical is Mary Poppins, and her final role was as the chimney sweep. She animatedly told me this story complete with actions for cleaning a chimney, and were were both in stitches laughing about it.
She worked hard all her life as a cleaner, and saved all her money. She was paid in cash and wanted to buy a house, so she bundled up the money for a mortage and carried it in her arms to “The Civic Permanent” (a now obsolete Building Society).
She told me she is sad and doesn’t want to live any more because she went to hospital, the ‘government’ sold her house and took all her money and put her in a home, and her children don’t visit her.
Some people are quick to prescribe medication for ‘behaviours’ of dementia. She does not need medicine, she needs so much more than that, and yet so little.
My prescribing was non-pharmalogical.
- Buy a handbag and purse from an op shop and put a few $5 notes and put some coins in it. Let her feel like she has some control and ownership over her money.
- Buy her some clothes.
- Play “Mary Poppins” on the big screen in the lounge. Sing with her when she sings, dance with her when she dances.
- Spend time listening to her, find out what other musical and plays she likes, then play them and encourage her to watch them.
- Referral to a psychogeriatric nurse practitioner, who will know so much more than me and will help the staff with strategies to engage and de-escalate her behaviour.
I don’t have all the answers, but during my time with her there was not an ounce of aggression. We laughed, we talked, we touched. She kissed me on the cheek when I said goodbye.
It was the highlight of the week.