I forgot how old she is now, I definitely overlooked that bit. But she doesn’t look that old entirely. Small-sized & she’s got this adorable toothless grin that she gives on and off. Now in her advanced stage of dementia, she was also suffering from sleep-wake cycle reversal. But what sets her apart from my other patients, was the fact that she cried out, all the time, whenever she was awake. Really loudly too. And because she has limited vocabulary now, the one thing she can remember to say is: “Let me pee!”. Occasionally, she remembers other words like “Exercise!”, or “Sorry”. Occasionally. But mostly, “Let me pee!” is all you’ll hear her say. Or rather, cry out. And then she’ll wail really loudly.
If I can sum up this situation: imagine a baby. No. More like a toddler. A year old toddler, or slightly older. Crying for attention. But what this toddler is saying doesn’t seem to make sense of what she/he actually wants. It is exactly like this now with Mrs A. Everyone who doesn’t know her story thinks we’re mean nurses who ignore her pleas. We get shot with these looks of disdain, of “how could yous” and complete disappointment. Because while Mrs A. is busy shouting “Let me pee, let me peeee!”, we all know it’s not the bathroom she’s asking for. She was probably asking for many things, but definitely not the bathroom. For all we know, she could be hungry, cold, or even in pain – but we’ll never really know. It’s all guesswork.
When her eyes are closed, sometimes she looks like she’s at peace; other times, she looks disturbed. Like tangled thoughts in her head and she’s trying to sort them out. Or maybe, I’m the one who’s making it all up in my head. But that was how I saw it. I feel this sense of loss whenever I was nursing her. She doesn’t remember her children anymore, has vague impressions of her husband (because she apparently make small talks with him when he comes by), and she calls all of us, whoever who attends to her “aunty”. And she has this really pitiful look on her face when she cries, a look that screams out “HELP ME!”. It is that expression from her face – that lost, helplessness expression that gets me. Not the cries.
She was discharged, and then readmitted in less than a week. Her behaviour remained unchanged, if not a little better – not so much of continuous wailing like the last time. Again she was discharged; and some time within the month, again she was readmitted. This time she wasn’t under our care in the dementia unit, she was admitted in the general geriatrics. She still wails out and we all give a little chuckle, all too familiar with that sound. Only this time, I found her somewhat improved in certain ways. For one, her appetite picked up drastically. The first time we nursed her, she was too busy crying to want to eat. Now she can finish a good bit of her meals, and that kinda made me glad. She seemed to be more responsive, although still lost to the world. She would reach out for your hand, and give it a good kiss, before rubbing/caressing her coarse, roughened palms along your arm. Little acts of love she is still capable of.
Once, she was put on the geriatric chair and looking all cute, but actually crying out once in a while. And probably still dopey from all the medications, she placed her head down on the geriatric table when she got tired. It looked really uncomfortable. I couldn’t help but took her pillow from her bed on my way out, and offered it to her. I have yet to say anything to her, but she looked up when I approached her with the pillow and cried out a really loud “Thank you” to me before snuggling down onto the pillow. My heart melted. This is why I am here for. This is why I am still doing this.
Maybe all this time while she wails and shouts and calls out, and we go to them, helpless; she’s trying with all her might to tell us what she really needs.
The most we can do for her now, right now, is to sit by her. Keep her comfortable, keep her company. Hold her hand, give her all the attention she needs. Let her wail, let her cry. And occasionally we get that toothless grin that makes our spirits soar a little.