Friday, July 31, 2009

Finding a facility.

"For all the fancy trappings and smiling activity directors, the realities of Dad’s disease and his future faced us everywhere. Illness and dementia could only be dressed up and disguised just so much. Bone thin women, shuffling aimlessly down hallways, eyes fixed on nothing. Frail, hunched men mumbling and rocking on the couches of gaily-decorated activities rooms. An old woman frantically approaching people in the hallway, asking each one if they knew where the bus stop was. Hallways redolent with the smells of past meals, antiseptic, and old age. Every facility I visited, I saw first- hand what Dad would become, what he would suffer, and my heart quailed within me.
I was also intent once again that Dad be allowed to inhabit whatever space and time he wanted; the old approach to dementia had been to try to keep the patient in the present at all times. It was called “reality orientation” and the idea was to correct patients when they wander in time, telling them the year and that what they are thinking or remembering never happened. As a practice, I thought that was just ridiculous. Most places, fortunately, subscribed to my philosophy; as the rate of dementia had grown, more natural and humane practices were being developed, and patients were encouraged to dwell in whatever part of time and memory that comes up."

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