My older sister, Kathy, was diagnosed as developmentally delayed as a young child. Later in life, she was also diagnosed with schizophrenia and today, at age 69, she has dementia and is nearly deaf. She was dealt a bad hand but she is spirited and generous. She’s outspoken and has no filter. Life with Kathy is never boring.
Updated:
I am so so opposed to TeleHealth! And I know, I know the arguments about improving access and everything and I’m sure they’re valid. But I see situations like this every day at my work— a patient who can not really use TeleHealth, being “seen” by a provider who is hanging by a thread. At least if they had been face-to-face, maybe the NP could have read more of her/your body language? Easier to understand each other if there isn’t a screen separating you?
This week I took my sister to her psychiatric appointment. Usually, the facility where she lives transports her to her appointments but I go when I can. Recently she told me she’s been seeing mice in her room and could Bob, my husband, get an exterminator.
Whenever she starts seeing mice I know it’s time to re-evaluate her psychotropic meds.
Her provider this time was a young, nice Indian NP. We sat in front of a giant screen on folding chairs for a Zoom call. For most of the call, the top of his head and eyes were cut off. He has a thick accent and is a soft talker. Right away I knew he was in over his head. I was so glad I was there to interpret. I wonder what happens when I’m not there.
NP: Good morning, Kathy. How are you today?
Kathy: Are you going to weigh me? They didn’t weigh me on the way in. (Kathy loves to be weighed at her doctor appointments. She obsesses about her weight).
NP (clears throat): Do you know what date it is?
Kathy: No answer.
NP: DO YOU KNOW THE DATE?
Kathy: Yes, I am. I’m racist.
Me: (horrified): KATHY!! (loudly in her ear) WHAT DATE IS IT?
Kathy looks blank.
NP (trying to be helpful): THE DAY, MONTH, AND YEAR
Me: (trying to simplify): DO YOU KNOW THE MONTH?
Kathy: I think it’s June
Me: GOOD! WHAT DAY IS IT?
Kathy: I don’t know
Me: WHAT YEAR?
Kathy: I don’t know
NP: WHO'S THE PRESIDENT?
Kathy (after long thought): Actually I don’t know. But I want to vote. My sister votes for me. I trust her judgment. She's very smart, you know. She fills out the…what’s it called…the...the...menu?
Me: Ballot
Kathy: Ballot? Yes, ballot. She fills out the ballot.
(note to readers: I do not fill out a ballot for Kathy)
NP: Do you know where you are?
NP: DO YOU KNOW WHERE YOU ARE?
Kathy: Yes
NP: Where are you?
Kathy: I’m here.
(He's already asked date, time, day, President, place. Pretty sure we're not going anywhere with this train of questioning. I feel a strong need to move things along and interrupt)
Me to NP: Kathy’s been seeing mice in her room again.
NP: Do the meds help?
Me: ~pause~ Obviously not.
NP: KATHY DO YOU SEE MICE?
Kathy: Yes, they’re behind the dresser and under the bed. They’re hungry. Did you know if I reach out and pet one the fur is soft but then they take off. They could be pets. But I don’t want mice for pets again. Remember in San Diego I got tuberculosis?
Me to NP: I’m also wondering about dementia. When I walk into her room she’s talking into the remote control of her TV. I ask who she’s talking to, she always says Bob. She has long conversations with him on the remote control.
NP: Let’s increase her Risperdal and I’m referring her to a dementia specialist.
Kathy and I go back out to the waiting room and are told to wait while they complete the paperwork for the assisted living facility. We wait and wait. At some point, I realize the paperwork waiting is longer than the provider visit.
Kathy: Before we go back, can we go to your house and talk to Bob about the exterminator?
Me: Umm, not today, no.
Kathy: Why not?
Me (lying): Ummm, well, he's not there.
Kathy (alarmed): HE'S GONE?? (as in he deserted you?)
Me: (still lying): He’s not GONE! He had an errand to run.
Kathy: An errand? What errand?
Me: (stumbling and lying some more): Um.. a doctor’s appointment?
Kathy: Did he have a heart attack? He told me on the phone he had a heart attack.
Me: No, he’s fine, Kathy. Bob did not have a heart attack.
Kathy: Oh. Well I hope they didn’t turn off my TV while I was gone. It’s hard to turn it back on and it’s the only way I have to get ahold of you and Bob.
……to be continued
Do you want to hear more Kathy stories? Let me know ?
About Nurse Beth, MSN
Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger and author.
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