We had nurse practitioners (NPs) across the country submit a story from their professional experience that celebrates their career. Here is one of the winning stories:
Anyone who has worked in a Skilled Nursing Facility (SNF), Assisted Living Facility (ALF), or even Independent Living Facility (ILF) knows the difficulties of working and caring for patients with Dementia and memory deficits. I could give you all kinds of statistics about the disease. I could provide information about progression and staging and all the associated health conditions, but it boils down to a one-on-one challenge for the nurse and the patient. Challenge is the most common denominator in any conversation about the disease.
The challenge of diagnosis, acceptance, treatment, care options, family interactions, emotions, and empathy all leave an imprint on those involved. Trying to keep the patient healthy, safe, and happy is a never-ending story. Several years ago, I was sitting in my office giving an interview to a young communications student from a local university. I was working as the in-house Nurse Practitioner for a moderate sized SNF. He was sitting in my extra chair with his voice recorder on, trying to put together what he had told me was his final Senior Project: “Music from the Past”.
He wanted to talk to several residents about the music from their days as teenagers and young adults, asking how they felt about their favorite songs and what the songs made them remember. He was trying to draw some parallel emotions and thoughts between the “oldest and the youngest” emotions about music. A lovely thought. Goodness knows I remember my music from those times in my life. I was trying to explain to him some of the problems many of my residents have with memory and prepare him for some things he might encounter during his talks with them. He nodded his head quickly, and was apparently in a bit of a hurry to get started. He said that his grandfather had Alzheimer’s Disease and that he knew what to expect.
It is almost as difficult to talk to someone who knows “a little” about a condition as it is to talk to someone with memory deficits. They know what they know. Experience teaches the young, not words; and reminders help the ones with memory issues. Both require a great deal of patience. So I shut up and started the facility tour with him.
“Trying to keep the patient healthy, safe, and happy is a never-ending story.”
He had permission from several families to speak with the residents, and I walked around with him, greeting and introducing him to the residents. Most had moderate memory issues, but they seemed to be able to remember some of the songs that he played to them. They swayed or hummed along. One even got up to dance a little. The songs were from the 40s and 50s, Big Band mostly. He had a lot of questions to ask, but most of the residents tired of them, and talked on tangents.
I could tell he wasn’t getting all the information he felt he needed, and his frustration was showing a little. He said, “This is quite a challenge, isn’t it?” I just smiled and nodded. We came up to our last interviewee, a resident in the last stages of Dementia. He was unable to feed himself, spoke rarely, needed total physical care, and was failing on all levels. The student made several attempts to talk with him, played him a few songs, and patted his hand, but he could not elicit any response.
On a hunch, I started singing an oldie I knew was probably from this resident’s childhood. “You are my sunshine, my only sunshine. You make me happy when skies are gray. You’ll never know dear, how much I love you. Please don’t take my sunshine away.”
At the second verse, this resident, who rarely spoke, began swaying a little in his wheelchair, and singing the song along with me. When I say “second verse”, I mean we repeated the first verse again. I didn’t really know the second verse. I will also not pretend that we were making lovely music, just an old nurse practitioner and an older resident, singing at each other. However, by the third verse, the student was singing along as well, and we were attracting attention from the nearby Nursing station. The fourth verse, we let the resident sing by himself, and he smiled as he was applauded by the small audience. Then he stopped and retreated back into his own world again. The student was in a state of amazement.
He said, “OMG, I’m so glad I got that on tape!” God knows, that was a moment I’ll never forget. I still get tearful when I remember the resident’s smile and raspy voice. The student’s reaction was priceless as well. I thought, at that time, “What else in the world would I rather being doing at this moment?”
“That was a moment I’ll never forget. I still get tearful when I remember the resident’s smile and raspy voice.”
Yes, it is sad that the resident had such a horrible impairment. And the song itself is sad. However, I felt, at that time, we had given that resident a little gift of memory for a short time. I felt that the student also received a small portion of what I believe is the daily gift for nurses and caregivers; the ability to direct sunshine into the lives of our memory impaired patients who have very little, and being able to bask in its reflection. A challenge for us all.
YOU ARE MY SUNSHINE
Credited to Davis & Charles Mitchell 1940, however it is well known as a folk song from decades prior:
You are my sunshine, my only sunshine
You make me happy when skies are grey
You’ll never know dear, how much I love you
Please don’t take my sunshine away
The other night dear, as I lay sleepin’
I dreamed, I held you in my arms
When I awoke dear, I was mistaken
So I hung my head and I cry
You are my sunshine, my only sunshine
You make me happy when skies are grey
You’ll never know dear, how much I love you
Please don’t take my sunshine away
You told me once dear, you really loved me
And no one else could come between
But now you’ve left me and you love another
And you have shattered all my dreams
You are my sunshine, my only sunshine
You make me happy when skies are grey
You’ll never know dear, how much I love you
Please don’t take my sunshine away
I’ll always love you and make you happy
If you will only say the same
But if you leave me to love another
But you’ll regret it all some day
You are my sunshine, my only sunshine
You make me happy when skies are grey
You’ll never know dear, how much I love you
Please don’t take my sunshine away
Please don’t take my sunshine away
