Goodnight, Elsie

by Tony Apperley

  As she was eating, a nurse arrived and said with a professional attitude, “good morning, Mrs. Herbert, shortly we are moving you to another ward. But you don’t have to walk. We will take you there while you lie in your bed. An orderly will arrive soon and push you to your new ward. You won’t have to get up or do anything, just relax.”

  Elsie just looked at her without any expression and said, “okay, just do what you do. I don’t care.”

  The nurse gave her a smile and walked away to let Elsie eat her breakfast. A short time later, the orderly arrived, accompanied by a nurse, to verify it was Elsie Herbert who was to get transferred. They always made sure who was being moved to another ward, or for any other reason, was indeed the one who the orderly was sent to get. Depending on who was being moved and why, and what their state of health was, sometimes a nurse would accompany the patient still in bed. But for Elsie that wasn’t required, she had no coronary issues nor was her life in danger in any other way.

  CHAPTER TEN

  The ward Elsie was now in was set up specifically for patients such as her. She was where she was to be monitored, tested, and correctly diagnosed. If she had gone to the clinic, she would have been in a similar place. And perhaps wouldn’t have ended up here with a broken leg. She didn’t feel as stressed here as she did in the other ward, this one felt more relaxed. She also noticed the age group of the other patients, which suited her. She was left in peace for the first day, but on day two she was approached by a doctor and nurse.

  “Hello Mrs. Herbert, we are going to perform a number of tests on you so we can sort out your illness. There will a number of verbal tests where we will ask you questions and take note of your answers. There will also be a few specific, physical tests done to determine your overall health. I have a note about your incontinence while you were still at home. We can see if that has a medical side to it or not. At one point, we will have you scanned. We know you have had a CT scan but we are going to give you an MRI scan this time, which may take some time as we want to take a good look at everything that bothers you. That will give us an in-depth look at what is actually going on. It will show us what is really happening in your brain and other parts of your body. We may also need to evaluate your spinal fluid, so will possibly need some of that. Do you have any questions you’d like to ask about what I have just told you?”

  Elsie was in a good state, feeling safe and calm, so was not at all concerned about the tests, “no doctor, I don’t, just do what you have to do. I’m okay with being here; I don’t mind what you do. I trust you.”

  “Very well then, I’ll talk to you again soon.” The doctor then left, but the nurse remained with her.

  She said, “the MRI scan frightens some people, so I just want to tell you what to expect. There’s nothing to be afraid of if you know what’s going to happen. You will need to remain still during the scan and you will need to breathe normally, so we’ll see how you are before we proceed. We may have to give you a sedative if you’re feeling a little twitchy. There are clicking noises going on while you’re being scanned, so we can give you ear plugs if you want. It’s a big machine that you will be inside of when you’re being scanned; it may take half an hour, or more, maybe an hour and a half depending on what they are looking at and why. I’m just telling you about it now so it won’t come as a shock when you go to have the scan. Anything else you need to know about, any questions?”

  Elsie looked a little worried about being inside a machine, “could Frank be with me when I have it?”

  “He can be close by, but not too close. He can wait for you in the same location, so you’ll know he’s there.”

  Elsie thought that would be good, “will you tell him about it when he comes to visit me? If he knows when it’s happening, I know he’ll come with me.”

  The nurse smiled at her and said, “yes, we’ll tell him about it. We’ll let you know in advance when it’s actually going to happen, but it won’t be today. I have things to do now, so I need to get moving.” She gave Elsie a compassionate look as she left. She thought she knew what they’d find with the scan.

  When Frank arrived later in the day, he was informed about what was to happen. He was grateful for being told what was to happen with her but didn’t give it too much thought. He trusted the medical staff to do what was correct for her. She was to be scanned in two days; he would be here with her when it happened. Coming here each day was to be his primary daytime activity now. There was not much else going on in his life at the moment; taking care of Elsie had become his main concern, but as she wasn’t at home now, he would be spending a lot of time here each day. He realized that he had gotten a little offbeat himself with his concern about her welfare. He knew he should have sought more advice about her. He had thought letting her do what she wanted to do when she wanted to do it, such as going out on walks alone, was an act of kindness in her favor. But now he thought he needed to keep a more watchful eye on her. Giving her the freedom to do whatever she wanted hadn’t worked out very well for them. She could have done whatever she wanted to do, but with someone keeping an eye on her. He could have been in the same street at the same time as her, not too far away.

  Two days later, it was time for her scan. They had given her a mild sedative as she had become tense, showing signs of stress the closer it got to her being taken to have it done. Frank was at her side. He walked next to her bed, holding her hand to help her stay calm as she was being taken to the scanning facility. She was pleased he was there, and with the mild sedative in her system, she was not as nervous as she had been. Once they arrived and she was being prepared, he went for a walk; he didn’t like the environment at all. He was not one who was interested in medical procedures. He arrived back after an hour of aimlessly walking around both inside and outside just as she was being removed and taken back to her ward. They had found what they were looking for, so that part of the process was done. Things were moving along so it shouldn’t be too long before her discharge now.

  The days seemed to pass quickly with him coming and going each day. He was not too interested in doing anything at home. He had been tidying up her garden a little bit at a time but that was all he did. He was feeling his age creep up on him more rapidly lately. While visiting her and seeing the other patients, he wondered how many of them were just filling in time before they passed away. While sitting at home alone each evening, he had been thinking about what life is all about, and if it was really our choice when to end it or not. He was in no hurry to do that.

  After just eight days in the ward, Elsie was given a discharge date, which was the next day. Things had gone smoothly with her assessments; everything they found out confirmed what they thought was her problem. They approached Frank one morning and informed him of her discharge, but said they wanted to talk to him before she left. He was to see them the following day at 1:30 pm for a discussion about her medical condition.

  Frank arrived not having a clue as to what he was going to hear. He would just have to accept whatever they told him. He was led into an office which didn’t resemble a consultation room, it looked more official.

  “After an in-depth analysis of your wife, we have come to a conclusion. Elsie is physically all right, the osteoporosis is stable, and not too much of an issue at this time. Her primary organs are functioning as they should be for someone of her age and condition. But I’m sorry to say, your wife has been diagnosed with having Alzheimer’s disease. It hasn’t progressed too far yet however, some of her memory loss and confusion may just be age related, although the Alzheimer’s will have a part in that. I suggest some brain stimulating activities may help to slow the progression. Her toileting problems are not physical; she may not be obeying her body’s warnings about such things. There is nothing more we need to do for her here as she is now physically well and is able to return home. Your own doctor will look at it and give you some feedback and discuss certain medications that may help her overall condition. Her leg will heal, but it may not
be as good as it was once. Breaks for senior citizens are not good. She was lucky that it was a clean, sharp break; a crush would have been much more serious. I would suggest to you that you get some help to take care of her. You’re not a young man anymore, so you need to get some assistance, depending on how you live your lives. But if she were to put pressure on you, then it would be wise to have someone else on hand to do certain things. I’m sure your doctor will want to discuss that with you. Well, that’s the way it is, Elsie Herbert has Alzheimer’s disease. You may take her home now, she’s ready and waiting.”

  Frank replied, “very well, I’ll do the best I can for her, and we’ll look at maybe getting in some home help.”

  “That would be good for you both; you need to take care of yourself also. That’s it then, we’re all done here. Good-bye.” As Frank left, the doctor noticed that he looked a little blank, he wondered about Frank’s health.

  As he was walking out to the ward, he got called aside and offered some advice on caring for someone with Alzheimer’s disease. It was mentioned to him to look at her normal likes and dislikes, and to allow her to feel at ease by not creating conversations that would confuse her, which she may forget. Keeping the home environment simple and safe would be a good thing for them both. Perhaps setting up certain routines would help alleviate the stress of having to make a choice if she got confused about certain things. He was also told there were community support groups he could contact for more in-depth advice. After hearing what he had been told, Frank thought perhaps he did need some advice now, he hadn’t taken it very seriously before. And he would occasionally forget what he had been told. Not because he was sick, it was just because he hadn’t clicked on to the seriousness of it all. But now, he would need to look at it more seriously as Alzheimer’s doesn’t go away, it was here for the duration of her life. It would eventually end her life, but that was a number of years away at this point.

  Frank entered onto the ward and saw Elsie sitting in a recliner chair laid back with her leg on a footstool. He walked over and got her up, a nurse approached and bid her farewell, while escorting them to the exit. Elsie had been given a single crutch to help her mobility; it was to be returned when the plaster cast came off. It was a slow walk to the car, but she managed all right as she had been given some practice sessions on how to use her one crutch. She only needed one as the break was on her lower leg and not too serious, the crutch just helped take the weight off and helped her stability. When they got to the car, Elsie showed no reaction at all, she just acted like this was normal. Frank helped her to get into their car, having her leg in plaster made it slightly difficult for her; he moved the seat back as far as it could go to give her room. To him she appeared far more stable than she had been. He wondered why that was; being in a hospital surrounded by strangers didn’t seem to have a negative effect on her at all. He thought perhaps the ward she had just come from may have been good for her; he assumed they knew what was best for people with dementia and broken legs. Or maybe it was just the medication that had settled her somehow. He couldn’t help but wonder if all this could have been avoided if she’d gone to the clinic for assessment and diagnosis. He thought he should have just taken her there.

  The drive home went well, with her happy to be heading home and she was talkative, just mildly so, but it was nice for him to hear her actually have a conversation. Although she did flit between different subjects, he thought that was all right, at least she was showing she had some life left in her. He also wondered if being in a situation surrounded by people of a similar age and condition had stimulated her mind somehow, maybe they needed to go out more. He would now perhaps ignore her earlier comments about not letting her live with a bunch of strangers; it had seemed to help rejuvenate her. Or perhaps she had been given the right sort of meals and without having to make decisions about her daily activities, she had become less stressed. He wondered if the accident had been a blessing in disguise, as she had now been tested and diagnosed. Now that he knew what was actually wrong with her, he could plan their future, or look at alternatives.

  CHAPTER ELEVEN

  Once Elsie had returned home, she felt she had been given another chance at life; she felt lucky. She knew the accident could have had a much more serious outcome. Although she felt like she had done well to survive it, she still wasn’t sure how it had all come about. She thought there must have been a crazed driver on the road as she couldn’t recall doing anything that would have caused her to be knocked down by a passing motorist. She couldn’t actually recall why she was in the street or how she had been hit; her knowledge was based more on what she had been told than what she could remember. It felt to her like the world was out of control, so she would just stay at home and not bother going on her walks now. But with her leg still in plaster that wasn’t even an option at this point. Although she had a crutch to help her walk, long walks around the neighborhood were not really possible. Besides her current physical disability, it had been suggested that she not go aimlessly wandering anymore. If she wanted to go walking then she should have someone with her. The thought that she could not go out alone now bothered her, but not too much, as part of her didn’t care anymore. Frank had said to her if she did go out alone without telling him she was going, he would start locking the door. He had also suggested that if she was bored and wanted to go out, then they could go for a drive around the district and perhaps explore some areas they weren’t familiar with. She didn’t like that idea; the walks for her were about looking at gardens and time alone.

  She now looked at things differently than before, but in both a more positive way and also more negatively depending on her mood and mind set. As the days wore on, she became content with being house bound, she had her magazines and the TV, so there was nothing more she needed. So now her attitude was a little different toward life, she just lived for the moment most of the time. There wasn’t a lot of thinking going on in her head at all.

  Frank thought about the idea of getting in a care-giver, or just home help. He decided he didn’t need either; he was doing all right running the household and looking after his wife, he didn’t need strangers in his home to tell him what to do. Frank wasn’t aware of it but he wasn’t thinking as sharply as he once did. Years prior he would have done what was necessary without hesitating, but now had a different opinion on what was necessary or not. His retirement had changed his outlook on life; he was now just casual about everything. With Elsie in a plaster cast, she was now no problem to him. She didn’t go out aimlessly walking the streets or mess things up trying to reorganize them, he knew where she was all the time now. He thought care-giving was easy; all he had to do was feed her and keep her safe.

  After several weeks of hobbling about and often having to ask Frank to help her, they returned to the hospital outpatient department to get her plaster cast removed, there didn’t seem to be any serious issues as the break had healed. Her leg would never be quite the same as before the break, however she didn’t feel damaged or sick, but she was. They entered in and gave their names and returned the crutch that Elsie had been using. She hadn’t needed it too much lately as her leg was working properly and could take the weight without hurting. They were told to take a seat and wait, they would be called shortly. Elsie got a magazine to read, so she was content and didn’t appear stressed or impatient.

  As they sat in the waiting room, a nurse appeared and called their names. Frank stood up but Elsie didn’t move. It appeared as if she hadn’t heard her name called. Frank said to her, “come on El, it’s your turn. You can get rid of that leg weight now.” The nurse walked over to them and said, “Elsie Herbert, we need you now, it’s time to remove your cast. It won’t take very long, but we will need to check your leg movement before you leave. Follow me please, and I’ll lead you through.” She looked at Frank and said, “you’re welcome to come through as well, I think that would be good, we approve of having a support person nearby.” Frank nodded to her and reached do
wn and took Elsie’s hand. He gently pulled her hand up, which caused her to stand up. The stool she had been sitting on was higher and wider than a normal chair, so it didn’t take much for her stand. They led her through to an area where there was a bed for her to lie on. She noticed some stainless steel buckets by the wall and some cutting tools stacked on a shelf and she was distressed by what she saw. She wasn’t feeling good at all about what was happening, she couldn’t piece together what she saw, what was happening or why she was there. The cutting tools were for removing plaster, the buckets for disposing of the removed plaster. But for Elsie none of it made any sense, her fragmented mind was playing tricks on her by messing things up in her head. The staff noticed she looked pale and afraid, so they were gentle but firm in their approach to her. They helped her lay on the bed, then set about cutting off the cast and freeing her leg. As the cast was being removed, Elsie looked like she was in another world. There was no expression at all. It wasn’t long before it was off and that part was over. After the cast was removed, she was asked to stand up, Frank helped her to get off the bed. She was then asked to take several steps so they could see how her leg handled the weight. It appeared to be functioning correctly; she didn’t stumble as it held the weight without cracking again. Frank was at her side in case she slipped and fell, a nurse was close by on the other side of her. She managed to take her steps without too much difficulty. She said she felt no pain, so he was happy with that. Her leg had been bound inside a cast for weeks, now it was free it might take a while to sort itself out. It shouldn’t take too long for it to recover though; the muscles should begin working again now her leg was functioning normally. After several steps and another quick analysis, the nurses told Elsie she could leave. But her leg didn’t feel right to her; it felt different than it did before she got hit, as if something had permanently changed now.