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Dementia

Courtesy flickr user: jamie-uk

Courtesy flickr user: jamie-uk

Close to home

Having had a relative affected by dementia I realise that it can be very distressing to witness a loved one suffering from its dreadful effects. Watching the person you love as they struggle through the mental deterioration is a painful experience. You may wish to stop them driving or cooking and this loss of independence can be hard to tolerate, particularly in the early stages when some insight remains and they themselves are aware that something isn’t ‘quite right’.

Coping strategies

In the early days many families find clever ways to help their loved one remember important things and to keep them safe; they may leave little notes and prompts around the home and installation of smoke alarms is very wise. Wearing a medic alert charm can be really useful if your relative has a tendency to wander. It can aid the police and ambulance service to quickly reunite everyone. My relative had to spend one night in ‘police custody’ until they could establish who she was which was obviously not ideal. Those with family around are the lucky ones in many ways.

Introducing … Dot

Dementia isn’t funny but it does occasionally throw up some amusing situations and bizarre conversations and recently I met a lovely lady, Dot, who made me smile as she told me about some of the things that had been happening in her world.

Dot dialled 999 one evening because she had apparently had an episode of vomiting. She lived alone and appeared to have very little social support. As it turns out, I wasn’t overly worried about the vomiting but as my assessment progressed I started to become increasingly concerned about other matters.

All is not as it seems

Dot was obviously a very intelligent and polite woman who had worked as a teacher before retiring. The first sign that alerted me to things not all being well was that she was wearing her sweater inside out and back to front. I enquired as to whether she had realised her error; she explained that she always wore it that way because she is Irish and it is lucky. She went on to mention that someone had been breaking in to her house and turning all the radiators up. I asked her if there had been any signs of a break in or if she felt vulnerable; I suggested we tell the police if someone was breaking in to her home. She replied that ‘they’ had probably sneaked in and had her keys copied and that there was no point bothering the police. I let that one pass too.

“I’ve been gardening recently” she told me.

“Oh I love to get out in the garden too” I replied.

“The other day when I looked up there was a man standing there right in front of me.”

“What in your garden? That must have been very scary” I ventured.

“He said to me, ‘there is a bird in your tree but I can get it down for you if you wish?’” She continued “I told him I had a friend that was very good at that kind of thing and that I would call her straight away to help him – well, that made him clear off. I phoned the police immediately and they said I was lucky to be alive; he was the most wanted man in the country and I was lucky that he didn’t murder me” she explained.

Clinical Tests

At this point I decided to perform a Mini Mental State test on her and she didn’t do too well; she was unclear about the day and date and had very poor recall in general.

While I accepted that there may be some truth in elements of her stories I was more concerned because she was living all alone. She seemed very happy in herself and not at all distressed by any of the things that she told me about. However, I didn’t know how she was normally and felt it best to pop her to hospital for a full assessment of her mental and physical health. I explained this to her. This was her response:

“Last time I went to hospital they stuck me in the waiting room for hours.”

“That can happen sometimes because it gets really busy, but I have been there tonight and actually it’s not too bad today” I replied.

“Well last time these young men wanted to beat me up, I was very scared.”

“Oh dear why do you think that they wanted to beat you up?” I asked.

“Because I am a vegetarian, it can make people very angry!”

“Really? A group of men wanted to beat you up because you are a vegetarian?”

“No not just that – I’m an herbalist too!”

“Wow, that is quite unusual; don’t worry I will be taking you there – we can check out the waiting room together to see if there is anyone to worry about there.” Reluctantly she agreed and we made our way to the car. During the short journey I reassured her that it was unlikely that she would encounter that particular gang of violent anti-herbalists on this occasion.

As we arrived at the hospital the conversation about the violent gang sparked up again; and once more I tried to reassure her that she would be safe from the gang. I said that it was most unlikely that they would still be at the hospital after all this time.

“Well I think you may be wrong dear they do work here; they are all doctors!”

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