The Chaos of Medicine: Just An Ordinary Day

Thursday, January 5, 2012

Just An Ordinary Day

A woman I don't know comes walking towards me across the hallway. "Help! Hėėlp! I'm being abused!"
I am at the psychogeriatric part of the nursing home. In other words, the place where patients with progressed dementia have a safe environment adapted to their specific needs. In theory, because it is hard to manage a group of patients often harmful to themselves and others.
The woman, who has now reached me, is clearly upset. I quickly screen her, as I learned to do over the past months. I look at her and try to assess her mental status. Her incoherent answers to my simple questions tell me she does indeed suffer from dementia. (Important lesson: never assume. I can imagine that upset family members would appreciate a different approach.)
"Hèèlp! Police! Oh, finally. Someone who can help me. Let's go to the police station together."
I try to calm her and convince her that it is not a good idea to leave the nursing home. From the fact that she starts trying to hit me, I conclude my approach is not working. I find out where her room is and take her there. As if a switch was flipped, her mood changes instantly. No one is abusing her anymore. She continues wandering around the building like nothing had ever happened.

Just ten minutes of an ordinary day. They left me thinking. Only then I realized how vulnerable this group of people it. The chance that she was actually abused is small - she also talks about how she should get home to her little kids - but still. If she was abused, would I believe her? Probably not. Everyday there are many concerns like this. Even if it is just an ordinary day.


  1. So do you just let it go? Or do you keep checking up on her in case there really is something wrong?

  2. I do keep checking up on her, but 1) the staff is constantly changing, so that makes it hard to know who would be abusing, and 2) it is hard to determine what would be reasonable grounds for suspicion. She is often agressive and sometimes delirious, so her statement/possible bruises and wounds do not directly point to abuse either. It's hard. The 'what, if' feeling. But right now, she seems fine, luckily.