My job as ‘lifestyle assistant’ at the nursing home, also shortened to OT (occupational therapist) continues to be thoroughly enjoyable. The shifts are only three hours – from 3 to 6pm and I do an average of six shifts per fortnight so it’s not a lot of work but hopefully I will get more shifts in the future.
The dementia “house” is set up like an open plan house with the kitchen and dining room in the centre, a sitting room with a big television, and ten bedrooms down three hallways, each with its own ensuite. Then there are a couple of separate little sitting areas as well as a lovely patio out the back, with a garden. Seven of the ten women are ambulant, some with walkers and some without, so there is a code to open the doors due to the risk of anyone wandering off.
I have now established a routine whereby I take one or two of the women for a long walk outside around the grounds and in and through the other four houses, all of which are designed in the same way except Anthony’s which is more like a hospital ward. If I come on duty and find anyone already in a wheelchair, I begin with that person and this week I started to take J. by herself because she doesn’t seem to ever have any visitors and, even though she can walk a bit she is difficult to manoeuvre and quite tall, so I use the wheelchair. I don’t think this has been done before because previously the OTs took her on short walks until one of them wrenched her shoulder doing so (J. has a grip of iron!) In the wheelchair it is possible to take her on much longer walks and she seems to really enjoy this although it’s difficult to tell because she doesn’t talk much and even when she does she is hard to understand.
I like to take her by herself for that whole one-to-one thing but sometimes one of the ambulant women comes too. We go out the locked door into the sunshine and gardens then through a small parking lot at the back of the nursing home then inside Anthony’s section which begins with a foyer, then a large activity room, down a very long hallway, saying hello to the residents in the rooms to the left and right (including Anthony of course!) then out to another garden area at the front of the nursing home, up a steep driveway at the top of which you can see the ocean, then left down a road that enters the section where the independent elderly live in self-contained units, all with beautiful gardens, around a roundabout and back to the ocean view. Then we go back down the driveway and into Anthony’s section again, turn right to go through the dining/living area up another hallway and then back down and out into another garden area, then back down Anthony’s hallway, waving to him on the way (which he finds extremely amusing) then, once outside again, instead of turning left which leads back to the dementia house, we turn right and head up the narrow driveway past two other nursing home houses and up a hill to where there are other self-contained units. Sometimes the residents will come out and say hello to us and have a chat; then we turn around and head back to the dementia house. This takes around half an hour. Once back, I pick up F. or O. or D. and begin again. And again, with different people.
One of the things I have found most difficult about these wheelchair walks is walking slowly. It’s like the way you have to walk up the aisle! I am ordinarily a very fast walker but having already frightened the hell out of two women who thought they were about to be catapulted out of their wheelchairs, I now walk extremely slowly in a smell-the-roses way (and there are lots of roses to smell because the gardens are beautifully kept).
With the weather so beautiful lately this seems to me to be the best activity and my goal is to get all ten women out and about during one shift, but so far I have only been able to get seven out and about (yesterday), because dinner is served at 5pm.
The wheelchair walk tends to calm even the most agitated of the women down which is pretty much what I am there for as this time of day is notorious for ‘Sundowner Syndrome’ an anxious time for many people with dementia who may remember it as a busy time of day, getting dinner ready etc. B. who walks without any assistance, becomes increasingly anxious about getting back to cook dinner and when is her husband coming home? S. cries a lot, and O. becomes aggressive. The long, slow wheelchair walk seems to calm these anxieties to some extent and I much prefer doing this than singsongs and card games.
The sunshine, fresh sea breeze, gardens full of late blooms, and interaction with residents and staff outside the dementia house, is, I think, the most beneficial thing I can do in this wonderful role. The fantastically weird conversations we have with each other outside create a rapport and laughter that isn’t as easy inside.
Me: Are you enjoying it out here, S?
S: Not particularly.
Me: (laughing) What?
S: You cheeky man!
Me: I keep telling you I am not a man!
S: Oh, sorry (starts crying)
Me: Stop it – I was only joking. Do you want a hug?
S: Yes, please (we hug).
Me: If you start crying again I will bop you (laughing)
S: I’ll BOP YOU, young fella!
OR:
Me: Do you want to go for a walk, Y?
Y: Leave me alone, leave me alone, leave me alooooooone – doesn’t matter.
Me: Your chariot awaits (pushing wheelchair next to her).
Y: Oh all right, all right, all riiiiiiiiight.
Me: See! Look at all the flowers, Y.
Y: Pretty. Pretty flowers, pretty flooooooowers.
OR:
Me: Do you want to come for a walk, B?
B: Oh I don’t think there’s time. X. will be home for tea soon and where are the boys? What’s the time? Do I need my lippy (lipstick)?
Me: It’s only a short walk and I need you to help me with O. (O. in wheelchair).
B. Well as long as we’re not too long. Have you seen my handbag?
Me: We won’t be long and X (deceased husband) doesn’t mind.
B: Are you sure. Could you ring him?
Me: Somebody already has and it’s fine.
B: Well I suppose it’ll be all right. Just let me get my handbag and put my lippy on.
[15 minute search for handbag]
Me: Come on B.
B: Oh I think I should stay put. X. won’t know where to find me.
Me: He knows exactly where you are and we won’t be long anyway, B.
B: Oh well I suppose so but what about money? Wait a minute darling I just have to put my lippy on.
Me: B, I really need your help with this wheelchair.
B: Of course.
OR:
Me: O. do you want to go for a walk outside using the wheelchair?
O. No, no noooo – I don’t want the red with the pink. What is this? Stupid!
Me: How do you like the sunshine?
O. Too HOT – too fast, slow down!
Me: Sorry, sorry.
O: Slow down!
Me: We are crawling now, O.
O. Oh you crazy one – crazy crazy (guffawing).
Of course there are many more conversations, lots of silences and miscommunications, but the wheelchair walking routine I’ve now established is a winner in so many ways!
jmgoyder 
Looks like this has been a “big step” for you. You’re working with people from “all walks of life” and making a difference. It has been a change of “pace” for you also. It sounds like a lot of exercise, too – and that has benefits. Really glad that this job came to you, Julie!
Punny girl!
You are exactly the person that is so right working with those with dementia… Someone who can banter back and forth with them… Eventually you’ll likely end up with full time… Diane
Yes and I love it!
Julie the Angel…
BS!!!!!
Now that comment tells me you haven’t lost your sense of humour
I wrote it ‘specially for you!
Oh sun downers are a little frightening to be around , I have worked with them many years but on the feeding bathing and dressing side. Glad the walks help with anxiety
B. and O. become tormented at this time of day so the walks help a bit. But I leave feeling anxious for their anxious if you know what I mean and of course you do.
Yes, I do understand very well
Plenty of entertainment. Gives you a little lift amid the sadness.
I have decided to combat their sadness this way. Sometimes it works and sometimes it doesn’t so I’m learning to go with the flow (with Anthony too).
Those walks sound like a splendid idea, a target for you and the goodness of the outdoors to give them pleasure.
There are a couple of women who almost never get outside so I’m glad to have discovered that I am allowed to do this wheelchair walking – wonderful!
what a gift these walks are for them, and for you as well. i love the conversations and the time you take with each of them, enjoying them for who they are. i agree about the slow wheeled walks helping to calm them, exactly as it is at the beginning of life, with little ones calming in a stroller.
I wish someone would invent a wheelchair where the wheeler and the wheeled could face each other!
I dont know whether smiling is right, but I admire patience… 😉
Smiling and patience – an exact tune!
The residents will fairly love their walks. They will love you for them.
When I was a student I worked in an NHS nursing home and used to take the residents out in their wheelchairs. You get used to knowing how fast each resident wants you to push them.
I found things which we find easy really annoying like people who park on pavements and make passing difficult and trying to cross roads with kerbs – finding a dropped kerb can be quite difficult.
When I started taking the residents out I found that a lot of them wanted to be wheeled about so I spent most of my time doing this except when it was lashing with rain. You may find that there is a queue of people wanting taken out now, Julie!
Ah, I will use your experience as an example!
It suddenly occurred to me, while reading this, why in the evenings I feel a huge weight of guilt if I am sitting down. The need to be doing for our families never leaves us….. I love your words Julie. There are SO many people you should be teaching on how to treat family members with dementia or Alzheimer’s.
I think that once we get over the confusion thing it becomes quite easy to just go with the flow. Plus respect. I wish I could fast track a book about how easy it is to give comfort to people with dementia – just a hug or kiss or handshake is enough to provide joy.
And just accepting where they are, and giving comfort by redirecting. I wish you could fast track it as well Julie.
Sounds like wheelchair walking is a brilliant routine (and I wonder if the Nursing Home know what a treasure they’ve got in their new ‘driver’).
You are such a Treasure, Julie.
Wanna come ‘east’ when I get old(er)?
V
x
On my way!!!!
Walking with you is ALWAYS a winning experience, Julie.
Thanks!!!
YOU are the winner, Julie!
Yes! So far this new role has been amazing and it is wonderful to be able to have the simple role of entertaining one and/or all of these ten fantastic women.
I couldn’t agree more with everyone’s comments here. You are a visiting angel if there ever was one. xoxo
Thanks but no way am I an angel because an angel is someone who does stuff she/he doesn’t want to do whereas I am loving this whole thing.
Don’t let that fool ya Jules….just ’cause you like it doesn’t mean you ain’t wearin’ wings! You, my friend, are one of the angels walking this earth! xo
That book you’re writing, or putting together from posts, will be invaluable. There’s so much for others to learn from you and your real and loving manner in dealing with all of this. Sending a big cyber hug. ❤
I am onto the book idea but progress is slowww!
You took me back to walks with my mom. Thanks, Julie. x
Thank YOU!
I think you are a wonderful wheelchair walker!
I AM – hahaha!
It is a wonderful thing you are doing for these people as it helps to ease their mind and help them feel content.
I am still amazed that this is a paid position!
All I could do is smile when I read this post, Julie. You came to them uniquely equipped to minister to these folks, and it seems to be serving you as well. xo
Exactly!
It must be keeping you pretty fit too which is a bonus….even at slow speeds.
Yes, those hills are a bit of a challenge for my middle-aged legs, especially if the person in the wheelchair is a biggish person!
Those conversations are priceless! I can’t walk slowly, I try but it is soooooo hard. lol
I have to do the 1,2,3,4 thing in my head in slow motion!
Kind of like dancing but it must still be pretty hard. You are most definitely a trooper! Hugs Jules 😀
I can assure you, you’ll learn to walk slowly (and Mindfully) when you wear your feet out as I did, Laurie.
My nearby Olympic Park Sports Physician said I had the feet of a top athlete (with all the power walking I did about 10 years ago) – the fat pads under my feet are no-pads-at-all any more. 😀
Wow, you definitely have a point, I haven’t yet had that experience but I know that I will in the future and I’ll be thinking of your wise words.
I’m sorry I haven’t been able to keep up with everything but this is remarkable, both your abilities assisting and your deft description of your encounters. Also amazing you can cover all that distance at such a slow pace.
What a wonderful thing you’re doing!