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Monday, September 5, 2011

Clawed Heart

“We have a problem!” Sarah, a nurse assistant, exclaimed as she burst in my office.  

“A problem?”  I wasn’t surprised.  As the nursing home social worker, problems were my daily quest. “What is it?”

“Ms. Barnett has been stealing her roommate’s clothes.” Sarah’s face was distorted from obvious stress.

“What do you mean ‘stealing’?”

“Ms. Wilkinson complained that Ms. Barnett was wearing her sweater.  I peeked into Ms. Barnett’s drawer while I was helping her to get dressed, and saw more of her roommate’s clothes, but I didn't feel like saying anything.”  Sarah’s eyes sparkled with fear.  “Ms. Barnett has been in a bad mood lately.”

I frowned. I had known Ms. Barnett for being a private person, but I had never heard of her taking another resident’s belongings. 

I headed to her room.  Sarah had taken Ms. Wilkinson to one of the activities so I’d have some privacy when speaking with Ms. Barnett. 

“Ms. Barnett, I’d like to visit with you.”

“Go ahead.” Her voice was firm. She was sitting on the edge of the bed. 

I tried to break the ice with a casual conversation first, but she showed little interest in talking. Then I focused on the complaint I had to follow up.

“It appears that some of your roommate’s clothes have been mistakenly placed in your drawers.”  I was confident that the matter would be promptly resolved, and in a most polite way. “If you don’t mind, I would like you to help me go through your drawers and try to find Ms. Wilkinson’s clothes.” 

“Those are my clothes.” Her voice was tense. “You can look if you want!”

I started my search and soon spotted a gown labeled with Ms. Wilkinson's name. 

I retrieved the gown.  I was going through the second drawer when I found a pair of sweat pants with Ms. Wilkinson label.  As I was putting them aside, Ms. Barnett abruptly jumped up next to me. 
“These are mine!” she screamed and then pulled the pants from my hand.  I could sense her outrage.  Motionless and speechless I glanced at Ms Barnett.

Within seconds, she lifted up her hand, and as if a feline defending her territory, then bounced toward me, clawing her nails in my arm, as deep as her strength would allow her. 

I stepped back, borderline terrorized, with my gaze fixed on Ms. Barnett, my lips parted to speak, but my voice frozen in disbelief. 

“Oh my God, Ms. Barnett...” I managed to say, my voice  breaking.  I turned around to leave the room and noticed Sarah standing in the doorway.  She had witnessed the attack and called for help.  I headed to the nurse’s station to have someone assess and treat my wound. 

I was somewhat in shock for a while.  Until that day, I had never been physically assaulted by a resident, not even when I had been in the Dementia Unit.  Ms. Barnett wasn't known to have dementia.  She had never exhibited aggressive behaviors, or been seen taking things that belonged to other residents. 

Certainly, something was bothering her.

My arm hurt little compared to my worry about Ms. Barnett.  My mind drew blanks in trying to understand what was causing Ms. Barnett to act in the manner in which she did.  I had no answers.  I felt as if my heart, not my skin, had been clawed—clawed with the uncertainty of what had caused my resident to change.  That was not the Ms. Barnett I had known. 

Ms. Barnett was thoroughly assessed and tests were run. Her urinalysis test came back positive for a Urinary Track InfectionUTI.  I knew that a UTI could cause confusion and altered mental status in the elderly.  And Ms. Barnett’s case was now one clear example. 
I was relieved in having an explanation of Ms. Barnett’s behavior.  She would be fine after completing treatment. 

I followed up on Ms. Barnett through staff and reports, but I refrained from visiting her for a few days.

“Excuse me!”  A nurse assistant popped in my office. “I have a note for you.”  She handed me a piece of yellow lined paper, folded twice.

I unfolded it and read the hand-written note:

                                To Doris.

                                I’m sorry.  Please forgive me. 

                                                     Alice Barnett


the other side of me said...

That was so sweet but sad!!!! MAy God bless Alice:)


I hope Alice dosen't get more urinary tract infections, it must have been unerving for you, but you did get an apology which I'm glad about,


Bica said...

Oh my, how frightening, and sad at the same time. I feel bad for Alice, as I'm sure this is not normally how she behaves. Glad it ended well.

Hilary Melton-Butcher said...

Hi Doris .. it tells its own story .. so sad when these infections cause distress with patients.

All the best - Hilary

MunirGhiasuddin said...

Apologies are always good. They help you to move on.
Also thanks for the info. I did not realiaze that URI can coause confusion in the elderly.

Amrita said...

Gosh, this sank very deep into my heart.

Ann said...

This is sad, touching and frightening. I am delighted you weren't badly hurt. I am also delighted the cause of Mrs. Barrett's anger was sorted. Take care Doris.

K. Tree said...

Actually, I'm kind of surprised that she remembered what she had done. Usually when the UTI is cleared up, the memory of the behaviors is gone as well. Makes me wonder if someone felt the need to tell her what she had done.

Glad it ended well.

Jules said...

We just got my grandmother healed from one these and yes it does affect them. She thought someone was stealing from her... only to find she was hiding stuff from herself. :)
Jules @ Trying To Get Over The Rainbow

Arkansas Patti said...

This was very sad but an eye opener. I wonder how many elderly are restrained when they really just need medical help.
Thank goodness your facility went the extra mile.

Big Mark 243 said...

All is well that ends well. You that work in the health care industry have many challenges... it is a good thing that the staff is as invested in the proper treatment and care of each resident, otherwise I could have easily seen this going another, more negative and disastrous turn...

Dr. Kathy McCoy said...

It's always frightening to be assaulted by a patient. (It only happened to me once about 15 years ago, but it's still vivid in my mind.) What a sweet ending and how great that you linked her infection to her previously inexplicable behavior. Another wonderful post, Doris!

Mariette VandenMunckhof-Vedder said...

Dearest Doris,

What an unfortunate fate... None of us are prepared for anything like that but at least you were able to analyze her sudden behavior! Glad they sorted it out and the little note will soften your 'scars' somewhat. Hope this will not happen again and will be a minimum to all who are caring for the elderly.
Love to you,


Anonymous said...

Like you, I know from experience how physical problems can alter our thoughts and actions. You've shown this fact beautifully in this story--as always.
Ann Best, Author of In the Mirror, A Memoir of Shattered Secrets

Have Myelin? said...

What a sweet story you wrote...

Deb Shucka said...

I had similar experiences with my mom and the affects of UTI. This is a powerful and important story. I love the ending.

Retired Knitter said...

So sad the a simple UTI can cause such havoc, but I know it can... and much worse.

Vilisi said...

I had no idea that UTI could have such an effect on the elderly. Thanks for this story, Doris.I'm glad all ended well. God bless.

Anonymous said...

God bless you Doris for taking the time to look into this and for being so understanding and compassionate!

DUTA said...

Infections cculd have bad mental effect even on younger people. Glad the problem ended well for Alice, her roomate, the staff, and for you Doris.

A Lady's Life said...

I feel so sad for old people,especially those who family put away. They can be a little difficult but you feed them wash them and most of the time it keeps them happy.

Mary Aalgaard said...

Oh, wow. That must have been so difficult. Your description that you felt it was your heart that was clawed, got me. The note sent healing.

M Pax said...

What a story. I'm glad Alice is feeling better. Must have been frightening for her, too.

Karin said...

An all too familiar story from where I've worked all these past 25 years. Sometimes reality therapy elicits an outburst of aggression, and other strategies have to be used to deal with an issue. Never a dull day in our line of work. So glad that this time Alice received proper treatment and it worked. Glad she is well again and asked for forgiveness! Trust you're ok as well!

A Plain Observer said...

That's all it takes, Doris. A sincere apology heals all wounds

Diana said...

Oh my, that was so sweet it made me want to cry. Very moving story which also gives one time to pause and think.
Love Di ♥

Arlee Bird said...

It was fortunate that a cause was found for the disorder and it was able to be treated. Sad to think that perhaps cases can get misdiagnosed and the outcomes may not be so good.

Tossing It Out

Unknown said...

What a sad story but how fortunate that, after the treatment for her UTI, she'd be fine again. It makes me wonder how many such cases go undiagnosed. A thought provoking story - as always. Thanks for sharing!

Toyin O. said...

This is kinda sad, I am praying for Alice:)

Myne said...

My heart goes out to Alice, what a sad story. But very well written too, thanks for sharing.