Daily journals while living in a locked dementia unit: Days 1 and 2

by, Jim Vanden Bosch, Guest Blogger

Prologue

Recently, I arranged with the administration of a local nursing home for me to be admitted as a “resident” without the care staff knowing that I did not have dementia.  We arranged that I would come in as someone who had mild dementia and needed a place to stay for a few days while my sister (with whom I lived) was out of town.

Day 1

I was brought in by my sister today and admitted to the dementia unit at a nearby nursing home.  I had given some thought to how I would “present,” and decided to simply recede into an inner place and not say anything. If asked a question, I would respond in a polite, but hesitant manner.  I am surprised at how easy this has become to do.

What has caused the most consternation for the staff who are caring for me is my vegetarian diet, along with my request for soy milk to replace regular milk.  Apparently, I am the first person to come into this facility and ask for a plant-based diet.  Even though this was noted in my preferences profile at my admission, I have been approached several times by different staff to clarify what this means.  Can I eat soup?  Do I eat fish?  How will I get enough protein?  I answer slowly with some pauses built in: “vegetables… soup—yes; fish—yes.”  I act confused on the protein question; then I say, “Sometimes… protein powder.”

At around 5:30 I am taken to a small area and seated with two other residents where I am served dinner on a tray: a large helping of fish, along with salad, yogurt, and soy milk.  The gentleman at my table repeatedly tries to stand up. Each time he does, an alarm goes off.  The assistant in the room tells him each time to sit down.  At one point when she is not around, he actually manages to get up and take a couple of steps, holding onto the table for support.  The alarm beeps for a minute or two, before she finally returns and guides him back into his wheelchair.

At 11:00 I am ready for bed but it is far too noisy for me to sleep prior to the 11:00 shift change.  At 11:30 it seems to quiet down enough for me to try to go to sleep.  Anticipating the distracting noise level at night, I have brought with me a small white-noise device, which I place next to my bed.  I turn this on and put out the lights.  Sleep comes fairly quickly, but then at around 12:30 someone knocks lightly, opens the door, walks by my bed and then leaves, saying something to another staff person like, “there is nothing there, no water or anything.”  I go back to sleep.  A little later the door opens again and someone walks in with a glass of water and puts it next to my bed.  I sleep through the rest of the night (thanks to the white noise device), waking occasionally to turn and readjust myself in the small hospital bed.

Day 2

A little before 7:00 AM the bustle of the morning shift wakes me.  There must be a door near my room; it closes loudly again and again.  Loud voices.  I try to ignore the noise and go back to sleep.  I am not, by nature, an early riser.  Then at 7:30 there is a loud knocking on my door.  I  ignore it.  It persists, even louder.  I still ignore it.  Then someone walks in and with a loud voice says, “Mr. Jim!”  I turn to look.  “Good morning!  I’m from the dietary department and I just wanted to ask…the bread, what kind do you want?  White?  Wheat?”  “Wheat,” I say.  She leaves.  Now I am awake.

I get up and put on my sweatpants and pullover shirt. I try to find a weather channel on my TV, but the remote is not working.  (It did not work earlier yesterday when the person who was admitting me was showing me the controls.  He said he would get a replacement, but that’s the last I have heard of it.)  I sit on the edge of my bed, not quite sure what to do next; should I go out and ask for coffee, or wait until someone comes to my room.  I wait.  A few minutes later a new assistant comes in, cheerily introduces herself, and asks about breakfast.  I ask for just coffee for now.  She goes to get it.  Then, for breakfast I ask for oatmeal, uncooked, which I usually mix with soymilk, yogurt and fruit.  I guess this is a foreign concept because I am questioned about how the oatmeal will get hot that way.  I think my attempts at saying “cold is ok,” probably adds to the perception of my dementia.  Eventually the oatmeal is found and I am brought the breakfast I requested.

I spend part of the morning trying to do some reading.  Then I go and sit near the small nurses’ station and quietly observe what is going on around me.  The residents seem content and are, for the most part, very quiet.  The assistants are cheerful and friendly, greeting residents by name, although some of them often call certain residents honey or sweetie.  I am called “hon” many times by a couple of the assistants.

Around noon I am asked about my choices for lunch that are printed out on a small sheet.  There is very little on the sheet that I normally eat, so I’m having a hard time responding.  My assistant then says something about a sandwich.  I tell her that I am vegetarian and she says, “how about peanut butter and jelly?”  “That’s fine,” I say. I join many of the other residents in a large dining room.  I am seated with two older women.  I am quiet, as are they, throughout the meal.

To be continued…