Those of you who have ever undertaken Safeguarding training with me will no doubt remember Albert (who could forget that humorous old Lothario with his Sunday Sport!). Albert came to me one day as a way of answering a delegates question about the principles of the Mental Capacity Act, and how we test for capacity, and put simply, he just never left. Now a staple of my adult safeguarding sessions (he even gets his own chair!), he has a new mate I expect to be hearing a lot more from, who was introduced to me last night. In a dream, as it happens….
‘Stan’, (he doesn’t like being called ‘Stanley’…only his mother calls him Stanley…) is another 82 year-old, a veteran of the first world war trenches, afflicted, as it turned out, with Alzheimer’s disease and PTSD. ( I know the math doesn’t add up….it was a dream, remember?).
Stan was recieving 1:1 care, as, still rather sprightly, he would try to move everywhere at double-speed but was at high-risk of falls. he would frequently crawl around the ward on all fours, much to the annoyance of other patients and some of the more ‘Old school’ staff. Not much of a talker when I first encountered him, but this is where the magic began. In this dream, I was back at St. Mary’s Hospital, In Hereford, where I trained as a nurse, and was caring for him in my dressing gown with no underwear on (as you do!). We were taking a rather ambitiously rapid stroll around the grounds when Stan suddenly dropped to his knees and rolled into cover behind a low hedge. No amount of encouragement or cajolery would get him to his feet again, and so I did what any experienced psychiatric nurse would do under the circumstances – I dropped to the ground beside him and continued to follow him along the hedgeline on all fours, whispering and calling to him “Stan! Stan!….What the hell are we doing?”
That’s when I heard him speak for the first time. “Enemy troop movement!” he hissed back at me. I poked my head up to peer over the hedge, seeing only other patients and nurses milling about some 100 yards distant. A gnarled, 82 year-old hand yanked me back down unceremoniously to the ground beside him. “Keep your head down! We’re out of ammo!”
Hell….we didn’t even have a rifle between us, let alone ammunition.
That’s when I got it. When you work with these guys, somehow, you just do.
Long story short, we circuituously arrived back on the ward, where Stan, still afraid and feeling lost, billeted himself under a stout dining table, not shaking, but very quiet. I got under it with him, and stayed with him until the storm had passed. Nothing was said. There was nothing TO say. I called out from under our erstatz fort, and organised for us tea and biscuits, and we sat there in silence consuming them, Stan staring into some internal distant horizon and experiencing a brief quiver every now and then.
Memories, I guess. And not very good ones.
I don’t recall how or from where I obtained them, but this was Hereford, with plenty of military supply shops, and I acquired an olive green ammo pouch and a clip of five de-activated rifle rounds, which I presented to him. His face lit up. No words. His apparent relief said it all. And from that moment on, until the dream ended, Stan and I were firm freinds, he became a kind of ‘protector’ to me, which was kind of nice, if I’m being honest.
Ok, I know it was just a dream, but it demonstrates two things, firstly; for those living with dementia, you have to enter THEIR reality to be effective. Do not expect them to come into yours. Secondly; it doesn’t take much to analyse the situation and take steps to work with it. You just have to look with different eyes, hear with different ears, and feel.
Stan exhibited perfectly natural reactions for one who’d lived it. The use of cover. Stealth. Fear. The return to his billet under the table in the trenches. The terror of being powerless and unarmed in enemy territory. To him, this was real, and so it became to me.
Some of you may be thinking…“Ah…How sweet”. Well, I’m not the hero here, Stan is. He and the millions like him that suffered in silence and returned to a home that was anything but the always promised “Home fit for heroes”.
That ammunition pouch and a few shop-bought deactivated rounds gave him that security blanket that we all need from time to time and he knew it would keep him safe. I knew it would keep him safe.
I entered Stan’s reality in my dream. He entered mine when I awoke. And I hope to see and hear a lot more from him in our dementia training.
Welcome aboard, Stan. Do NOT, under ANY circumstances, drag Albert off to the pub.
SEED Training 