Table of contents for Dementia Diary
- Diary Of The Demented
- Maybe Tomorrow : Diary Of The Demented 2
I get woken up by two staff. Very smart in their uniforms. I try to pull the covers over my head. It is very bright, the paper thin curtains don’t block the light. One of the staff gently prises the covers from my grip, the other pulls the curtains round the bed. Looking around the bay I can see three other patients still asleep. I shout loudly.
I am stripped naked and placed on a commode next to the bed. One of the staff stands in front of me to prevent me from standing up. The other starts stripping the bed. They chat about Eastenders. Just when they are about to drag me off the commode I start to do the toilet.
Given an all over body wash from a luke warm basin of water with skin dissolving soap. One of the staff holds my wrists when I try to punch the other in the ear. Much shouting. The staff talk to me and tell me what they are doing and why they are doing it. Efficiently they reuse the commode as a seat when washing me.
Eventually they dress me. Guide me to the hallway to let me walk up and down the ward. I try the doors at both ends. Locked as always. I try the office door, locked. I go back to try the exits again.
Other staff cheerily say ‘Good Morning’ and tell me how smart I look in my ancient shirt, faded tracksuit bottoms and cheap deodorant.
8.30 am
Breakfast time. Same as yesterday. Also the day before that. Grey gloop. Sometimes we get bitty light brown gloop. One member of staff spoons it into my mouth as I have no idea what to do with cutlery. I like to secrete cutlery about my person.
In turn I try to knock the bowl over, stand up and shout a bit. Then repeat.
Breakfast finished I watch the others. Some sit at the table, some get fed by staff. Some are probably getting fed in their beds. We are missing a couple of faces, it must be time for their weekly baths.
I go back to the corridor. The exits are still locked. So is the office.
Staff tell me how smart I look in my breakfast covered ancient shirt, faded tracksuit bottoms and cheap deodorant.
A group of staff are in the kitchen. They are making comment about how often another member of staff is off sick and how suspicious it is that she was seen at the pub last night.
10.00 am
I am given a cup of cold tea. By the hold it up to my lips and tilt until I drink it method.
10.30 am
Have spent the last couple of hours wandering. Have been incontinent. Thankfully just urine, otherwise it would be a longer trip to the bathroom. Still no joy with the exits or the office door.
The staff look quite frazzled. I think they had one of the difficult people to bathe this morning. There was certainly a lot of screaming. I joined in with a bit of shouting.
Two staff approach me. One gently places her hand in the small of my back and guides me to the small bathroom. I can hear shouting from the other bathroom and a little screaming.
In the bathroom one gently holds my wrists again. Based on previous experience there is a fair chance I will try and box someone’s ears. The other professionally sees to my personal hygiene. She is humming a Queen song to herself under her breath. I join by shouting a bit.
Mercifully briefly I am released from the foul smelling room. The two staff de-apron and de-glove and start a round of the bays for those still in bed. Later they will fill in all their work in the bowel book.
I try the exits and the office. Still no joy.
Some staff go off the ward for their breaks. Despite standing at the door I don’t make it out.
12.30 pm
Lunch time. I am fed something which is described as stew. It is brown with lumps. At least this time the kitchens have not accidentally puréed the entire ward’s food supply. I have a yellow pudding. Then it is all washed down with a plastic beaker of cheap diluting orange juice. Again the hold and tilt method. By some timely blowing and shouting I manage to cover my shirt and the face of one of the staff with the foul muck. I follow this up with some shouting. I wave an arm around too. No more juice.
One of the other patients has managed to kidney punch a new member of staff who turned round at the wrong moment. He is wheeled back to his bay where he will sit for an hour or so. Till it is decided that he has calmed down.
I go for a wander.
2.30 pm
I have been doubly incontinent. One of the other patients has had a seizure so the staff are distracted. I manage to get in the office. Feeling very uncomfortable I remove my pad and put it in the office bin. My hands end up somewhat stained.
Time to go try the exits again.
One of the staff notices me and my hands. I can see her calculating, it is near the end of her shift - should she just wait and let someone else find me ? No. She decides to bite the bullet and deal with me. Two staff delicately take me to the big bathroom. Gloved and aproned. The quickly discover the missing pad. One goes off and tells the other staff to instigate a pad hunt. She also gets me a new set of clean but elderly clothes.
Hysterical laughter echoing down the ward signals the end of the pad hunt.
Briskly I am given a good clean and change of clothes. Despite being late for the end of their shift they are very pleasant and chat away to me.
I go back to my wandering. Exits still locked. Office too.
I hear a woman wailing somewhere.
4.30 pm
Time for the toilet check again. I am dry. Also I get congratulated on my usage of the office bin. Much smiling. I shout a bit.
5.15 pm
Dinner time. I am told it is minced beef. It looks very much like lunch. Quite tired I don’t make a fuss. The staff chat among themselves. Mostly making comments about the early shift and how they have left everything for the late shift to do. The night staff say the same about the late shift. The early about the night staff.
I see one of the lady patients walking past the glass walls of the lounge, the only common room, she is naked and screaming. Someone goes to deal with her. Evening is coming on, things are about to get interesting.
I have not had a visitor today. Every now and then someone tells me that one of my family has phoned to ask how I am getting on. I can’t remember when I actually saw any of my family. My wife used to visit but she is in a care home now.
I go for the wander. The lounge gets a little bit dangerous when the sun starts going down.
The exits are still locked.
7.15 pm
One of the staff is explaining in the lounge how much easier the job would be if they all had cattle prods or tasers. There is much laughter.
I notice all the visitors have gone.
I seem to be first on the list as I am taken to the bathroom to get checked and changed for bed. I shout quite a lot.
I have pyjamas that expose more than they hide and a gown that looks like it has been infested with moths.
I wander up and down the corridor again. Still no joy with the exits or the office. I notice the lady patient is again having a nudist moment. Also wailing.
All the curtains are closed.
9.15 pm
Night shift have started. They are in a good mood. They make cheese on toast for everyone that has enough teeth for it. Very nice. I shout a bit.
Being tired I sit in the lounge and try to pick things off my dressing gown that no one else can see.
10.00 pm
Bedtime after a quick trip to the bathroom.
One member of staff takes me to my nice clean cool bed. After a quick shout I go to sleep. Easily done with the sleeping tablets I was given previously. Hopefully tomorrow they will give me my as required pain killers, might be a bit less shouting.
Another day over, another day closer to death.
[I removed some of the more depressing bits - Mental]




13 comments
June 18, 2007 at 10:05 pm
Pingback from Mental Nurse / From large bin to small bucket
June 15, 2007 at 8:02 am
skellybones
Wow..I now have a big lump in my throat!
I did a brief stint as a community carer last year, working with the elderly. Most of them had dementia to one degree or another. I think the saddest thing was when you saw all the pictures they had around their house. Pictures of soldiers, proud in their uniforms…or of vibrant young women bouncing babies on their knee…..women who were the same age as me now…who were no different to me.
I worked with one lady who from time to time would go searching for her baby and get really distressed because the baby was lost. The baby that was now a Grandma herself. It must have been so terrifying, because to this lady, it was as real as if I lost one of my children.
Anyway, thanks mental for that excellent bit of insight.
June 15, 2007 at 9:40 am
accident and emergency charge nurse
Thank you mental, an exquisitely realised account, funny and painful in equal measures. It raises many professional, and of course existential issues.
This came to mind,
‘Today we have made a fetish of choice; but a chosen death is forbidden. Perhaps what distinguishes humans from other animals is that humans have learnt to cling more abjectly to life’ [John Gray - Straw Dogs, p131].
Your final line is the most intriguing - is this your observation, or the demented patients ?
June 15, 2007 at 3:47 pm
Mental Nurse
A bit of both (the final line). I have had patients, who otherwise speak fluent garbage, look me in the eye and tell me they want to die.
If I get round to it I will do one for a Care Home resident.
June 16, 2007 at 12:54 am
Mr Mans Wife
You took out the depressing bits??
I agree with A&E charge nurse, funny yet painful at the same time.
June 16, 2007 at 11:23 am
bipolarmo
Thank God these are just old people and all we need to worry about is the cheapest way to feed and clean them until they die. Now if this were to happen in a children’s hospice, every member of staff involved would be jailed. I doubt that just saying “well we did the best we could in difficult circumstances” would be an adequate defence as I outlined recently in “We were only following orders“.
An excellent post Mental. Pity it can’t be aired nationally… but then again I suppose if people in the UK are indifferent to the devastation in Iraq, why should the suffering of a few old crinklies bother them. While our nation is happy to condemn asylums in Eastern Europe, I doubt they would be so quick to condemn asylums here in case it meant an extra penny on income tax.
Ochh! I’ve gotten all wound up again… hmmm… too early for booze… I’m off for a cup of tea.
June 16, 2007 at 1:46 pm
Mental Nurse
Yes. Depressing bits removed. This was the upbeat version.
June 16, 2007 at 5:09 pm
Ariel
“I am stripped naked and placed on a commode next to the bed”. How degrading is that? back in 1999 I worked at the Department of Health supporting the team who were developing the National Service Framework for older people. I’m saddened to learn that nothing has changed since its publication.
June 16, 2007 at 5:18 pm
azazel
Forgive my ignorance but why would every member of staff be jailed ? For the comode incident and the cold tea ? I am just interested to know how things should be done.
June 16, 2007 at 5:31 pm
Ariel
Also whilst at the Department of Health I was encouraged to read a book by Tom Kitwood, a psychologist who specialises in the field of dementia care. He posited a theory that the deterioration seen in dementia patients could not always be simply attributed to the illness. He argued very convincingly that their is a dialectic between what he called a ‘malignant social environment’ and organic processes within the brain. In other words bad, degrading of neglectful care would actually precipitate the organic decline whereas decent person centred care could often hault or even reverse the decline. I would strongly recommend his work to anyone who hasn’t read it.
June 17, 2007 at 12:23 am
bipolarmo
In response to Azazel…
Hi Azazel, sorry, I may have got carried away there. But I often think children and old people are sometimes analogous to fluffy rabbits and rats. If a vulnerable child in care is thought to have been neglected e.g. a social worker finds them covered in old food and excrement there is generally a very swift and serious response. If the press gets a hold of it, the carers are demonized and a public lynching demanded. However, a social worker seeing an old person in a similar state in an EMI unit might be more likely to smile at the carers and say “looks like you’ve got your work cut out today”.
This week there has been much coverage of the abuse at Kerelaw children’s home. The Glasgow Herald reported “The revelation that around 40 individual members of staff at Kerelaw School and secure unit in Ayrshire were involved directly in the abuse of young people is truly shocking…. the abuse by individuals is bad enough, but for that to be compounded by the system of care is unforgivable.” Many people are now calling for an enquiry as it is believed the majority of staff on the unit were aware of the culture of abuse and did nothing.
I think if an ensuing enquiry reveals that an adolescent had been stripped naked and left humiliated on a commode while staff chatted about Eastenders, I think it likely the staff involved would be at the very least disciplined or dismissed and some sort of compensation paid to the individual.
As for how things should be done… hmmm… scary question… but it’s something that’s often debated here and I think it’s generally agreed a sensitive caring nature combined with an evidence based university education is the best way.
June 17, 2007 at 9:19 am
Mental Nurse
Thanks for the tag line Mo !
June 17, 2007 at 10:37 am
azazel
Thanks for explaining that Mo. I guess when reading the post I was thinking of the care given on the EMI unit I am currently on which is second to none. In fact the relatives of the patients can’t sing the nurses praises enough.
I helped look after two patients with end-stage dementia last week and was touched by the sensitivity shown by the nurses and the condition of the patients skin was much better than my own ! These were people that evidently love what they do and strive to give the best possible care.
However, as it is the only EMI ward I have been on I have nothing to compare it too. I am aware though, that the standard of care on other wards will not be as good.
I think I know the answer to my own question about how things should be done. The same way they are being done on this particular ward. I am glad to have been at a place like this because I think I will be even more aware when things aren’t being done properly.