Pam Belluck's story in the 6/20 New York Times described to a tee my dad's hallucinations in the hospital following his second hip break in 2007. When I read it online, I instantly knew a half dozen people to forward the story. We all have terrifying experiences with elderly parents, hospitalized and completely out of their minds. For five days, while I stayed with Dad in his hospital room, he alternately believed I was my deceased mother, or the Devil running a small town Depression Era picture show projection booth. I watched Dad writhe and rip out his IV, then converse with the midnight aide about sandwiches and ice cream like a perfect gentleman.
According to Belluck's article, a spell of hospital delirium increases hospital stays, and the likelihood of being sent to a nursing home or rehab facility. It aggravates chances of future dementia. I would add that it undermines the relationship between an elderly person and his responsible children and relative.
Many factors contributed to my father's delirium. He'd been through surgery with general anaesthesia and serious pain pills. He was in an unfamiliar setting where it was difficult to tell night from day. He was awakened frequently for vital signs checks, IV changes, and increasingly difficult blood drawing for lab tests. Being a hospital patient is much like participating in a sleep deprivation study. The hospitalist doctors did not know my dad, or realize his confusion was abnormal. The eerie lighting and constant beeping were reminding Dad of his WWII foxhole experiences, not helped by the sounds of Care Flight helicopter landings on the roof and snowplows outside on the street.
Two things helped Dad move out his worst delirium. First, getting the anaesthetic and narcotics out of his system. Second, a very simple switch to a TV channel that showed lovely landscapes all day, and constellations and galaxy images all night. Did the doctors or nurses suggest turning on the TV channel for Dad? No. The aide who brought him a sandwich and some ice cream at 3 a.m. on the fifth day was the one who flicked on the TV.
Talked with my friend who cares for Alzheimer's patients. Her sweet, five foot tall, roly-poly client described fighting a Bad Man who was squeezing her arm, managing to "kick him in the groin and reduce him to a vegetable" before shoving his body into the "rolling black cart with the shelves".
Holy cow, stuff that squeezing man in the cart! He's the blood pressure cuff. I've had a few anxiety attacks when I was trapped in the grocery store pharmacy self-check blood pressure machine. I've wanted to kick that cuff into vegetable status myself.
I worked in the hospital kitchen for five years beginning in 1970. We had big carts that were black and stainless steel. We served the patients' trays in an assembly line, then loaded the trays into the carts. The trays slid into grooves. It seems like the carts were plugged in and the hot sides were preheated, and the cold sides chilled before we loaded the trays. Each cart probably held thirty trays. The doors closed. Then some teen boy would drag the cart away to the elevator.
After patients ate, the nurse aides would load the dirty trays of dishes back in the carts and the process reversed. We unloaded the carts onto a disassembly line that fed to the giant dishwasher. Then some teen girl would steam clean and disinfect the cart, dry it, and shove it back to its parking place.
We did all this as fast and with as much flirting and banter as teenagers can. We were the supper shift, 3:30-7:00, and we wanted to get out of there early. We were making $1.21/hr., and wearing hairnets and white uniforms. When we worked on the weekends or school vacations, 6:00 to 2:30 we couldn't understand the full-timers who made the work last as long as possible to fill the shift.
Anyway, I'm quite sure a person could be shoved in one of those steamy carts if they'd been kicked in the groin and reduced to a vegetable. Especially a soft, canned vegetable with Low Salt.
© 2010 Nancy L. Ruder