The Alzheimer’s Unit

A Smile is Enough

As I sat reviewing my patient’s chart, I stopped to look at what was going on around me on the Alzheimer’s Unit. Music from the Big Bands era blasted from one end of the room. Geri-chairs and wheelchairs lined the walls. Chairs from neighboring tables had been pulled up to fill in the circle. Activity directors danced around the center of the circle, clapping their hands and encouraging the residents to do the same.

What’s wrong with that? I questioned. Everybody needs social interaction and stimulation. The problem was not with the residents and their distinctive personalities, nor with the activities. The problem was with me. I was overwhelmed by the fact that these people were content to stare into space and occasionally clap their hand. My own grandmother, of comparable age, was planning her trip to New York City.

It hurt me to see someone confined to a wheelchair, disoriented and requiring total care, and knowing that no matter what I did, this person would never get better. I was shocked to see a former kindergarten teaching yelling obscenities at everyone who walked by. I didn’t know whether to laugh or cry wen a woman told me, “Today is the first day of school, I’m starting first grade.” When I asked another what she was doing tapping the table top she replied, “I’m trying to get away because he’s beating me.” With this, I almost did cry.

One patient affected me more than she’ll ever realize. She taught me, as a student, I would have to assess my own feelings and experiences, come to terms with them, and then put them aside when I entered a patient’s room. Miss King was ninety years old, confined to a wheelchair, and required total care. She was a beautiful woman, always armed with a smile for anyone willing to take the time to speak to her.

When I first began taking care of her, I was overcome with hopelessness and depression. As I struggled with my internal turmoil I came to realize that sometimes making someone smile is enough. By accepting Miss King and her situation, I was able to give her and others something they could never have too much of — dignity and love.

When a ninety year old woman like Miss King thinks she’s sixteen, you can tell her how beautiful her hair looks in the braid she’s wearing to celebrate an occasion. If a patient is crying for help to escape an invisible persecutor, sitting and holding her hand will let her know that someone still cares and may free her if only momentarily from her hears. When a patient is losing self-esteem along with physical disabilities, every accomplishment, no matter how trivial, can be considered praiseworthy.

Though it was a very difficult lesson, I learned that in a situation where the patient is not going to improve, I do not necessarily have to give up my ideals. I have learned to rechannel them so that I can focus on the fact that I am able to make someone smile or put a twinkle in her eye, even though I am not able to make her understand that today is not December 19, 1948.

Tori Brown Sheahan

Student Nurse, Riverside School of Professional Nursing


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