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Day 22: Volatility

Posted Dec 16 2010 8:07pm
Someone peed in a corner of Dad’s room.  

Lily discovered the puddle one morning during her daily visit to see Carter.  At first she thought the strong smell emanated from Carter needing a diaper change but after carefully checking, she realized the stench was closer to the window.  Shocked, she wondered how it had gotten there.  Carter was barely able to help lift himself into a chair next to his bed so there was no possible way that he could have mustered the strength to do this.  
Lily thought she might know the offender.  Raymond, the patient next door to Carter, had been a problem lately and it was possible that he had made this special scent-marking as an angry response to Lily.  Like many of the patients at Sunset, Raymond did not have any visitors and found ways to remind others that he still existed.   It was only a few days earlier that Lily had met him in the hall.  She was getting fresh linens from the nurses’ cart when she felt a presence behind her.  As she turned around, Raymond swung his long right arm extending it out from his six foot four frame.  He landed a direct hit on the side of Lily’s head sending her reeling.  While stunned, Lily was fortunate because the cart provided a wall preventing her from falling over.    Raymond’s has been a patient at Sunset Home for just over three years.  His dementia causes him to exhibit violent physical behavior combined with tourette’s style cursing.  It’s hard to believe that he was a paramedic in his previous life, where he spent his time responding to emergency calls from people in crisis.  Now Raymond passes his days isolated from the outside world, remembered by no one and tormented by unseen demons that precipitate angry outbursts.   Lily suspected that Raymond could also be blamed for stealing her wedding picture that used to sit next to Carter’s picture on a small shelf in his room.  When Frank came to visit a few weeks ago and noticed the missing picture, Lily joked that some stranger probably admired her beauty so much that he stole it to worship every night before falling asleep. Other than the remaining photo of Carter, all of the other pictures in the room were fixed to the wall. Erin made a collage with each of the kids’ pictures, Carters’ parents and a wedding photo to cheer Carter up when he felt lonely.  This was hung next to tacked individual calendar style pictures of water, mountains and markets that looked like scenes from eastern Canada.  They comforted Carter who increasingly  believed he was living in New Brunswick.  When Lily recounted the cart story to Maggie, who came to visit the day after, Maggie was warned.  Maggie insisted that she would speak with the doctor after today’s visit.  “He got me this time”, Lily boasted, “but it took three at bats.  I dodged two other near hits last week when Raymond swung at me as I left your father to go home.  I had lots of room in the hallway though and saw it coming dear, but this time I just couldn’t see it coming.” They were just getting settled when, speak of the devil, Raymond starts to wander into the room.    “Raymond.  Don’t come in here.  Go back to your room.”  Maggie spoke slowly and gestured a shooing motion with her hands hoping to gently guide Raymond back down the hall.   It looked as if he would go complacently after taking a few steps towards his door when he suddenly whipped round and swung at Maggie!   “Hey!” Maggie screamed.  “Stop Raymond. Stop. Get back to your room,” Maggie yelled  putting her arms up in front but trying to making direct eye contact with him to show she was not afraid.  Wrong move.  Like some wild animal provoked to attack, Raymond’s eyes were on fire as he lunged at her a second time.  Maggie wasted no time after that.   She found herself running towards the elevator door, to get away and hopefully to lure Raymond away from the room - away from Lily who by this time was frantically buzzing the nursing station.  Knowing she could outrun him, Maggie comically imagined Raymond diving at her, both feet airborne and arms stretched upwards in flight, trying to kick her ass!  Part of Maggie was really afraid but she settled down as the distanced between them grew.  Maggie’s fears for Lily’s safety increased now, as she considered Raymond’s unpredictability.  What if Lily was cornered in Carter’s room with no where to run or hide? Meanwhile, Raymond is wildly cursing at Maggie.  He is shuffling towards her furiously and nodding his head as he yells: “Get the f*** out of her you dirty s***!  You’re a f***** b****!”  The slur of profanities was shocking but impressive in their variety and forcefulness.  Maggie realized that she was shaking but she tried to keep perspective.  This poor man was out of his mind.  Raymond’s diatribe ended when Dr. Busby arrived to subdue him. Two nurses showed up with the doctor and the large male orderly grabbed Raymond’s wrists and restrained him in seconds.   Quickly sedated on the spot, Raymond acquiesced and let them take him back in his room.  The emergency response was over and Raymond was tied to the bed until he eventually slept peacefully. Apologizing profusely, Dr. Busby talked with Lily and Maggie out in the hall. “I’m so sorry this happened.  We have put Carter on a waiting list to change rooms after I heard about yesterday’s incident Lily but unfortunately we can’t move him from the  floor because he is also too volatile.  We like to keep the volatile patients on the top floor and away from the other, more placid patients”, Dr. Busby explained.  This was true.  Lily noticed that Carter’s mood swings followed a two week cycle: his hostility to staff and other patients would build slowly with each day and eventually he would become extremely agitated and explode.  When this happened, Carter lashed out at nurses or doctors, swearing and threatening to kill them all.  Lily had witnessed this snowball effect and knew Carter was a danger to himself and others around him.   Carter had played Junior A hockey for the Canadian National team and his heart was still very strong.  None of the children knew about Carter’s athletic talent on the ice until Erin found an old photo of dad posing for the team picture.  Much of dad’s time before marrying mom remained a mystery.  When asked, both Lily and Carter always changed the subject.  As kids, we always wondered why but never pushed the issue.   Despite his weight loss, Carter continued to exercise his strength and had a documented history of swinging at the nurses.  After a meltdown episode, Carter would sleep for an entire day or two and gradually become more responsive only to repeat the cycle all over again. Maggie and Lily listened patiently as the doctor said it could be a long wait to change rooms at this point because none were available.  Sunset Home was at full capacity and Carter had been lucky even to get a placing here when he did; his long stay in the emergency wing of Thornhill Hospital had pushed him to the top of the wait list.   For now, Lily must remain vigilant until new arrangements were made.  There are not enough nurses on staff to watch the patients more closely and Raymond is still free to roam the halls and enter other bedrooms.  For now, waiting had become a familiar ritual for Carter and his family, and this next step was no exception.
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