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Tuesday 12 March 2013

'Night Shift on the Alzheimer's Ward' by Rejecter_ex_machina

When I came to America from Norway a few years ago, I got a job as a nurse aide in a horrible nursing home/rehab facility in Missouri. (For anyone who doesn't know, the job of a nurse aide in a nursing home is usually to wipe butts, feed people, bathe people, fetch things, assist with exercise and so forth. Important job, but not cool at all. :P)

I liked it well enough. I had a night shift on the Alzheimer's ward, and it was a small place, so usually I didn't have to deal with anyone but my patients. Although it could be heartbreaking at times, it was usually dead quiet, very calm, and not particularly stressful. I'd often spend my night walking back and forth down the long, dim hallways, just happy for the quiet, the light exercise, and the sense of dutifulness from keeping watch and keeping everything in its place. All I was required to do was bathe a few people, help each of them get up in the night to use the bathroom, feed snacks, and defuse the occasional meltdown that happens when an Alzheimer's patient gets upset or anxious, or when their schedules are disrupted by something out of the ordinary. On most nights, the only people there aside from patients would be me, the charge nurse, and my favorite doctor; a tall, dreadlocked Jamaican man whose every action suggested laughter.

On this particular night, I went into the room of a patient we'll call "James", to give him his bath. James was in the last stage of Alzheimer's disease and heavily medicated due to an enormous bed sore on his heel. He was tiny and withered. Sedate and silent until something frightened him, at which point his blue eyes would fill with tears and he would wail plaintively, like a hungry baby. It was a deeply unnerving sound, enough to fill even this ex soldier with fear, pain and urgency. Since I had never seen flowers, balloons, cards or gifts in his room, I assumed that he were alone in the world.

James was in his customary comfy position, lying on his back, quietly staring at the mobile of stars and planets that I'd hung above his bed a few weeks previously. It swayed gently in the breeze that came from my opening the door, and his eyes, almost imperceptibly, followed the sun.

I spoke gently to him, but loudly enough that I was sure he could hear. Although many of the patients with late-stage Alzheimer's never speak, I talk to all of them as if they can understand me, and as if they are capable of holding conversations. I don't know what it's like to be them. I have no idea what is happening inside their riddled minds, but I can only imagine this: To be trapped inside your head, unable to speak or express yourself, and to have everyone around you treat you as an object. A behind to be wiped, a mouth to have food put into it, a lifeless, plastic face to be washed, a head of nylon hair to be combed. Just the thought of it keeps me up at night, so I would always talk to patients, no matter what their condition.

I went to the sink, my back to him, and began to talk while filling my basin with water and soap to bathe him. “Hi there, James! It's such a nice night out there. Would you like me to open the window for you, maybe? I think you'd like the breeze.” From behind me, I heard him whisper “Yes, please.” I froze in place, having never heard him speak before. I shook it off quickly and went to open the window, just happy that I was able to do something that I knew would make him happy.

I went back to the sink. “Tomorrow will be sunny just like yesterday was. There'll be a service in the morning too. You have seen the preacher, haven't you? His nose twitches like a rabbit, but he's a very nice man.” From behind me; “Yes, yes, it's very nice.”

I went to his bedside and began, methodically, to wash the front of his body. As per usual, he was still and quiet, although I continued to keep up a steady stream of pleasant conversation. I told him about the other patients, about the weather outside, that his fingernails looked very nice since they were clipped and filed the previous day. For once, I found myself struggling not to cry. I swallowed my tears and continued to speak and wash him, now telling a funny story in my awful accent that sometimes made him smile. Anything to hide my discomfort and sadness, because I knew that if he caught on to it, it might frighten him and cause him to get upset, waking the other patients and... well, you know. It's a domino effect, really.

I dabbed a towel over his face to dry it, and prepared to roll him over and wash his back. But just this once, I laid my blue-gloved hand on his forehead and stroked his hair a few times. I suddenly worried that maybe he couldn't hear everything. I wanted to reach out and touch him, and to be assured that he knew someone cared. I stopped quickly, afraid to be overcome by the strange, unfamiliar sadness that I am feeling.

I gently slid my hands underneath his body and rolled him to his side.

The back side of his body was the navy blue of livor mortis, the settling of fluids in a corpse due to gravity.

James had been dead for hours.


Written by Rejector_ex_machina
See Also: NoSleep

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