by Starr, Faith
Lizzie squeezed my hand tighter. “Did I say something wrong?”
“Yes. As a matter of fact, you did. You compared me to a Jonas brother. Uncool, Lizzie. Uncool.”
Mason cracked up. Jonas hid a smile. Nick glared at her.
“Nobody has ever said that to you before?”
I gave Lizzie props. She held her own with Nick.
“Maybe.” Nick shrugged.
“I like her. I vote yes.” Mason approached and held his hand out to Lizzie. “Nice to finally meet you. I’m Mason.”
“Nice to meet you too, Mason.”
“Fine. I’ll agree too. She has balls. She spoke up to Nick. That has to count for something.” Jonas also shook her hand. “It’s nice to meet you, Lizzie.”
“You too, Jonas.”
“You’re all traitors. The entire lot of you.” Nick waved his hand at all of us. He then came over and shook Lizzie’s. “Nick Reynolds. Not Nick Jonas. Not Ryan Reynolds. Got it?”
She nodded and shook his hand. “Nick Reynolds. Got it. Lizzie Shine. It’s a pleasure to meet you.”
“Sunshine. That’s your new name.” Nick nodded in agreement at his choice of words.
“Sunshine?” I repeated.
“Yeah. She managed the unmanageable. She put a smile on your fucking pouty face. Lizzie Shine. Sunshine. Same difference to me.”
“I’m good with it,” Lizzie agreed.
“Great. Now would you mind if we got back to work, Sunshine?” Nick resumed his usual spot in the far corner.
“Why don’t you sit here, babe, next to me?” I pulled an empty stool over to the side of my keyboard. “We’re rehearsing some of our newer stuff.”
I had specifically told the guys I didn’t want to play the song we had practiced earlier. I wanted it to be a surprise for Lizzie.
“Sit next to me, babe,” Nick mumbled. “Christ. This is how it’s going to be now. Lovey-dovey shit and pet names…” he continued with his rant.
Jonas overshadowed Nick’s whining by strumming his guitar. “Let’s do it.”
And we did, for another two hours before we called it a day.
32
Lizzie
“I agree that your grandmother isn’t herself. The aides informed me she’s been having accidents during the night. One of them also reported that she tried to hit her last night.”
Since when had my grandmother been wetting the bed?
Dr. Haynes, the internist who monitored the memory care residents’ physical health, met with me after examining my grandma. It was a good thing too because the aides hadn’t told me anything about these sudden changes. Then again, why would they? They didn’t know I was her granddaughter.
“I was unaware she was having accidents.”
“It’s been documented.” He scrolled through the progress notes in her medical chart. “From what it says here, it’s happened on several occasions in the last week alone.”
“Hmm. Maybe she has an infection. I’ve learned from being here that people with dementia can get irritable when they don’t feel well or when something is going on that they can’t verbally express to others.”
“I’ll order blood work to see if any of her numbers are abnormal.”
“I’d appreciate that. I also wanted to mention that I’ve noticed bruises on some of the residents’ arms.”
“Many of the patients are on blood thinners. The slightest bump can cause a bruise.”
It was more than that. I felt it. My grandma sported a bruise on her wrist that hadn’t been there the day prior.
“It could also be because when residents act out, aides restrain them inappropriately.”
He eyed me warily. “I’m not going to go there. If you have an issue with the aides, bring it up with Maria or Tabitha.”
I didn’t respond.
He scribbled a script for my grandmother. He tore it off his prescription pad. “I’ll go ahead and submit the order for Mimi to get her blood drawn. I’ll let you know if I find anything.”
“Thank you. I appreciate it.”
Since I had a few minutes to kill before my shift began, I took Dr. Haynes advice and spoke with Tabitha.
“Good morning, Lizzie.”
“Good morning. Dr. Haynes informed me that my grandmother got agitated last night. She also has a bruise on her wrist. Is there an incident report in her chart?”
“I didn’t see one when I reviewed it this morning.”
“I find it interesting that when certain aides work the night shift, some of the residents have new bruises in the morning?”
“What are you insinuating?”
“I’m simply asking you to look into it.”
“I’ll address your concerns. I’ll review the charts again. Let’s not jump to conclusions, though. Now that I’m aware of the issue, I’ll be more mindful to keep a log.”
As the head nurse, she should have been doing that all along. It shouldn’t have been my job to protect the helpless residents—another reason why I hated to leave. I was always on high alert and as a result, was a ball of tension by the end of the day.
The hours went by like minutes. My grandma became agitated during our morning activity to the point she was given a sedative, the center’s protocol for residents who became a danger to themselves or others. In my opinion, my grandma hadn’t been. She was merely fussy and irritable. Big deal. She would have simmered down. She always did.
After given the medication, she slept through lunch and the rest of the activities. Drug ‘em and move on. Grrr! It infuriated me.
During my lunch break, I did research on my phone about my grandma’s symptoms. I checked out Alzheimers.Org. Sure, it was a UK website, but Alzheimer’s was Alzheimer’s no matter what country the patients lived in. I skimmed through the site and read about urinary tract infections or UTI’s and Alzheimer’s.
‘UTIs can cause sudden confusion (also known as delirium) in older people and people with dementia. If the person has a sudden and unexplained change in their behavior, such as increased confusion, agitation, or withdrawal, this may be because of a UTI.’
That had to be it!
Upon reading further on a different website, I discovered that a urinalysis and ultrasound should be performed to rule out a UTI and that incontinence could be a warning sign of one.
Why didn’t Dr. Haynes pick up on that and order those tests? A blood test wouldn’t reveal the incidence of one.
The site also said the person suffering should drink lots of fluids. Kind of difficult when the benzodiazepine Tabitha had given my grandma made her a zombie.
Feeling my own sense of agitation, I returned to work. I asked Tabitha to reach out to Dr. Haynes since he had left to visit another local center. I wanted him to order a urine culture in addition to the blood work.
Before leaving, I checked in with her to see if she had been able to reach him.
“Dr. Haynes informed me that he’ll order a culture during next week’s visit. He wants to wait for the blood work to come back first. I’ve taken it and sent it off to the lab.”
“If my grandma has an infection, waiting a week will only allow it to get worse. Please put in a call to him. I’d like to speak with him directly.”
“I’m sorry, but you’ll have to call his office and leave a message for him. This is personal. It’s between you and the doctor, not the center and the doctor.”
“It should be between the center and the doctor. One of their residents might have an infection.”
Her annoyance didn’t faze me because it couldn’t top mine with her, Dr. Haynes, and the center as a whole at the moment.
“I’m not the prescribing physician. I’m simply following his orders and doing what he requested.”
For God sakes! It was like talking to a brick wall.
“Fine. I’ll call his office myself.”
I stepped away from her desk and made the call. I didn’t hear back from the doctor’s office until hours later when I was alread
y at Carly’s sorting out my stuff. I had told Ryan I wanted to get myself organized before bringing anything to his apartment, something he had talked me into. It wasn’t a difficult decision to make being Carly had a prospective roommate coming to see my room the following day.
Dr. Haynes agreed to have the nurse do a dipstick test on my grandma’s urine. From what I read online, it wasn’t the most accurate means for diagnosis. Sending the specimen out for a culture was the ideal; therefore, his decision wasn’t acceptable to me. I had to let him know I wasn’t a puppet. I wouldn’t back down when it came to my grandma’s health.
“I understand your worry about your grandmother. Her lab results should be back in the morning. I’ll have Tabitha do a urinalysis, and we’ll go from there.”
Still not good enough.
“Please ask her to send the specimen out.”
“Are you telling the physician how to treat the patient?”
High and mighty, wasn’t he?
In this case, I had a gut feeling. It usually led me in the right direction.
“I’m not telling. I’m asking.”
“Fine. If it makes you happy, I’ll fax orders requesting that the urine be sent out.”
“Thank you. I appreciate you hearing me out and respecting my wishes.”
He disconnected the call. I didn’t get why he was so against my suggestion. It wasn’t like I had asked him to get her a new kidney or something.
In addition to stressing about my grandma, I was also preoccupied with Ryan’s upcoming departure which was a few days away. His manager wasn’t keen on the idea of me joining him on tour. Ryan pretty much gave her an ultimatum, and she caved. I hated that he had to make a threat to bring me on board. The last thing I wanted was to bring strife on the tour bus or between the members of the band.
Maria was actively searching for a replacement for me. For the time being, I was perfectly content being at the center because it enabled me to keep a closer eye on my grandmother.
The following day, she was totally out of sorts. She hadn’t come out of her room. She had missed breakfast and after questioning Tabitha, I learned she hadn’t eaten dinner the previous night either.
“Was the same aid on shift the last two nights?”
Tabitha swiveled in her seat in the glass-enclosed office. Her gaze met mine then she glanced at the window to address Seymour at the half door. The bottom portion was locked to keep residents out. The top remained open, so the nurse on duty could both see and hear what was going on in the main area.
“I can’t find my car keys.”
“I’ll ask Nilda to find them as soon as I finish with Lizzie.”
“I have a poker game tonight. I don’t want to be late.”
“You won’t be. Please have a seat on the couch, and I’ll ask Nilda to find your keys.”
“Thank you. I would appreciate it. I’d hate to miss the first game.”
Seemingly pacified, he sat on the sofa facing the window. A show playing on the television caught his attention. The lost key crises had been averted.
“What were we discussing?”
“I had asked if the same aide worked the last two nights.”
“Right. The answer is no. It was the first thing I checked when I arrived. I did see a note in Mimi’s chart that said she was hallucinating and had to be restrained.”
“What!”
Tabitha motioned with her hand for me to keep it down.
Sorry, Charlie. No can do.
“Why wasn’t I called?”
“Hallucinations are part of the process. You’re well aware of that.”
“Still. I would have come in and taken care of her.”
“I understand your concern but—”
“Do you? Do you really? You don’t have a family member living with this horrific disease.”
“Please lower your voice.”
“Hello.”
Christ. First Seymour. Now Irma. In my current state, I couldn’t deal with her or any other patient. There was a private door in Tabitha’s office that led to Maria’s. I used it because I wasn’t getting anywhere with Tabitha.
“Is everything okay in the unit?” Maria asked from behind her desk.
“No. It’s not. My grandmother hallucinated last night and had to be restrained. I’m sure if I hadn’t questioned Tabitha this morning about my grandma’s condition, I wouldn’t have been old about it either.”
“We don’t call family members unless there is a medical emergency.”
“I work here, Maria. It would have been respectful for the aide on shift to call me.”
“Not everyone is aware your grandmother resides here, remember?”
Yeah, I remembered. The interesting thing was I was listed as Mimi’s emergency contact. Nobody had ever picked up on that tidbit of information. Unbelievable.
“In addition, the night aides are told to call family members only in cases of an emergency. Those are the rules.”
“The fact my grandmother’s health is deteriorating with every passing minute counts as an emergency to me.”
“I am aware that Dr. Haynes faxed orders for a urine culture to be sent out. Tabitha has taken care of it. We are still waiting for the results of her blood work. These things take time, Lizzie. You have to trust that we are on top of it and that Dr. Haynes is monitoring her condition.”
Monitoring her condition? Little did Maria know I had played doctor and told Dr. Haynes which test to order.
“In the meantime, she’s not eating or drinking. She’s going to get dehydrated.”
“I’ll have Tabitha check on her.”
What would that do? Shit. That’s what it would do.
Once in the unit, I went straight to my grandmother’s room, stopping in my tracks upon entering.
My grandma may have been sleeping but her hands were floating upward. It was the most bizarre thing I had ever witnessed. Was she dreaming?
Her blanket shifted. I went to cover her exposed leg when out of nowhere she socked me in the arm. Ouch! It hurt like a bitch too.
“Get away from me!” she screamed; eyes open. She looked at me. Rather, through me. She didn’t recognize me.
“It’s okay, Grandma. It’s me, Lizzie.”
“Get away from me!” Her arms flailed.
Fear engulfed me. I ran to the nurse’s station to get Tabitha.
“Lizzie, you’re supposed to be doing an activity with the residents. What’s going on?”
“I think my grandma is hallucinating again. She screamed at me to get away from her and punched me.” I held the side of my arm to ease the discomfort. For such a frail woman, my grandma sure had a right hook on her. It would definitely cause a bruise. “Please come check on her.” My foot bounced. My heart pounded. I kept picking at a piece of loose skin next to my thumb nail.
“While I do that, please get to work.”
“I’m calling in sick.”
“Excuse me?”
“You heard me. I’m taking a sick day.”
“You better tell Maria. She’s not going to be okay with this.”
Who cares! My grandmother was my number one reason for being there. She came first.
“Fine. I’ll tell her. Now please go check on Mimi.”
We went our separate ways.
“What is it now, Lizzie?”
So much for her open-door policy bullshit. “My door is always open for you to come and discuss any concerns or issues you have.”
“My grandma isn’t doing well. Tabitha is checking on her as we speak. I’m taking a sick day.”
“You have a job to do. I’m sure Tabitha is more than capable of watching over your grandmother.”
“Ryan paid for Mimi to be here. I’m no longer held by a leash. You’re paying me minimum wage to bust my ass, a salary I can barely cover my expenses with. If you want, fire me, but I’m taking a sick day. I’ll be in my grandma’s room. You can have someone else fill in for me.”
Her mouth fe
ll open. “You should be grateful for all I’ve done for you and Mimi.”
“I am grateful. Beyond grateful. But it doesn’t mean I have to be taken advantage of either. I’ve given my all to those residents and you know it, going above and beyond what is expected of me. Today my grandma needs me and I’m going to be there for her.”
“And the residents need activity. If Tabitha is concerned about Mimi, I’m sure she’ll reach out to Dr. Haynes.”
I shook my head. Nothing she said would persuade me to change my mind. “Before I came along, it had been weeks since the residents had been entertained. And now you’re worried about one day? What about on the weekends when all they do is sit in front of the television? I’m sorry, Maria, but right now my grandma needs me.”
“I don’t appreciate your tone, Lizzie.”
“And I don’t appreciate being disrespected. I’m all my grandma has and I’m going to take care of her. I’ll be in her room.”
I stormed out of Maria’s office and went straight to my grandma’s room. Lo and behold, things had gotten worse.
“I’ve called for emergency services.”
Tabitha stood next to the dresser, keeping ample distance between her body and my grandmother’s.
“Why, what happened?”
There my grandma was, in her bed, in a comatose state. Both her hands and feet drifted upward as if possessed. It scared the hell out of me. In all my time at the center I had never actually witnessed a patient experience a hallucination.
“When I came to check on her, her bed was wet. The urine must have soaked through her undergarment. She was resting peacefully, but I didn’t want her lying on a wet bed. I went to clean her, and she attacked me.”
Because you woke her up!
“I restrained her and called for one of the other aides to assist. I gave Mimi a sedative to help calm her down. It should kick in soon.”
“My God. That damn doctor should have checked her urine sooner! I know it has something to do with it.”
“The paramedics are en route. I’ll stay until they get here,” Tabitha said.
“So will I. I’m not leaving her for another second. I plan on going to the hospital with her too.”