Final day of fieldwork :)

Final Day, Day 10, of my final Level I fieldwork, in Geriatrics, at an Alzheimer's Day Center.

This was probably one of my quietest days. First of all, good news – the lady who was unresponsive at the end of Thursday ended up eventually responding and was okay, no ambulance needed.

In the morning, MsL, a talkative little woman, decided she wanted to sit with me/socialize. Unfortunately, my FixxyLady was in an extra talkative mood, and came over and monopolized the conversation, much to MsL's chagrin. When we ended up in a room for current events, FixxyLady would not be quiet, so I took her to the art room. On the way, MsD decided she wanted to join us. FixxyLady and MsD are exact opposites in looks and I hadn't really encountered MsD before, so I wasn't quite sure what to expect. I set up three rocking chairs facing the big glass windows (it rained steadily all day long), and then got babies for FixxyLady and MsD. We sat there and rocked and watched the rain for, literally, hours. We talked too of course. FixxyLady would say her random things and MsD was wonderful at talking to her normally. She was well aware that the dolls weren't real, but played along for FixxyLady's sake. MsD was quite with it in many ways, although she repeated her same thought every few minutes – Look at that rain. I sure could take a nap. I love napping with the rain. Look at how high those trees are. I remember when they were just tiny buds.” x 100. It was nice though.

At one point, when talking to FixxyLady, I asked her something overly complex, according to all the Alzheimer's books I've read recently. As her mouth struggled, I said “Sometimes it is hard to come up with an answer, isn't it” and she said brightly “Yes, ansy-pantsy!”. LOL. I laughed and so did she, it was so adorable.

During the afternoon, we had two ladies that were especially agitated regarding wanting to wait/look for their caregiver to get them. No amount of persuasion would allow them to relax. I asked for permission to drag a table somewhat near the front door, so that I could sit down with those two ladies and tell them we were right where their caregiver would see them, and still get them to do something besides wander. I got the tables/chairs set up, just 3 chairs, and then immediately MsR and MsE took over two of them…I was chagrined. I asked if they would consider moving because the table was set up for special reasons but one of them got grumpy and the other one said she was there to help me. I bit my tongue. lol. So I just dragged over more chairs and we all sat down.

I once again got out the pipe cleaners because they are pretty and fuzzy. I sorted them by color and handed one of the twisted ones to my agitater, MsY. I asked her to try and untwist it for me because I was having trouble. She obliged. Since MsY typically does nothing but watch and/or wander, I was glad she was doing something. I started twisting two different colors of pipe cleaners under the table in easy to fix ways, and then would incorporate them into her stack without her realizing. So she ended up with a large stack of twisties to unravel while I sorted. We chatted and had a nice time. The PCAs were impressed since MsY is hard to handle in general. But the only reason she is hard is that MsY requires one-on-one loving and that is something she can't get in a group. MsY is adorable and her smile makes me melt. She was convinced she still worked in a doctor's office and was ready to get back to work.

The other agitater, MsT, was not willing to sit down. She mostly wandered and looked upset. She had a bunch of fake Monopoly money clutched in her hand. At one point she sat down with us for a while and I asked her for her hand, but she refused to put the money down. She believed it was real money.

One of the PCAs let me know that one of the ladies “boo-booed”, as she put it, in the trash can instead of toilet the other day. It's fascinating how the brain works and confuses objects, huh.

My nonstop talker man who can occasionally state a single sentence, hugged me and said “You're in good shape” before lapsing into his random stuff. My other lady who appears like like females a lot, kept on adjusting my collar, touching my necklace, touching my hair, rubbing my arm…it wasn't overtly sexual by any means, but I was like ummmmm….do I stop her? Does it matter? I didn't really know the proper response.

My poetry lady really liked the Shel Silverstein poems I brought her, all of which are amusing within every line. She doesn't appear to have all her reading comprehension intact by any means, but there is some form of subconscious comprehension as she would laugh at some of the absurdities. Which is exactly why I picked his poetry.

There is something called anosoagnosia, that is mercifully a common symptom in dementia/Alzheimer's. It basically means the person is unaware of their own mental shortcomings. This is a blessing in some ways, because it's heartbreaking for the participants who DO understand their brain is deteriorating. One lady said faintly to me, “I don't understand why I can't find the right words” and I told her, “I'm sure you're tired. We all lose our words when we're tired”. She nodded.

When I left, I told all the participants I was just going for the weekend, because I realized it would be too hard to explain I was leaving and probably they'd forget my existence by Monday anyway. Those who were higher-functioning already knew I was only here two weeks. A few wanted to exchange phone numbers and I promised we would the next week. I look forward to going back after next week's AOTA conference, even if none of them remember me. I feel like even if they don't technically have any real recognition of me day to day, that the feelings of comfort I give some of them stick with them enough that deep down they associate me with kindness. Maybe that's arrogant, I don't know, but it did seem like the ones I spent a lot of time with got more and more comfortable with me over the course of two weeks.

I really love babies, but I was surprised at how much I enjoyed working with patients with dementia. It's FASCINATING to see what parts of their brain function and how their minds compensate for discrepancies. I plan to keep visiting as frequently as I can. 🙂

Apr 06, 2008 | Category: Occupational Therapy | Comments: none

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