Day 2/10 of Geriatric Level I Fieldwork in an Alzheimer's Day Center

Today was Day 2/10 of my Level I Geriatric Fieldwork at an Alzheimer’s Day Center.


Today went smoothly and was quite fun. I did a lot of bouncing around from group to group, observing personalities of both “participants” and the staff. I was overall impressed with the behavior of both groups. Today I observed and/or participated in Civil War Jingo, Bingo, Rubber Chicken Hot Potato, walking, breakfast/lunch/snack, trivia, you name it…

There were several interesting incidents today. In all cases I mean no offense to the participant – I’m merely explaining some of the things I encountered.

1)      There was a man there today who NEVER stopped mumbling. Not once. Not even for a minute. Constant mumbling that was mostly incomprehensible. If you said HI! To him, he’d say Hi! Back and maybe a “How are you?” before lapsing back into his nonstop speech. He definitely annoyed other participants. At one point I led him (with permission) into an empty room. I held his hand to take him there, and then when I got there I gestured for him to sit down, and he kept standing up and talking. Eventually I literally gently took his hand and somewhat initiated the sitting down movement for him, and then he was fine. I got out some of the big poker chips they use for Bingo, because I figured I could play with them while he talked, while also seeing what responses I could get out of him. I sorted the chips by color slowly, occasionally waving one in front of him to see what he’d do, or trying to put one in his fingers to see if he’d stack it. Occasionally he’d take it and then examine it and lay it back, but never in one of the stacks. Another time I held up a red one and he said clearly “That’s a red one” before going back into his mumbles. Another time I deliberately knocked over a stack of blue ones to see if he’d startle/respond, which he did, and even hesitantly started rebuilding the stick for a few, before lapsing back into mumbles. I tried interrupting him a few times which mostly didn’t work. At one point I said “Knock Knock” to see if he could quickly do a Who’s there? But instead his response was “Memphis State”. LOL, I thought that was awesome. J To me it felt like there were snippets of his prior self inside of him, but those snippets had almost no choice against the tornadoes destroying his brain. I wondered how his wife caregiver handled the incessant talk.

2)      The wandering woman was in full force today again. She walks with her hands drawn up and a worrisome look on her face, very rarely saying anything and always aimless. She will walk for hours and hours, so long that she will start falling because she gets so tired. Today they had to physically restrain her in a special chair to make her rest for a while so she wouldn’t hurt herself, but she was very upset about this, and she kept trying to get out, and crying. The staff was very kind to her and stayed with her. I don’t know this lady’s background, but from an OT perspective, I thought that while restrained, she would benefit from a weighted vest (deep firm pressure), as well as some duct-taped phonebooks underneath her feet so they wouldn’t dangle and she could feel better contained. My friend Suzy mentioned a stationary bike or something, which to me was an interesting idea. I would like to see her charts to see if there is any background on her previous occupations, because ideally of course, she wouldn’t need to be restrained at all.

3)      There was a nice intellectual looking woman there who walks jerkily and always carries a sippy cup. She started talking to me today and the first thing out of her mouth was something along the lines of “I have lost what I cannot find, but how can I find it if I don’t know what I lost”….I said to her (kindly), “You sound like Alice in Wonderland!” She repeatedly said things that made no sense at all. She loved to talk, so I just did a lot of nodding, smiling or frowning, and making little “listening” comments, even though there was never a time she made sense. She could clearly read well, reading and discussing (but not making sense) the lines of the songs we were supposed to be singing. Most of which I’ve never heard – like Bye Bye Blackbird and Meet me in St Louis and Wild Irish Flower or whatever.

4)      I met a thin wisp of a lady who would say to me (and others), “You’re very pretty. You’re an angel. Thank you so much. I love you.” She worried incessantly about her husband picking her up and kept asking about him every few seconds, as well as asking about eating. I would say to her, “Your husband had to go do some errands. He’ll be back soon. And we’re eating lunch soon.” So she’d say the whole “I love you” stuff, but then 15 seconds later, ask me again. And again. And again. It takes patience to repeat the same words a thousand times. J She wanted me sitting next to her and was scared I would leave her, so I spent a lot of time holding her hand. When I finally did leave, she said to me, I’ll be so lonely. I told her that  the lovely ladies next to her would be her friends and keep her company, and the woman next to her nodded and told her, “I love you”. And my sweet little lady responded “Thank you, I love you too”. LOL. Awwwww.

5)      Some of the higher functioning patients reassure the lower functioning patients in ways that teach ME how to react…I learn from them as well as the PCAs the proper ways to respond. It seems validation theory is in use here – just going with the flow.

6)      At one point I wandered over to an activity where they were cutting out brown things for some reason. I realized the lady I had just walked up to was in the process of cutting her up name badge (they all wear one around their neck). I let the PCA know, who wasn’t pleased but didn’t chastise her or anything. The lady knew she had done something wrong and she put down her scissors and put her head on her desk like a little girl crying from being in trouble. It made me feel so sad. I rubbed her back and told her it was okay, it’s easy to make mistakes like that and we’ve all done it, and she isn’t in trouble. She perked up a little after that.

7)      I got to feed a woman this morning. I’ve actually never fed anyone over the age of like, 2, before. She kept her eyes closed the entire time with her head bowed. The feel of the spoon against her lower lip would cause her to open her mouth and get the food, and she didn’t appear to care what the food actually was.

8)      Overall, today was really neat. I got to do more helping out, and tomorrow I plan to try and do even more…and then after tomorrow, start seeing about taking people aside and trying out various things with them. J Everyone there is so great.

Mar 26, 2008 | Category: Occupational Therapy | Comments: none

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