|
For three years now, Ola Arije, RN, has ensured the
physical and emotional well-being of 30 long-term care
residents. Arije's patients, whom she regards as her
second family, are Alzheimer's disease patients.
She is beginning one of three 12-hour shifts--6 a.m.
to 6 p.m.--that make up her workweek at Garden Terrace
in Aurora, Colo. From the driveway portico, she passes
through a double set of smoked-glass doors and across
a hotel-like lobby, complete with complimentary coffee
and plush sofas grouped on lightly patterned carpeting.
She reaches high on a wall next to a white enamel doorjamb
and fingers a keypad. The secret code hushes an alarm
for a few seconds, long enough for her to pass into
another world.
Until the end of Arije's workday, time consists only
of now and tomorrow. Yesterday rarely exists at Garden
Terrace, one of six Alzheimer's facilities in the Life
Care Centers of America system. No childhood memories.
No raising of families. No gold-watch careers. For some,
conversations and activities of 15 minutes ago are gone
as if they never happened.
"Sometimes, it's depressing," Arije said.
"There's nothing we can really do to make them
get better," she said. "Hopefully, one day
they'll find a cure. It's a degrading disease, with
no known cause and a diagnosis that only can be definitive
at autopsy. But at least we can improve their quality
of life."
After taking her morning report, Arije passes medications.
Support staff then come in to reinforce residents' daily
living skills for physical therapy and for activities
that range from singing to reading to gardening. Arije
said she also insists that she and her CNAs sit and
talk with residents during activities for two reasons:
"We want them to feel at home" and it's a
good way to ensure that they are drinking and snacking
adequately during the day. Some Alzheimer's patients
can't even tell you they are thirsty and dehydration
always is a threat, she said.
At 38, Arije, who is from Nigeria and started nursing
in geriatrics, said she first became familiar with Alzheimer's
in 1994 when President Reagan publicly announced that
he likely would be afflicted with the disease. "It's
something that can happen to anybody," she said.
In the years since the Reagan revelation, she's come
to regard Alzheimer's care as her calling. "I love
it," she said, despite the trying nature of dealing
with Alzheimer's patients.
Among Arije's challenges is the phenomenon known as
"sundowning," in which the agitation that
is a hallmark of Alzheimer's disease essentially becomes
contagious. It typically happens in late afternoon.
"Everybody gets hyper," Arije said. "You
need just one person to start it and you never know
what to expect," including residents screaming
and throwing things. "You just have to love them,"
she said, her soft-spoken voice trailing off. "Even
if they're going really, really crazy, they kind of
calm down."
The flip side is the satisfaction of persuading residents
to eat or shower when they are-to put it mildly--reluctant
to do those things. "When we find a way to make
them do things they don't want to do--eat, for example--I
feel like we've done something good today," Arije
said. There also is the joy of conversations that at
least temporarily tap into a resident's yesterdays,
she said.
To further stimulate memory, residents have shadow
boxes at the entrance to their rooms, which line a hallway
running in front of a central nurses' station. The boxes
are a common tool in Alzheimer's care, Arije said, and
are used as reminders of oft-forgotten lives. They feature
pictures of residents in much younger times, family
snapshots, perhaps flowers if gardening was a significant
part of a resident's life and mementos of careers.
The most memorable part of any day may last just an
instant. "I have a lady I always call the most
beautiful woman," Arije said. "She gives me
a big smile. It makes me happy, something that makes
them happy. An Alzheimer's smile is from the heart."
|
