Lucy’s eyes narrowed. “Nooo!” exploded the grandmotherly woman capped with downy white hair. Her cries sounded more like a toddler’s tantrum.
I guided her legs into sweatpants. No matter what I said or did, dressing Lucy always felt like a wrestling event. She heaved the bedside clock across her bedroom. Plastic alabaster cracked in half. For someone who couldn’t dress herself, she maintained surprising strength.
Shifting her weight on the edge of her bed, my overheated body finished dressing Lucy. Her body slackened, so did mine. Lucy’s damp red-rimmed eyes smiled at me. She brushed my head with her palm.
“How about breakfast?” I asked, returning a grin. I patted her knee after tying her shoelaces.
The former housewife leaned into her walker and shuffled across the polished floor, as if on a mission.
In the dining room, round tables were set with potted silk poinsettias. Christmas carols played in the background. She settled in her seat and devoured her French toast.
Peaceful, I thought, for now.
This was a typical morning for Lucy, punctuated by the ins and outs of reality.
Alzheimer’s disease stole Lucy’s life. Her challenge was to live with the ravages of this disease and I, a registered nurse in a nursing home, tried to connect with her while providing medical and personal care.
Thirty years ago, my nursing school philosophy maintained we constantly reorient them to the present. I found this to be futile and traumatic for everyone.
As I strived to comfort Lucy and other Alzheimer’s residents, I asked myself an uneasy question: Should I go to their reality, or force them into mine? Click To TweetI finally found my answer.
Later that morning, I entered the family room to retrieve Billie, another resident. Lucy reminded me of her upcoming hair appointment. Bursts of hot pink topped her newly manicured nails. As I wheeled Billie to her room, I heard Lucy laughing as another resident sang, “How much is that doggie in the window?”
For Sundowners, confusion and agitation increases as the natural light fades, ushered in with the late afternoon hours. A staff member found Lucy around four o’clock emptying her bureau drawers, packing framed pictures and underwear. Chaos littered her bed, and her mind. She insisted her husband, Armand, was coming to take her home. She tried to elope—a term used for their tendency to escape the facility—almost every day.
“I have to get home to cook Armand’s dinner. He’ll be upset if it’s not ready on time.” She spoke to anyone passing by—other residents, staff and visitors. Her voice rose over the television’s talk show. I tried to calm her by speaking in a quieter voice.
Lucy always failed to remember two crucial facts: Armand died many years before, and her home was sold. Her voice grew louder as we tried to reason with her.
“He’s coming to get me! Let me call him to prove it.” She rattled off a phone number, one she had obviously used many times.
The corners of her mouth quivered, hands trembled. Her eyes shifted as if searching for an escape route. From experience, I knew forcing this reality would only escalate her anxiety.Lucy had lost her grip. I had to do the same. Click To Tweet
I entered Lucy’s world.
At first, I was reluctant. How could I deceive her or any other resident? I thought about who they were: mothers, fathers, aunts, uncles, and friends. These people contributed to our communities: librarians, teachers, baseball coaches, fire fighters. They dreamed dreams and hoped for more.
More often than I cared to see, I witnessed Alzheimer’s patients looking into the eyes of a son or daughter, and only yielding a vacant stare or violent outburst. They seemed so locked away, scared and lonely.
Lucy deserved to experience comfort and connection—even if only in brief glimpses.
“See the blizzard out there?” I said making it sound worse than it was. “It would be dangerous for Armand to make the long drive. Look out the window with me.” I extended my hand, prompting Lucy to view the snow squall. We watched the snow, swirling like mini tornados. “It looks treacherous out there, doesn’t it? Let’s wait out the storm.”
Alzheimer’s disconnects brain pathways like a flood blocks off sections of roadway. To get her to shelter, I “guided” Lucy in a “boat”—I took her to the familiar ground of her realty.
I shared a story with her. “There was this big hill behind my childhood house. When I was a girl, I loved racing down the hill on my sled with my younger brother.”
She stepped in the “boat” with me—shared a childhood sledding story then drifted to stories of ice fishing with her dad. Her belly jiggled with her jolly laugh. Lucy’s vivid details invited me there with her.
She discarded her intent to elope—for now.
We walked toward her Canadian rocker. She nested in as if she was home. Her hands with skin thin as wrinkled parchment paper, rested on her belly. She continued talking as if she had all the time in the world.
The lilt in her voice lifted my spirits. Her eyes softened. If even for a few minutes, I saw Lucy on her familiar ground.
“Who said we are obliged to make people with Alzheimer’s live in our reality?”As I looked into Lucy’s face, I realized her world looked better than her reality.
Hands photo by Jessica Wilson via Flickr through Creative Commons / Floor image by Susan Sermoneta via Flickr through Creative Commons / Family Photo by Boston Public Library via Flickr through Creative Commons