WHY I SPENT THE NIGHT IN A DEMENTIA WARD

My mother just died this past November and my Dad was placed in the Alzheimer’s wing of their Assisted Living facility. Mom had been his caregiver and the hider of how deeply into his dementia he was. She hid it well, with staff and with family because she gave Dad his clues. When we would visit she would prompt him with “Oh look! It’s Sharon and Jerry!” So he knew who we were. We never suspected that he didn’t know who we were until she was no longer here to prompt him.

Alzheimer’s and dementia is a horrible illness. It robs you of the person you’ve known your entire life, and it robs them of everything they’re known and experienced. There are behaviors that go with this disease that weren’t present in their “normal” lives, such as paranoia and anger. We thought Dad was in the best possible place he could be to deal with this. Over the past weeks he’s been “acting out” and they started to give him medications to try to keep him on an even keel – we thought.

When my husband and I got to Dad’s place for our weekly visit on Saturday there were fire trucks there. We didn’t see flames or smell smoke, but when we entered the girl at the front desk said, “Oh, you’re going into the Heritage wing? That’s where the problem is! It’s flooded.” We didn’t know if it was flooded from the fire hoses, or if anyone was hurt, but when we got into his wing we could see about an inch of water in the hallway going to the bedrooms, their living room area and their activity room. Apparently due to the cold weather a pipe in their sprinkler system burst. The residents were situated back in their TV room, and when we went in there we saw most of them, including Dad, sleeping. We decided not to wake him until we assessed the situation.

They asked us to leave so they could deal with the flood, but I didn’t want to leave until I learned if Dad’s room was affected. They TOLD me it wasn’t, and could we please leave, and they brushed us off. We left and when I got home I called my sister to fill her in. As we were hanging up I could hear that she was being beeped. Two minutes later she called me back. That call had been from his assisted living facility. Dad was freaking out, had supposedly gotten violent, hit other residents with his cane and threw a chair, and they were sending him to the psych ward in the hospital. My sister was going to meet us there.

I got there before she did, just as the EMT’s had transported him. The EMT said to me “Gee, they said he was freaking out, but when we got there he was gentle as a lamb. We asked him if we could take him to the hospital and he said yes, climbed onto the gurney himself and thanked us. Then he went to sleep. They told us they have given him Ativan before we got there.” So now we had this calm, frail 91-year old man who was drugged to the hilt and just wanted to sleep, lying in a bed in what I can only describe as a concrete cell, waiting for a psych evaluation. What’s wrong with this picture?

The hospital staff told us that they’re required by law to run a CAT scan, do blood work and a urine analysis, and a psych evaluation. When they took him for the CAT scan my sister and I went with him. He was NOT happy about being disturbed because at this point he just wanted to sleep. He wasn’t happy about being moved from the gurney into the CAT scan bed, when asked if he could scoot over himself he said, “Too complicated”. For a man who was drugged, it probably was. The three of us, which included the tech, got him moved over. He didn’t want to stay still so he had to be restrained in the machine. He kept saying “Good NIGHT already! Turn out the lights!” By the time the CAT scan was over our husbands were there so they helped the tech get him back on the gurney and the orderly wheeled him back to his cement cell.

A nurse came in to drawn blood. Already angered and confused by the CAT scan, he didn’t want to cooperate with her so she got another nurse to help her. He kept saying, “Leave me alone” and “You’re fired!” to them, but they drew blood. Now they wanted to catheterize him to take a urine sample. That’s when he really fought. We could hear him screaming from the other room “Leave me alone! Don’t touch me! Get your hands off of me! I don’t want this!” My sister and I were in tears; we didn’t know what to do. One of the nurses, who he had tried to bite, got three big orderlies and now there were five people trying to hold him down and put in a catheter. They gave him a shot of Ativan on top of the Ativan he’d been given at the assisted living. We’d were at our wit’s end at this point.

A social worker came to talk to my sister and I. We went to her office and she had us call his assisted living facility while she left us alone. They told us that they had their hands full dealing with the flood, and said that the other residents had been transported to a different facility for the night, and that my Dad needed to have his medications regulated so they wanted him admitted to the hospital for a few days before they would let him back. That he couldn’t come back anyway because the flood had affected his room so he couldn’t use it. That originally they’d had a room available for him in the other place they shipped the residents to for the night, but after they sent him to the hospital they didn’t keep a room for him so they weren’t sure one would be available for him there, but it would be “better for him” to stay in the hospital since he was already there. In other words, they wanted the hospital to do the work for them, so that when Dad went back to assisted living he would be all calm and happy. We were floored to hear this, and told them we’d call back and let them know what we were doing. The social worker, when told about this call, said “No, that’s not how it works. They’re responsible for adjusting his meds, not us.”

Since Dad was not ill, so there was no medical reason for them to admit him to the hospital. He was drugged so he couldn’t be evaluated, but even if he could be he as dementia so what would they find out? That he’s confused?? She said if they wouldn’t take him back at assisted living, we were left with two choices. The choices were either voluntary commitment – obviously out of the question in his condition – or enforced commitment in a mental health facility. She explained that meant he lost all his rights once he was committed, that would be a one-way ticket, and he could be placed in any mental institution in the entire state; alongside people with real mental illnesses, and alongside the criminally insane. She was adamant that was NOT the place for him, and we agreed. We were devastated. If he was committed he would lose any rights he had, and so would we - our power of attorney would be rendered meaningless.

In the meanwhile, after the failed catheterization Dad was freaking out. He was angry, furious, and wanted to leave. He ripped off the hospital gown. In the fracas with the nurses he had cut his arm and was bleeding, and wouldn’t let anyone look at it. He kept screaming that he wanted everyone to leave him alone; he didn’t want anyone’s help, and would rather just die. That he wanted to kill himself, so it would all be over with. He tried to get off the gurney and would have fallen if my husband and son weren’t there to help sit him in a chair. Once he got in the chair he seemed to calm down a bit. My sister and I, our heads reeling with what we’d been told, were now back out with Dad. We covered him with blankets and he looked at my sister and me and apologized. “I’m sorry for acting out”, he said, “I’m just frustrated and angry”. We said, “Dad, we understand. We just want you to be calm. Your arm is bleeding, can we get someone to bandage that for you?” He agreed, and the nurse came and bandaged his arm. My husband asked if my father felt like he could give a urine sample, and he was agreeable. Between my husband and the nurse they were able to get a urine sample – voluntarily – from Dad. Ironically through all of this, he had been the most vocally lucid he’s been.

During this time the social worker had been talking to the facility administrator and head nurse at the assisted living facility. Obviously she tore them a new asshole, because when we called them back a short while later, they now said that the flood had NOT affected his room, and that he could come back if a family member agreed to spend the night with him, because they didn’t have staff available to stay with him. Both my sister and I agreed to stay with him together, since we knew it would take more than one person to handle him.

While all this was going on, the hospital had brought a tray of food to Dad. He did manage to eat some of it, but by this time the shot of Ativan was kicking in and he was becoming incoherent and sleepy. He went back onto the gurney and fell asleep but it was a drugged sleep, which he kept waking from, sort of. He was talking in his sleep, calling out and from what we could tell it appeared that he was hallucinating when he wasn’t asleep.

Dad was transported back to his room at 10:45 that night. My sister and I spent the night, not sleeping, in his room. Every few minutes he would call out in his sleep, or claw at the air, or do something that would make us spring up out of our chairs and run over to the bed. Even if he’d been quiet I wouldn’t have been able to sleep – the fans they had running in the hallway to dry the carpeting sounded like 747’s to me.

In the morning when they woke him for breakfast, we could see he was still under the influence of the drugs. We helped him with breakfast, or he wouldn’t have been able to get food into his mouth or drink his coffee. When my sister and I finally left he was sitting on a sofa in their living room area, was fast asleep, but was with a staff member who said she would look out for him.

It was funny how the assisted living place changed their tune over night. The nurse yesterday morning told us that when Dad had been acting up he was waving his cane around and they were afraid he would hurt himself, but he hadn’t hurt anyone else. We asked about him throwing a chair and she said he had pushed a chair but hadn’t thrown it. When we heard that my sister and I were sure of what we had suspected – Dad had acted out and they had their hands full with the flood, and they sent him to the hospital just to get him out of their hair. My sister made sure to find out that it’s NOT normal protocol to do this, and she also made sure she told the nurse just how devastated we felt when we thought commitment was looming, and how unacceptable an option that was. She also made sure that this will not happen again, their routinely sending him to the hospital; that it was pointless and accomplished nothing except create an untenable, stress filled seven hour ordeal for him. I told the nurse that since this was all new to us, we were going to ask a lot of questions because, really, we want everything clarified. Hopefully, we got our points across.

My head is kind of fried now, from lack of sleep and I’m sure a little posttraumatic stress. I hope I’m never diagnosed with dementia; I never want my son to have to deal with this.

But that was how I spent the night in a dementia ward.