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Personal Experience

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Mommy, where are you? I am afraid.

Kristína Vančová
Language: English
Country: Slovakia
Typology: health care professionals
Text:
Edita suffers from a severe form of Alzheimer’s dementia. Her loving husband, after nearly three years of dedicated care taking of his wife, decided to accept the doctors’ offer and he agreed that Edita will live in a senior citizen home and he will be visiting her. He as well as their children were extremely exhausted from the nonstop alternating care. Mrs. Edita is 75 years old. She is married with two daughters. She used to be a music teacher and even during her retirement she had some private students. She played piano beautifully and she taught to play it also to her grandchildren. But now, when she sits by the piano, she looks helplessly and presses the keys as if she had studied the strange sound that comes out of it. Sometimes she runs her fingers through the scale and then starts to play a beautiful melody and expression in her face is shining with enthusiasm. Today she walks in the room helplessly, touches various objects, comes in to the rooms of the others. She takes a blanket and put it on the floor, takes a vase, tissues, clock and a book from a table and put them to a bed and covers them with a blanket. A nurse is watching her and asks Edita what she is doing. Edita looks at her in astonishment and does not understand. The nurse repeats the question and Edita answers her with a question: Mum, is that you? The situation repeats a few times. A try to take Edita back to reality failed. Once the nurse answers Edita’s question: “Mum is that you? “with “Yes, Edita it is me, come and help me a little.” The expression in Edita’s face softens and she slowly walks towards the nurse. The nurse is going to fold disposable pads. She folds two or three, looks at Edita and tells her to try it. Edita repeats the movements without any hesitation., they fold together. In between the nurse has a call from another client. She takes Edita with her and tells her that they are going to look what another woman needs. The nurse explains to another patient that she took Edita with her because she is lost and she needs a contact. Nurse asks Edita to sit down for a while so she can see her all the time and changes infusion of the other patient. She explains to Edita what she is doing, similarly as mothers explain to small children. When Edita sees the nurse, she is satisfied. When she starts to wander helplessly, the nurse engages her into a simple activity. In following days Edita can look TV, sometimes she can walk on her own in a maze which is adapted for people who need long walks, for people who suffer from Alzheimer’s Disease. Sometimes she plays the piano but she cannot read or listen to the radio. She can fold clothes for hours, clean potatoes, cut a pulp or color mandalas. She needs to see her “mother”. Sometimes her “day” is at night and then during the day she sleeps sitting. Nurses always try to put her into bed. Sometimes after praying she snuggles to her blanket as a little child and then falls asleep. Sometimes she walks out of the bed with some question or request. Sometimes even at eleven pm the nurse needs to think of some activity which helps Edita to fall asleep, for example, folding disposable pads. OBJECTIVES: To ease the feeling of being lost and hopeless. Prevent anxiety. Prevent getting astray and lost with possible potential threat to Edita’s health and life. MEANS AND STRATEGY: The nurse takes Edita’s constant presence in her vicinity during her ordinary department duties as natural. Meantime she keeps explaining Edita what is happening in an attempt to establish her contact with reality. At the same time she listens and reacts to Edita’s talking and her questions in a way that she accepts them as the reality where Edita lives now. If possible, she connects Edita’s inner (childish) world with consensual reality. The nurse let herself be called Mum because she noticed when the answer is: “I am not your mother” Edita is confused, her anxiety rises and she keeps asking where her mom is. Alongside the risk that the nurse would overlook that Edita wandered off increases. That can be dangerous for her as she does not identify potential risks from the environment and is disoriented in time, space, and even with her own person. The nurse created for Edita a space where it is possible to fulfill her childish need of safety and employ her with respect to her limits. CONCLUSIONS: The client needs constant presence of another person to be calmer. She needs supervision to prevent her from hurting herself. The missing feeling of safety is drawn from contact with another person. She is happy for little successes with her simple chores and for praise. She feels better when her semi child world is accepted. ROLE: Diplomated nurse – reference person


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