Monday, November 07, 2005

Trapped in Dementialand

They call it the "Reminiscence Neighborhood," but actually it's a minimum security jail.
The residents can't leave unless an approved person escorts them for a few hours or few days visit to the outside world. Most never leave at all.
The security measures are fairly simple. Only one elevator is available for residents and their guests. To leave the third floor, one has to punch in a code to open a door and reach the elevator. Then on the first floor, one has to walk past a central desk in order to walk out the front door or reach the parking elevators.
Most residents don't know a code exists and couldn't remember it if they knew it.
Mom has no idea that she's confined because she leaves the third floor and the building frequently with someone accompanying her.
But some residents know they are trapped and haunt the hall near the elevator, waiting for people to go through the door so they can follow them out.
Regina is one of the smart ones trying to escape. When she's near the door to the elevator, I punch in the code and slip through the door quickly, before she can follow me. But the code disarms the door alarm for 30 seconds, so Regina can open the door and slip out after some leaves in the elevator.
One time I arrived in the elevator to find her standing there, about to enter the elevator after I walked out to the third floor.
"Oh--Regina!" I said, not sure what to do next.
I opened the door to the third floor to call someone, forgetting to punch in the code, and the door alarm went off, bringing a staff member running. Regina was apprehended and gently drawn back to the Rem Neighborhood.
Another time when I was leaving the floor to take my mother to a doctor's appointment, an agitated resident was in the area of the elevator, determined to leave. Staff members were dealing with him, but meanwhile no one could use the elevator.
I waited, then wheeled my mother around the floor to the service elevator, escorted by Beth, the Rem director, so we could leave on that elevator.
It turned out, however, that Beth had the key but didn't know how to activate that elevator, so we wheeled back to the first elevator. I was starting to feel claustrophobia: would we ever escape? This was making us late to the appointment.
That feeling of being trapped in dementialand occurred again last night. I had spent nine hours with Mom, first taking her to church, then to lunch at my house, then back to Ocean View.
Then I sat with her for an hour as she ate her dinner, waiting for her evening caregiver to arrive at 6 pm.
Dinner hour on the Rem floor is a real spectacle.
Sue sits there alert and curious, wondering what to do with her spoon, until a caregiver finally comes and puts spoonfuls of pureed food into her mouth.
Ralph leaves the table and returns, demanding his food, unaware that he has just eaten.
Julie shouts incessantly, "Could somebody please help me? Someone, anyone. I'm just asking for a little help, but you're all ignoring me. I guess I'll just sit in this chair 'til I die. I'll be happy to die. I'd rather die than be here. Help me, somebody, please!"
"Oh, Julie, Julie Adams," says Bethlehem, the lead caregiver, who is one of 4 staff members cleaning up dishes and managing the 26 residents. No one has time right now to push Julie's wheelchair to her room, and it's better to keep her with the group rather than leave her alone in the room.
"She always yells like that," comments Mom.
Leota sits blank and cheerful at the other end of Mom's table as a caregiver tells her, "You must eat something, Leota. Here, take a spoonful of this."
The new lady on the floor announces, "I'm boycotting." She hasn't eaten since she arrived.
I chat with Ryan, the young man who cares for John. "Don't you ever take him out for a walk around the block?" I ask.
"No, I can't do it," he answers. "If he gets out on the street, he wants to go home. I have to tell him 'No, your wife is dead,' and he gets upset."
Finally Racquel, Mom's evening caregiver, arrives and I bolt for the elevator after a few seconds of greeting.
"Oh, you aren't coming back to the room?" she asks. Usually I talk with the caregivers a bit, taking an interest in their families and their lives.
Tonight, however, I have a feeling of desperation as I punch in the code to reach the elevator. The door opens, then closes behind me, and I sigh with relief. I'm on the other side of the door.
On the first floor, I walk to the other elevator, go down to the parking garage, and punch the code again to leave the elevator lobby and get to my car.
As I start to drive out of the garage, I come around a corner and face a huge grilled gate blocking my path.
Panic comes before I can talk myself out of it: another wall preventing my escape. I know the electronic monitor will see my car at the gate and open it. I know this.
Finally it happens: the gate slides up slowly, and I drive out. A wave of relief hits me, and I find myself fighting back tears.
I'm not as tough as I think. A full day of caregiving, topped by dinner with people thirty years ahead of me in the life cycle, is enough to do me in.

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