Jun 25, 2012

General McArthur’s Credo

Sadly, it became very apparent that the hospital professionals did not seem to believe our story. We overheard them chatting about our family being, ‘in denial’.

By Ellen Belk
Alzheimer's Reading Room

Douglas McArthur
I received the call on a Sunday afternoon in March. The call that no adult child wants to get from a parent. As a long distance care provider to aging parents, my role had intensified as new issues continued to present themselves. Daily check-ins and follow ups became imperative.

On that Sunday in March, the call was urgent.

Dad had fallen around noon and mom was calling me from the Emergency Room. She assured me that Dad was okay, however she believed that he’d be kept overnight for observation.

My heart began to race.

An overnight stay in the hospital for an elder? Even if you aren’t currently a caregiver to an elder – you should know that Hospital stays typically don’t present a pleasant experience for Senior citizens.

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I had insider information that was contributing to my angst. In the 10 days leading up to his fall, Dad had been experiencing hallucinations in the overnight. His primary Doctor had prescribed an antibiotic to treat a urinary tract infection (UTI).

A UTI, in an aging body, isn’t unusual. Having hallucinations and significant agitation is both unusual and unnerving.

In addition, as a Senior Care professional, I had too much information about how Hospitals ‘treat’ those with any type of delusional or demented behavior.

I knew too well, that they frequently used strong medications to subdue delusional or dementia-like behavior and those medications could cause additional and far-reaching effects. I didn’t want any of that for my beloved father. However, from nearly 900 miles away, I felt helpless and anxious.

Unfortunately, my dad did spend the night in the hospital. Unfortunately he did have the hallucinations in the overnight. And, unfortunately, the medical staff was instructed to give my dad 100 mgs of the drug Seroquel.

By morning, he’d barely slept, had increased confusion and was significantly anxious.

It was a drastic change from the man who had walked into the ER and calmly discussed his bathroom fall, with the ER personnel a mere 12 hours earlier. The doses of this antipsychotic medication continued, my dad’s response continued to worsen. I arrived at the hospital on Wednesday morning and he was bedridden, unable to walk, speak coherently and sadly….didn‘t recognize me at all. Heartbreaking, for sure.

The situation continued to spiral out of control and our family became trapped in a continuous vortex of having to tell ‘our story’ aka, my ‘Dad’s story’ over and over and over again to every single staff member who entered the scene and asked the same repetitious questions.

Sadly, it became very apparent that the hospital professionals did not seem to believe our story. We overheard them chatting about our family being, ‘in denial’.

They seemed to think that we were holding back info or worse yet; we weren’t being truthful about my Dad’s pre-fall condition. They basically thought he had been delusional with dementia-behavior for quite some time and that we just weren’t being honest with them.

Within the week, they transferred Dad to another hospital, where we were told he’d have a Geri-Psych evaluation. I will never forget the torturous scene of my Mom sitting at my Dad’s bedside, explaining to him that it was in his best interest to sign the admittance papers. After 58 years of marriage, who would’ve imagined that it would come to this?

My Dad was transferred on Thursday. Four days after walking into the ER, to a specialty hospital, that we were told could better diagnosis and treat his now, significantly declining condition.

Within hours of arriving at the new location, our family was questioning the intelligence of the move. This hospital wasn’t a quiet, calming retreat for seniors who needed evaluation. It was a hectic, over-stimulated behavioral unit for people of all ages, who were struggling with a variety of psychiatric conditions.

On the day my Dad checked in, he was one of three older adults. The remaining patients were significantly younger with significant issues. No one in our family, including my Dad got a wink of sleep that first night. Little did we know, this journey was only beginning.

A week into this nightmare, the new Doctors continued to pump additional medications into my Dad. Up until this hospitalization my Dad’s ‘medication regime’ simply included a baby aspirin, Kelp, Vitamin D, Fish Oil and a cholesterol medication. This was a man who certainly didn’t take antipsychotics or anti anxiety drugs. And, with each new pill they introduced, my Dad’s condition worsened.

I made several desperate calls to his primary Doctor’s office, begging the nurse’s to get the Doctor to intervene in this situation. That Doctor had just seen my Dad within the last two weeks. He’s spent nearly an hour with Dad on that day, certainly – he could share his observations with this new hospital personnel. Certainly, he can share with them how he’d chatted and laughed with my very lucid Dad. Certainly, he would assist my Dad in his greatest time of need, right?

Sadly, after the third call, I gave up. More disconcerting, the Doctor never did reach out to assist. We felt abandoned.

At one point during this nightmare, I was alone in my parents’ house. On this particular day, while my mom was at the hospital I chose to stay behind. I planned to do some investigating, to see if I could uncover any information that would give me an indication that Dad had been declining.

Were the hospital strangers right? Had Dad been declining and we’d missed it? Were all of us in denial? I had to find out.

I began in their bedroom. I opened every drawer, searched every closet. Sock drawer – neatly coordinated. Closet – clothes hung straight, shoes aligned perfectly. I looked under the kitchen sink, in all the bathrooms. Desperately searching for something to be out of place. For a sign, ANY sign that my Dad was hiding a significant secret. As the search continued, I began to feel like I was betraying my parents. Here I was, digging through all of their personal belongings, hunting for clues that my Dad had lost his mind and we hadn’t noticed. I moved to his office.

I entered the familiar room. This was where I sat with my Dad, weeks before I moved to North Carolina in 2006. I glanced at the chair I had been sitting in, when he gave me one of his usual ‘pep’ talks. I had lost my job and had been searching for work to no avail. And, I had come to him and announced that I’d sold my condo and was planning to move across the country to start over. It was in this office that he encouraged me to follow my heart. He shared with me that he too, had left his home so many years ago to follow his heart and start a new life in a new City.
“Ellen, I left home and never returned. I met your mother and we began our life. Who knows, maybe you’ll meet someone in North Carolina and that’ll be that.”
As I stood in that office now, I brushed a tear away. My Dad’s encouraging words still ringing in my ears. I’d left in December 2006, in search of a new job. And, almost like he’d written the script himself, my Dad’s prediction came true. Three months later, I met the man who would later become my husband. It took me six months to find the job!

And now, in 2012, I was back in my Dad’s office trying to find clues to justify why he was in his current condition. Even though we all felt it was because he was over medicated. The burden of having so many hospital people not believe us, was sickening. I began opening the drawers of my Dad’s desk. I flipped through file after file, looking for clues of incompetence. My hand stopped on the manila folder labeled Resume.

Resume? Odd folder for an 82 year old man. I was intrigued. I opened it gingerly and began flipping through the pages. The resume, several head shots of a much-younger Dad and his government clearance paperwork, all neatly in place. In the back of this folder, were several pages that looked the same. I looked closer. My Dad had approximately 10 copies of General McArthur’s Credo. I sat cross-legged on the floor and began to read. I silently wept, as I absorbed the powerful words.

I read the text over and over, realizing they were someone else’s words, however believing that my Dad could’ve spoken them himself. In that moment, a warm flush came over my body as I felt a new conviction of strength and determination.

The hospital staff was wrong. We were not in denial.

My Dad was clearly having an adverse reaction to the extreme med-cocktail he was enduring. I put nine of the copies back and slipped the tenth copy of General McArthur’s credo into my suitcase.

I vowed at that moment, that someday I would tell my father what I had done. I had rummaged through his belongings in search of a clue and had come away with a deeper understanding of the amazing man that he was.

39 days later, my Dad was released from the rehab facility, his third stop on this non-sensical journey.

I went home again to visit ten days later. Dad was walking, talking and growing stronger every day. He’d seen a specialist and was being weaned off all the unnecessary medications. He was sleeping through the night with no hallucinations. As we sat on the porch, I shared my ‘scavenger hunt’ secret with him.

I told him I’d rummaged through all of his personal belongings, determined to prove the hospital staff wrong. He listened intently as I admitted that I’d taken one of the Credo’s from his folder. I stopped talking.

Our eyes locked and he said,
“You know, with all that staff you would’ve thought I could’ve been given a shower on a regular basis. Once a week, would’ve been nice.”
Youth is not entirely a time of life – it is a state of mind. It is not wholly a matter of ripe cheeks, red lips or supple knees. It is a temper of the will, a quality of the imagination, a vigor of the emotions, a freshness of the deep springs of life. It means a temperamental predominance of courage over timidity, of an appetite for adventure over love of ease. Nobody grows old by merely living a number of years. People grow old only by deserting their ideals. Years may wrinkle the skin, but to give up interest wrinkles the soul. – (excerpt from General MacArthur’s speech)

Ellen Belk is President of Keep In Mind™ and creator of Memory Magz™. Since 2001, Belk has specialized in developing programming for the memory impaired. A mature musician concert band, an intergenerational Senior Prom and a Fine Art appreciation program are amongst her professional highlights. Memory Magz™ are ‘magazine style’ picture publications with full page vibrant images purposefully designed for people with cognitive decline and/or developmental disabilities. As a public speaker, Belk engages the audience with her inter-active style and witty story telling. www.keepinmindinc.com.

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Original content Ellen Belk, the Alzheimer's Reading Room