Annie had Alzheimers.
She was pleasantly demented; she wasn't ever combative or mean. . .she was agreeable and easy to care for an just a joy to be around. She was one of my favorite patients when I first started working, a sweet, funny, gentle soul housed in a confused little old lady body.
She wandered. Perpetually. Eventually, I had her tag along with me when I made my rounds. She was content to go from room to room with me and it was a win win situation: she was occupied and calm, and I knew where she was. Even if she wasn't assigned to me, she'd still tag along. The routine helped her.
Occasionally, she would get away from me. I'd hear a commotion from a room down the hall and I'd hurry down there to see what was going on. The complaint was always, always the same:
"She's in my bed!!!"
Annie was unable to differentiate between rooms, so when she felt weary or thought it was bed time, she'd enter a room, pull down the covers, take off her shoes and pants and get into the bed. She thought every room was HER room.
I tried all kinds of things to help her. First, I made a sign with her name on it and put it on her door.
"What does that say?" I'd ask.
"Why, that says 'Annie'! That's me, isn't it?" she'd respond.
"Yep!" I'd say "that's how you tell this is your room! Your room has your name on it!"
"Oh! I see! My room has my name on it!"
It worked for a couple of days and I'd think we'd found a solution to her wandering. Then, I'd hear a ruckus from a room and the familiar cry of "she's in my bed again" and I'd go retrieve Annie and show her the sign on the door and put her to bed in her own room....and 5 minutes later I'd feel a tug on my scrubs and turn and see her standing there, smiling at me.
When it became clear the the name wasn't working, I took a picture of her, enlarged it, framed it, and hung it on her door above the name tag.
"Who's that?" I'd ask.
"Why, that's me! Don't I look pretty?! Goodness, what a nice thing you did for me!" She'd say.
"This is how you tell this is YOUR room, Annie" I'd say "All you have to do is look at the door. Annie's room has Annie's picture on the door"
"Oh! What a good idea!" She'd say.
The photo idea actually worked for a few months. There were incidents where she forgot to look at the door and clambered into someone else's bed (once she got into a man's bed when he was still in it. It's a good thing he still had his wits about him and called for help - if he'd been demented who knows what would have happened) but for the majority of the time the photo was enough to remind her that she was in the right spot.
I went back to college and found working full time and academia were not a good mix for me, so I quit that job. I went to visit Annie occasionally - I don't think she remembered me, but she was always smiling and seemed pleased to see me.
The last time I saw her, she was in a wheelchair with a cushion tray in front of her and an alarm clipped to her blouse. It wasn't restraints per se, but it did prevent her from getting up alone. Apparently her wandering had become problematic and the staff felt the need to confine her.
She was wilted. She sat with her head in her hands, face slack and expressionless. I knelt beside her chair and took her hand in mine.
"Hey, Annie. . . how are you, my sweet?"
She made no attempt to resond to me. She stared at the cushion in front of her, a light glaze of drool covering her lower lip. I took a kleenex from my pocket and wiped it away. I craned my neck further downwards, trying to meet her gaze, hoping that another human face in her field of vision would stir some response in her.
My eyes met hers. . . and there was nothing in them. No recognition, no sign of life. Nothing.
She was in there, but she was unreachable.
I saw her name in the obituaries this morning and for a brief moment I felt an icy stab of grief in my chest. . . but it was quickly replaced by relief and a sense of joy. She's free now, you see. I don't know what happens to us after we die; I don't know if we go on to another place or if this, this world and existence, is all there is. All I know is that Annie is not here anymore, that the torment that was her daily existence has ended.
She's not lost anymore. However you look at it, whatever you believe, one thing is true: she's not lost anymore.