Now, onto the blog proper!
essentially a day care for dementia-afflicted elderly.
Well, "day care" is a little unfair. A substantial minority
of our clients do not have dementia but merely go to the day care because
they're bored. Most of their friends are dead or have Alzheimer's disease. Their
children are working or simply not really comprehending what it's like to be
eighty or ninety years old. The only chance that a mentally-competent
elderly person can find like-minded, still-living friends outside of the nursing
home is in these day clubs. That's why I prefer the name "day club" to "day
care".... except of course most clubs allow their members to leave whenever they
feel like it while even our mentally-competent clients are forbidden from
leaving the premises. In that sense, our day club is more "day
On the other end of the
spectrum are our "lower-functioning" clients or people who have been so badly
afflicted by Alzheimer's dementia that they really can't do much of anything....
except scream, shit themselves, and (if we're lucky) sleep. Many of these
lower-functioning clients are violent and I literally bear scars from their
attacks. I hate, hate, hate these clients with an only-slightly-tempered
passion. My only consolation is that, on especially bad days, I can think
truthfully "Harriet is still dead."
"Harriet" is not this client's real name, of course. Nevertheless this woman was our most troubling client. She kept on trying to escape. She rattled the doors and screamed for us to let her go. That would have been disastrous, of course, so we tried to keep her away from the entrance. Nevertheless Harriet would go wild. She would shriek and scream and punch the hapless CNAs trying to control her. Luckily Harriet was so weak that her punches did not hurt. Regardless all the CNAs despised her and would always be occupied with other activities whenever Harriet started acting up.... and Harriet acted up all day.
As a new CNA at the day club, I would always volunteer to control Harriet. As a result, I hated her more than anyone. Harriet landed most of her punches on me. I was the object of most of her tantrums.
The head of the day club has never considered CNA safety to be one of her top priorities. Nevertheless Harriet's presence at the club dismayed our boss because Harriet's daughter could never pay her bills on time. When Harriet was finally barred from the club, all the CNAs breathed a huge sigh of relief. When I came in one day, my friend "Emily" slid her arm through mine and said quietly, with a smile: "She's gone."
I laughed. "She's gone?"
Forgiving Harriet for all the abuse and pain she has caused because of her Alzheimer's disease should, in theory, be the easiest thing in the world. It really is not her fault. Nevertheless, when your wrists are criss-crossed with pink scratches from Harriet's fingernails when you tried to toilet her, when a 9-year-old grandchild of another client is crying because Harriet has shrieked obscenities at the kid, when your brain is ragged from Harriet's screams as you try to bar her from jumping through the fire exit, when you try every bit of patience you have to calm Harriet down and you can't....... you start to really, really, really fucking hate Harriet.
We CNA's (if we're any good) keep our actual feelings to ourselves and present only the most patient, composed, forgiving attitudes towards the families of our clients. Nevertheless rest assured that as soon as you're out of earshot, we are letting our hair done with each other about how much we hate your dearest elderly dementia patient. We treat the patient as well as can be expected but when we are near each other.... we let loose. We do it in private, but we do it anyway because we need to.... because we need to be sane ourselves.
It was with unfeigned relief and gratitude that we learned that Harriet had passed away in January of this year. We weren't alone in our happiness either. Harriet's daughter and primary caregiver looked ten years younger after her mother's funeral. She was full of smiles as she visited our day club for the last time to pick up Harriet's few last items. We gave our condolences over her loss but Harriet's daughter was no fool. A few days after her last visit, Harriet's daughter sent us at the day club a card.
"Dear (employees at the day club,)
Thank you for your thoughts & prayers.
You took the best of care for my mom & made her days the best they could be. I'm glad for that. I'm sad that you didn't know her when she was well. She had a zest for life + lived it to the fullest. I got tired just looking at her calendar. 'Don't let life pass you by, get out & enjoy the time you have- life is short.' That's what I hope you'll remember when you think about my mom. God bless."
The message of Harriet's daughter's letter could not have been clearer. "Remember my mother the way she deserves to be remembered... not the way that- unfortunately- you will probably remember her." The note is kind, respectful, and sad because even Harriet's daughter knew that we will not be able to reminisce about Harriet in any happy way.
On paper there are few things more forgivable than a person's behavior when they have severe dementia. God knows it is not the fault of the person afflicted with dementia. Yet, in practice, there are few things that we are less able to do than forgive the violent, frightening, infuriating behavior of someone with dementia.
That is my own Alzheimer's game plan.