In the Geriatric Psych Ward, on Live-ing

picture from the papers…

Translated…

This, is the Elderly Psych Ward, a Unique Corner of the Hospital………

“Squeeze on the left, squeeze on the right, then, you can rid yourselves of hypertension…”, the nurse was working hard, leading us in exercise, the unique tempo and her sense of humor had made the elderly who just got up from their naps awake all of a sudden.

This, is the geriatric psych ward, a unique corner of the hospital.  Compared to the regular more emergent sections of the hospital, although the patients here are also, faced with the issues of bipolar, delusion, hallucination, etc., etc., etc., but, the years had, trimmed of the edges of the illnesses, and, there’s not that scent of violence anymore either, and naturally, the atmosphere is calmer here.

The demented elderly who were there because of their chaotic and disturbing behaviors, and the symptoms were caused by the deterioration of the brain, there’s NO way to cure, and so, the doctors and nurses dealt with it using more tolerance, between the questioning and answering, there would often be some interesting things that would happen, added some moments of humor, to the busyness of the pace of the hospital.

A Challenge of the Fast-Round of Q&A

Assessing the level of cognition is the primary activity.  We’d started from who, when, where, and the rest, we’d relied, on the various kinds of tests.

“Elder, for the next minute, please tell me names of fruits, the more the better.”  The fluency of language is a test for the frontal functions, and you must state more than eleven items, in order to pass the test.

“Orange, guava, papaya………”, Mr. L wrecked his brains, trying hard to think.

“More!”

“Apple…”

“Anymore?”

“…Small Apple, this, is different.”, the elder said, with that serious look on his face.

Uh, although the sizes are varied, but, I’m sorry, it wouldn’t count.

And, another abstract thinking ability is very important as well, the way to assess this is for the patient to state the similarities and differences of the mentioned nouns.

“Grandpa, what are the similarities of cats and dogs?  What do they both belong in?”

“They’re BOTH animals!”, Grandpa A stated loud and clearly.

The correct answer is “living organisms!”, although, he’d missed, but.  Next one, “How are children and winter melons different?”

“Children will grow taller, and the winter melons remained short!”

Ha, such a very interesting answer, interesting, indeed.

But, it’s not always, so smooth running, there would be patients who are totally, disconnected in thoughts.

“Auntie, I’ll read a sentence, and you repeat it after me, as similar as you can: “When the dog is in the room, the cat is hiding under the table.”

Auntie J stated it very clearly, not bad, I’d thought.

Then comes, the fluidity of speech test.

“Now, you have one minute, please tell me the names of fruits, as many as you can…”  “Now, you have one minute, please tell me the names…”, before I finished, the woman hurriedly repeated what I’d said.

“No, we’re on the next category!”  I’d explained.  “No, we’re…”, Auntie J hurriedly, repeated after me.

It seems, she can’t continue to finish up the task successfully, this, is the noted sign for frontal deterioration.  I’m at my wits end now, and so, I’d asked for help, from my colleague close by.

A Creative Way of Cooking, by the Doctors

Other than the tests, there are, funny moments in daily life too.

“Sir!”, Grandpa W who was diagnosed with Lewy Body dementia offered his salute to the doctor, and his body seemed a bit stiff.  His primary symptoms are army related and visual hallucinations related to biochemical weapons.

“When can I have my leave of absence?”, Grandpa W kept believing that he is working in the office.

“Grandpa, this, is the hospital.  Look, who’s taking care of you?”, I’d pointed to the nurse’s aide next to him.

“She’s an old lady”, Grandpa W stated, it’d made the young nurse’s aide looked very helpless.

After I’d dealt with Grandpa W, Grandma C came crying to me.

“What’s wrong?”

“I want my husband”, she was diagnosed with depression before her hospitalization, and she’d become wayward in action after admitted, kept claiming that she wanted to find her husband.

“Where is your husband?”, I’d asked.  Based off of children, he should be at home.

“Over there.”, she’d pointed to the elderly man who’s demented, in the next room.

“and, what about him?”, I’d pointed to another patient, to test out my theory.

“He is my husband too.”  Grandma C stated, so certain, and, everybody who’d heard her couldn’t help but laugh.  Gladly, she’s not disturbing anybody else, and, we’d stopped, arguing with her.

And, Auntie T who has a front lobe deterioration refused to eat, and, she’d shown a decline in communication ability too.

“Why won’t you eat?”, I’d inquired.

“Yes, I today, corn chowder”, although Auntie T showed verbal expressions, but, the contents are mismatched, clearly, she’d lost her ability to comprehend spoken language.

“Are you hungry?”

“Oh, Corn Chowder”

“You’re hospitalized, you need to eat, this is XX Hospital, come, say it with me.”

“XX Corn Chowder…”

We’d surrendered, decided to put a feeding tube into her, to make sure she has the needed nutrition.  But, I kept on wondering, if we brought her corn chowder, would she, eat that?

Grandpa Z with Alzheimer’s, had been bedridden for a very long time, and would eat on and off.  We’d changed his regular diet, to a softer, liquid kind of diet for him, but, nothing changed, and the team is very stressed.  One day, I was talking about Grandpa Z with an older schoolmate, and, he’d had an idea, ordered up a McDonald’s hamburger for the family.  And, the magical thing happened, Grandpa Z, seeing the bag from McDonald’s, became hungry, and started eating it, and it’d, impressed the family too.

After working with the elderly, I’d understood that nobody can turn back the hands of time, to prevent oneself from aging, but, with the deterioration of the brain, the person may regress into a child, relied on others around to take care of her/him, as if, returning to the beginning of life.

In the geriatric ward, we’d not fought the “process of aging”, instead, we’d gone with the flow of things, tried our best to help the patients, the families, to change the quality of life for the better.  And the cute behaviors of the elders are like the small gifts they brought with them, adding some laughter here and there, to the already too heavy hospital; and, it’d helped them be more humorous toward the destined getting older, getting ill, and dying, to cope, with death.

And so, this, is from the observations of a doctor, and, there would be an assortment of situations that happens with the demented elderly population everywhere, and, because you can’t stop the aging processes or the deteriorations of the mind, you can only make sure, that the elders have the best quality care available to them, as they head toward the exits of their separate lives.

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