Day 8 and 9 of 10 as a Level I geriatric fieldwork

Day 8 – Yesterday.

I started getting more and more saddened by all the women sitting around just wanting to go home/find their loved one (typically a husband). None of them could understand or remember for more than a few minutes what had happened to the person. I don't remember anything else now – I have a horrible memory myself. Maybe I'll find some notes to trigger my memory.

Day 9 – Today, Thursday

Today I started out the day by doing the Mini-Mental State Exam (MMSE) with my chosen participant, Ms X, who I would argue is the highest-functioning patient there. She is hilarious and sweet. She scored a 20 out of 30, and anything under a 22 is considered possible dementia. In her case, the biggest issues were not being able to count backwards by 7s very well (but once you mess up once, you are messed up for the next four points, so to me that isn't fair). Also, she thought it was March 28th at first, and that it was winter. She was otherwise talented. And um, honestly, when it came time to have her copy interlocking pentagons….I tried to draw interlocking pentagons and it looked like *I* was the patient with dementia, or perhaps a first grader. Awkward…lol.

She then spent the next hour and a half helping me (and by helping, I mean doing most of the work) make baby doll clothes. There are about five baby dolls in high demand, and none of them have any accessories. I had found some fabric, but we didn't really have access to needles, plus I don't really know how to sew. I borrowed some scissors and we made baby ponchos and bibs by just cutting them out, no need to sew. They were adorable. But it was Ms. X who really figured it all out. I didn't have any experience with fabric period, and I have serious visual perception issues, so for the life of me, it would have taken me a long time to figure things out. It was neat having her being the teacher.

I also spent some time with my Nonstop talker, who seems convinced that he and I are going to run away to go fishing or find his brother or something.

I spent about an hour with my Express Aphasia FixxyLady, reading The Giving Tree and the Legend of Three Trees. It seemed like she has read the Giving Tree before based on a few of the things she said. She seems to have demons in the sense that she keeps talking about some event that was traumatizing, but unfortunately she makes no sense. I wish I had more access to caregivers to get more of the puzzle pieces put together. We had a good time together. Many of these participants have told me “You'll be a very good girl” or something along those lines, which I think is sweet. At one point I said to her, Fixxy, you are amazing. She said “Sometimes, I'm not so sure”. It always surprises me/brightens me when they have a real response in an otherwise nonsense day. Also, if you bump her by accident, she'll say “Oh excuse me, I didn't mean to bump you” – ingrained habits deeper than Alzheimer's, at least right now.

Hmm. I spent some time hovering near the men's bathroom listening to some VERY personal noises, waiting for my participant to come out. Yikes. But it wasn't as gross as I would have thought. It really is true you get used to all this stuff, which I didn't used to believe.

This one lady, let's call her Bee, is a shy and quiet woman who doesn't initiate much, but is a very kind woman. Today she was agitated and kept talking about wanting to go home. Although I kept assuring her her person had called and she was on her way, she was so convinced she had to go find her herself. She wandered around looking distressed for a long time. I managed to keep her occupied for about 15 minutes and then she wandered off. I felt bad. It's interesting how each day really is a new day – one day the person is fine, the next day the person is agitated. I ended up accumulating patients though, because I had pulled out the colorful pipe cleaners, and the PCAs would wheel over their somewhat low-functioning people to sit at my table with all the colors. One lady, let's call her Sue, really was enthused about making things with the pipe cleaners, but was never willing to make even the first step. She talked constantly about safety issues and was anxious. She had a good sense of humor though, and she really liked me. She wanted to follow me around while I did things, and although I felt bad, I eventually got away from her (I knew she'd forget soon), because she is pretty high maintenance – she is hard of hearing and doesn't see well, and has somewhat of an abrasive personality, so she makes it hard to interact with others. I really do like her and I might take her aside for a while. I think she could benefit from some one-on-one, even if we don't get a thing done. Hmmm.

I made a rattle snake out of pipe cleaners and then showed Sue how I could scare PCAs. She loved it. I let her have it, but two seconds later she was like, what is this? So I took it back because I realized she'd be confused constantly over it, otherwise, lol.

Today, the big thing was, our lowest functioning participant, let's call her Nee, who basically does nothing but sleep all day and occasionally open her eyes or mouth (she has to be fed but doesn't open her eyes for it even – she maybe has her eyes open a second every hour), became unresponsive near the end of the day. When I left at 4pm, they were still trying to waken her, and were on the verge of calling an ambulance. I hope she is okay. But in some ways, it might be a compassionate ending to just slip away. She literally had nothing but her body (and that was in poor condition) left – all of her essence had seeped out. I hope she is there tomorrow, but if she isn't, I hope her family finds the strength needed to handle the situation. Poor Nee.

Overall I've become really touchy and Mr this and Ms that. I'm normally NOT like that, so it's freaking out all my friends because I can't seem to stop doing it even after I leave the center

Apr 04, 2008 | Category: Occupational Therapy | Comments: none

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