Friday, February 24, 2012

I Remember This From Last Time

"This" being the transition from being at the hospital, (visiting) to not being at the hospital (visiting).

I drive home, after spending a few hours with dad, thankful for nurses, fearful of aging, drained of energy, sad that dad has dementia, and hopeful that I can pull together a few normal hours with whoever I'm with after the visit. I rarely make that transition well. I can't get the visit off my mind.


When I got to Emergency yesterday (where they'd kept him for 48 hours), they were in the process of moving him to the Eldery Acute Care ward. I was there when a sweet, young, timid, tiny nurse was getting him to answer her questions while she filled out his forms. Of the 100 questions she asked him, he knew 2 of the answers; what is your name and when were you born.

My dad knows 50 - 75 random statements, all true. "My brother John is bald. You are my oldest daughter. Julie has a dog named Chewie. Clint lives in a basement in Vancouver. Drew has a pretty girlfriend. Butch Penner is not alive anymore. I don't have a drivers license. I sit in the front seat with my seatbelt on. I used to live in Winkler. Billie takes care of me." And so on.

"Do you know what day it is?" she asks dad.
"Do you want to guess?" she prompts him.
"Well. Do you know what month it is?" she tries.
He looks at me, with fear in his eyes.
I interrupt. "Even on his best day when he was on top of his game, he had no idea what the day it was. I don't know if he ever figured out calendars or months."

She doesn't know what to do with this information.

"Do you wear glasses?" She asks dad.
"Do you wear reading glasses?" She asks.

Again, I interrupt. "He doesn't remember, but he used to wear the strongest reading glasses you could get from Costco. But these last years, he has no reason to wear them. He can't read, and he doesn't ever look at anything close up."

Again, she is having a hard time knowing which box to check off on her survey.

My dad looks at her, and with longing in his eyes, he says, "I would like to go home and watch my movies. Ben Hur. IwantowatchBenHur."

So she takes this opportunity to tell him about television rentals and forms and payment and she's speaking fast and quiet and he's not sure what she's saying. So he interupts her and says, "On Friday nights me and Billie go to the Spaghetti Factory and share a bottle of Baby Duck wine."

She continues to ask questions about peeing and bowel movements which he defers to me. I call my mom on my cellphone to ask about his regularity, and end up discussing my dad's diarrhea and constipation with the nurse.

"How has the aging process impacted your quality of life?"
He answers, "On Friday nights Billie and I go to the SpaghettiFactoryandhaveabottleofBabyDuck."
She's not sure if she should write this answer down.
He shakes his head, "No. I don't like it."
"There's your answer," I told her.

"Are you under any stress?" she asks, plodding away at her form.
"When you used to be under stress, how did you handle it?"
Another question that he's not sure how to answer. He looks at me, straight in the eyes, and with determination coupled with sadness, he says, "I would just like to go home and watchmymovieBenHur."

Winnie, the nurse, says, "Oh, watching movies? Is that how you handle stress? So a few minutes ago, when you told me you wanted to watch a movie, where you feeling under stress?"

Oh goodness.

The questions kept coming, "How do you think your family feels about you being in the hospital? How has your illness impacted those that care for you? What are your religious beliefs and do you have any special dietary needs because of those beliefs?"

I love that she gave him the benefit of the doubt, and respectfully tackled that form with him. But it would have been easier on all of us if she would have simply allowed me to speak for him.


Today's visit was totally different.
I was prepared.
After bringing some Olive Garden soup to mom and having supper with her, I took a fully loaded backpack to the hospital.

Jule had been there earlier in the day with her laptop and together they watched "Overboard" which she said had worked well. So I had picked up some headphones for him as well as "Forever Young", brought both a portable DVD player and my laptop and all the cords and some chocolate milk and my cell phone. And settled in for a 2 hour visit.

First we called mom.
He cried when he heard her voice.

He misses her desperately.
Then, while I cleaned my laptop's monitor, I put the headphones on his ears and let him listen to Johnny Cash in concert. All the tension drained from his body and he fell asleep in seconds.

Ring of Fire is barely finished and Winnie is in our faces with a bucket, "Mr. Klassen? You need to wake up. The doctor needs a urine sample.

Dad is feduzted, so I ask him if he can pee in that bucket.
"Do you want to do it here, by the bed? Or in the bathroom?"
"In the bathroom."
He tries to get up, but he's weak from the bronchitis, and he's been laying on a weird angle, so he struggles. His gown is open at the back and they've put a peach colored diaper on him. He shuffles to the bathroom and I know this is not going to be pretty. No way he's going to be able to get that gown out of the way, and the diaper off. Plus his stomach is distended and had been making horribly angry noises since I got there.

I hear a mess being made and look at Winnie. She smiles at me and says not to worry. She'll clean it up.

I go for a walk.

I find the family room and watch the hockey game with 3 sleeping patients. It's tied, 1 - 1.

I walk back to dad's room and there is a flurry of activity and they are wondering why he is naked. I go back to the hockey game.

Still tied.

I walk back to his room.

Still cleaning. Still getting him settled.

I wander the halls. "God? I don't even know what to say. Or how to pray. But I'm right back where I was four years ago. Was I supposed to learn something back then? And I never did? So I'm getting a re-do? Should I be offering to help? Should I be doing something? What didn't I get right the first time? Is it my attitude? My fear of shitty situations? Maybe this isn't about me? I know I'm rambling. I don't know what I'm saying. Or anything. I don't know anything. But this is hard."

When I get back to his room, he is cleaned up and breathing heavy. That activity has made him very wide awake. His eyes are sharp and clear. He looks at me and says, "You are my oldest. Jane."
"Yup. And you are my oldest dad. Pete."
He keeps his eyes locked on mine.
"Hey dad, do you want to watch Forever Young?"
His eyes smile and he heaves a sigh. "Yes."

So I get him all set up and once the familiar storyline comes on he relaxes.
I pull out my book, but he starts to talk.
It has always been this way with him. Even before dementia took over his brain, he'd love having everyone sit in the same room, around a TV, watching a show. THAT is when he'd decide to start conversations.

So I put my book away and agree with his random statements.

Meanwhile, Winnie has come back into the room and with a jug, empties the catheter bags all of dad's roommates have dangling off the sides of their beds. The fellow beside dad, on the other side of the curtain tries to get out of bed and an alarm sounds. Two nurses come running and remind him he has to stay in bed. He indicates he needs to go to the bathroom.
Winnie reminds him he has a catheter.
He says he still has to go.
"Oh? Do you have to go poop?"
"Well, just do it in your bed. We'll come clean you when you're done."
And then she stands there. "Are you doing it? Are you pooping right now? Are you still pooping? Are you almost done? OK. I'll get another nurse."

Two of them enter his bed area and start cleaning.
The smells.
Are overpowering.
The nurses? Don't comment or complain.
Just as they finish cleaning him up, he starts grunting again.
"Do you have to go again?" they ask.
He grunts.
"Go ahead. Get it all out. We'll come back later."

Meanwhile, dad is watching the fellow directly across from him. He has severe dementia - from what I can tell, he's completely out of it. He swats at imaginary things flying by and organizes imaginary people sitting at his bedside. He talks non-stop but I can't make out any of the words. Anyway, at this point in the evening, he, John, has pulled his legs out from under the blankets and has bent his knees and spread his legs and has his hands down there. His legs are covered in scabs and bloody sores. He probably weighs about 80 pounds and  has not been in the sun for at least 20 years.

I've moved my chair and the laptop so that he is not in my field of vision. I don't know what to do about him. So I don't look.

My dad is fascinated, and can't stop looking. His eyes are filled with compassion. "That man has alot of sores on his legs," he observes.
"He sure does." I agree.

About half an hour later, a new nurse comes in, and introduces herself to dad as his night time care giver. She's there to take his blood pressure, temperature and check his heart rate. Dad gives her his arm, and says to her, and she wrapping the cuff around his bicep, "That man over there is in trouble. I think he needs your help."
My dad. Made an observation. And knew what to do about it.
I sat there, amazed.
I took a peak at John, and sure enough, he was falling out of bed, naked, except for his peach colored diaper.  He is sideways, his head dangling one way, his feet and legs the other way, and a mess of body fluids in the middle.

She calls for help, they pull the curtains, and set about cleaning him up.
New sheets, new gown, fresh diaper, quick sponge bath, and he's good as new. All tucked in and ready for the night.

She returns to dad, checks all his vitals and assures me he's normal.

Then they go the guy who's bed is beside dad's.
The guy who still had to go after they cleaned him up half an hour ago.

They had to bring in another person to help. It was everywhere. Up his back, on the floor, through to the mattress, on the pillow...

The smells.
Oh. Oh. Oh.

"Dear God.
Why? Why is the end of life like this? It's so messy. And smelly. And awful. And I don't know what I'm even feeling. Or why I'm bothering you. But this? Is just so.... so...
I don't know.
Thank you for these nurses. Thank you that they went to school for years to learn how to nurse. And they aren't impatient or rude or unkind about a shift spent cleaning shitty bums.
Be with them this evening, bless this shift they're working. Help them to feel peace. And a sense of accomplishment... Give them joy in this job."

My time was up. I needed to leave. I started packing up my things just as the nurses were finished behind curtain number three. I went up to one of them and said thank you.
"Thank you? I haven't even done anything for your dad yet? Why are you thanking me?"
I started to cry.
"Just... thanks..."

I threw my pack over my shoulder, gave my dad a kiss on his forehead and told him I loved him.
His stomach was objecting to something and it looked like the nurses were going to have another mess on their hands.

With tears streaming, I walked down one long hall, then another. Down the elevator, then another long hall. Out through the construction zone, down the ramp, over to the parking garage and up a flight of stairs.
I got to my truck and bawled.

My forty five minute drive home is not long enough to transition into a happier mind space.

Three things I'm thankful for:
1. Nurses. Seriously. They do not get paid enough.
2. Our health care system. So thankful for hospitals and doctors.
3. Opportunities like this to hang out with my dad.



Anonymous said...

Wow, that is so incredibly sad. Dave's Dad is in the hospital right now too, and we are experiencing some of the same things. He does not understand why he is there. First his heart, now his prostate. He keeps pulling out the catheter and fighting with the nurses when they try to put it back in. He keeps escaping so they had to put him in a private room and lock him in. He begs us to bring him home, and trys to find his coat etc etc. It has been very hard on Dave. Aging SUCKS...but somehow God is still good even when we don't understand at all. Thanks for blogging your heart. I am praying for you. Let us know when he's out.
Love Marj

Diane said...

I ache for you Jane. I am praying for you, and your family.