Dementia and the Doc

When I was taking care of my Alzheimer's-diminished parents, I became rather painfully aware of how ill-prepared and even inept so much of the medical establishment is in dealing with patients with dementia and their family caregivers. It's a checkbox world built on routine, codified processes that require a normal level of cognitive and communicative ability on the part of their patient-widgets. Dementia patients are a wrench in that machinery, and an organization built on fitting specific tasks to narrowly trained workers either grinds its gears on those widgets, or more likely, grinds those widgets in its gears, or just spits out the untreated widget completely.

I'm friends with a retired couple who recently faced this problem. The husband is a big guy whose dementia has proceeded rather quickly over the past couple of years--to the point where his communicative skills are nearly down to "word salad" level, so his ability to communicate meaningfully with medical staff is nil. Along with that, like a lot of dementia patients, he can get tense and angry when confronted with something out of his comfort zone, and has a low pain threshold--all of which came to the fore when his wife had to take him for a blood test recently.

Unable to process what was going on, he responded to the pain of the jabbing needle by ripping it out and not allowing the blood-test nurse (what do they call them?) to get a sample. So they left without giving a sample, intending to come back and try again another day.

And that's where the problem is. Because they simply try it the same way with the same people doing the same thing with the same result. The wife tried every which way to get them to try something different--sedation, topical anesthesia, anything--but it was obvious that they were thoroughly unprepared to think or act outside their very defined boxes, and the doctor was "unavailable" at the time.

We lucked out, though, because there was a male nurse who, like my friend, was physically large and had the willingness to step outside the box of the blood-test station and try it in a different place on the arm while we sat in the waiting area. My buddy yelped and complained in a sailor's tongue that shocked some of the more tender-eared staff, but that guy got it done. Had he not been there, or had the hospital been busier than it was (not much activity at this rural hospital), it would have been yet another useless trip for someone who needs care.

Dementia is not some rare condition, and it's getting more common all the time. I've got a dozen stories similar to this one regarding my own parents, in which medical staff just seem to be unprepared to deal with such patients. I'm not sure what the best solution is, but I do know that people who care for loved ones with Alzheimer's or other kinds of dementia need help, so if you know anyone like that, lend a hand.


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