Thursday, February 18, 2010

Confusion

Two stories related to patients with Alzheimer's:

1. "Raphael" lives on a Memory Unit at an Assisted Living Facility. He was a Ladies Man back in the day and yearns for those days. He often expresses sadness about his inability to have "hoochy koochy"- his wording, not mine. He seems harmless but I usually do joint visits with the hospice RN just to be on the safe side. One recent visit he was sitting in the common area with another resident "Wanda." Wanda was quite jealous of the hospice RN, whom she believed was trying to take "her" man away from her. Wanda would turn to Raphael and ask "Am I your girlfriend?" He would try to answer diplomatically, often telling her that his wife was his first love and only girlfriend. A minute later Wanda would ask "Are you my boyfriend?" Then "Are you cheating on me?" And then back to "Am I your girlfriend?" Then she would intersperse comments to the RN, whenever she thought Raphael was getting a little too close or just to state her territory. I wish I had a transcript because it was one of the funniest things ever.

2. The patient is a woman with Alzheimer's. Her husband has the disease too but is still ambulatory, conversant, and functions relatively well despite his confusion and tendency to wander. He is not clear on what is happening to his wife. She is close to actively dying. Their children have certainly been through a lot in watching their mother's decline and knowing what lies ahead for their father. I talked to the daughters for some time at the patient's bedside. Her husband came back into the room and lay down on his twin bed, which is next to her hospital bed. He seemed worried, he knows something has changed. He asked a few questions about his wife, mostly concerned with whether she had eaten or not. Then he lapsed into his own world. But for those few moments, all you could see was a man in love with his wife.

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