I hope this tale prompts a smile of recognition - "I've experienced something similar".
J's consultant has always remarked that her communication is better than would be expected based on the various cognition test scores. A close friend who is a retired Prof. of Linguistics has remarked how skillfully J. uses stock phrases and covers over her difficulty in finding the right nouns.
Huub Buijssen in his brilliant and helpful book, "The Simplicity of Dementia" notes, "It costs someone with dementia tremendous effort to put a good sentence together and in order to cope as best (s)he can (s)he, quite understandably, retreats into a series of automatisms and standard phrases" (p.78).
J. needed a blood sample taking (for a kidney function test recommended when taking Lisinopril for elevated blood pressure) and a cervical smear. Our GP practice has different nurses for these two tests. Using the internet-based appointment-booking system, I organised for both tests on the same morning with an hour between to enable us to go to a local tea room for elevensies.
The "blood nurse" opened J's file on the computer and checked key information - name, address, date of birth etc. "Quite right", said J. when asked if each element of information was correct. The information was duly transcribed to the paper form that would go with the sample for testing.
The "smear nurse" had J's file open on the computer but asked J. for the relevant information piece by piece. "Maiden name?" she asked. J.s face showed total panic as she turned towards me. I doubt if she understood the concept. I provided the answer. "Date of birth?" asked the nurse looking at J. I provided that answer followed by J. saying quite firmly, "That's quite right." The nurse continued asking J. the questions and taking the answers from me. Everyone was relaxed and happy.
Once the test was over - and it went well with less hurt than J. expected (she had a vague memory that smear tests were "not nice" and the nurse had remarked at one point that she was using a slightly new procedure that was more comfortable) - J. started to dress. Panic again; this time in her voice. I asked if she needed help, knowing that she did. The nurse watched with a warm, sympathetic smile and much patience as I prompted J. on how to get fully dressed (our procedure to help her do as much herself as she possibly can).
As goodbyes were said, J. went to the nurse. "You did that very well. Thank you" she said and promprtly gave the nurse a big hug and a kiss. One nurse with very tearfilled eyes and, I suspect, a huge lump in her throat struggled to say a simple "goodbye".
J's consultant has always remarked that her communication is better than would be expected based on the various cognition test scores. A close friend who is a retired Prof. of Linguistics has remarked how skillfully J. uses stock phrases and covers over her difficulty in finding the right nouns.
Huub Buijssen in his brilliant and helpful book, "The Simplicity of Dementia" notes, "It costs someone with dementia tremendous effort to put a good sentence together and in order to cope as best (s)he can (s)he, quite understandably, retreats into a series of automatisms and standard phrases" (p.78).
J. needed a blood sample taking (for a kidney function test recommended when taking Lisinopril for elevated blood pressure) and a cervical smear. Our GP practice has different nurses for these two tests. Using the internet-based appointment-booking system, I organised for both tests on the same morning with an hour between to enable us to go to a local tea room for elevensies.
The "blood nurse" opened J's file on the computer and checked key information - name, address, date of birth etc. "Quite right", said J. when asked if each element of information was correct. The information was duly transcribed to the paper form that would go with the sample for testing.
The "smear nurse" had J's file open on the computer but asked J. for the relevant information piece by piece. "Maiden name?" she asked. J.s face showed total panic as she turned towards me. I doubt if she understood the concept. I provided the answer. "Date of birth?" asked the nurse looking at J. I provided that answer followed by J. saying quite firmly, "That's quite right." The nurse continued asking J. the questions and taking the answers from me. Everyone was relaxed and happy.
Once the test was over - and it went well with less hurt than J. expected (she had a vague memory that smear tests were "not nice" and the nurse had remarked at one point that she was using a slightly new procedure that was more comfortable) - J. started to dress. Panic again; this time in her voice. I asked if she needed help, knowing that she did. The nurse watched with a warm, sympathetic smile and much patience as I prompted J. on how to get fully dressed (our procedure to help her do as much herself as she possibly can).
As goodbyes were said, J. went to the nurse. "You did that very well. Thank you" she said and promprtly gave the nurse a big hug and a kiss. One nurse with very tearfilled eyes and, I suspect, a huge lump in her throat struggled to say a simple "goodbye".
