Setting the scene . . .
Richard and I were once in the same nursing home rehab at the very same time. For those just tuning in, Richard was my husband. He got dementia about two years before I did, and died two and a half years before me. He still drove us around San Antonio before the State of Texas finally took away his drivers license.
I was in the rehab for wound care, following a hospital stay for the same reason. In short, I had chronic hospital-acquired cellulitis on my lower legs, which no one seemed to be able to remedy until Janet came, Dr. Stella found me, and the two of them figured it out together. But that’s a story for a different day.
Richard joined me at the rehab, after having been hospitalized following a sudden, acute worsening of his dementia. He recovered from that, but the hospitalist did not want him going home alone. So he sent him to where I was with orders for physical therapy.
The Aricept mistake
The rehab decided it would be a good idea to start Richard on Aricept. Big mistake. Aricept does not help unless the underlying cause of the dementia is remedied, first. It was prescribed for me two years later, and wreaked all kinds of havoc in my brain. Follow the link below to read about my experience with Aricept.
So, anyway – the rehab started Richard on Aricept. It caused total chaos within his brain.
The UTI factor
I, on the other hand, had a urinary tract infection (UTI) brewing, which caused me to exhibit mild-moderate delirium. I did not have real dementia at this point, but rather an acute pseudo type that lasted only as long as the UTI. It started to flare up just after Richard was admitted to the rehab.
Recipe for disaster
The two of us, together with our issues, became a recipe for disaster at the rehab. Richard was severely agitated and confused from the effects of the Aricept. I was agitated, paranoid, and delusional from the UTI.
One night around three in the morning, Richard awakened with a start, jumped out of bed, and headed for the hallway. He had no idea where he was. Yet for some reason, perhaps from whatever nightmare he had experienced, he was in fear for his life.
He went from room to room, opening patients’ doors, to find them all lying unconscious in their beds.
“They’re all dead! They’re all dead!” he said, “Wake up! You’ve gotta get out of here! They’ve come to kill us all!”
I awakened to his yelling, and headed out into the hall. (This was before I had became immobile from a broken leg.)
Richard, the human barricade
By this time, staff were all gathered in the hall, outside a closed patient room door, knocking, and pleading with Richard to open the door. He had apparently gone inside the room to hide when he saw what he perceived to be the enemy headed his way. He used his body to barricade the door.
”Open the door, Mr. Snow. Open the door.”
I approached the group.
”What’s going on?”
”Your husband is in there. He’s holding the door closed. He won’t let us in.”
They were pushing on the door, but could not budge it. Richard’s six-foot “thin as a rail” frame had produced enough strength to hold the door closed.
“Call the police, Ann!”
”Ann! Ann! Is that you out there,” Richard said. (He always called me by my middle name.)
”Yes, honey. I’m here. What’s the matter? Why are you in there?” I said.
”They’ve killed everyone in here,” Richard said, “Call the police, Ann!”
”Are you sure, Richard?” I said.
”Dadgummit, Ann! I said call the police!”
I turned, and headed for our room to fetch my cell phone. I dialed 911, and told the person on the other end of the line that they were killing people in here. A staff person came into the room about that time.
”What is the address here?” I said.
”Here, let me tell them,” the staff person said. So I handed my phone over to her. She explained the situation, and requested help. We then walked back to the hall, and stood outside the patient room where Richard was.
”I called the police, Richard. They’re on their way,” I said, “Don’t open that door until they get here.”
Staff continued to push on the door, and try to talk Richard into opening it. But no luck. He wasn’t budging.
Two officers arrived, talked with staff, and then one of the officers began pushing on the door.
”Mr. Snow, this is officer Green. Open the door. I’m here to help you.”
”No you’re not! They’re trying to kill me! They’ve already killed everyone else! If you wanna help, arrest them,” Richard said.
But the officers were not arresting the staff. They were working with them. I began to realize they were part of what was going on. They weren’t officers at all.
So I called the police on the police.
I opened my phone, and dialed 911 again.
”When are you going to send officers to help us?” I said.
”Mam, we already sent officers. They should be there now.”
”No! The two men here are not officers. They are dressed like officers. But they are not real officers. They are imposters. They probably jumped the officers at the door, and stole their uniforms. They’re here to kill us,” I said.
”Okay, then. I’ll send backup,” the voice on the phone said.
No backup arrived. And now both imposters were pushing hard on the door.
And finally . . .
After about five minutes of pushing, they were finally able to get in. Richard was still holding on, his stockinged feet sliding with the door as it opened.
”Oh thank God,” Richard said, “You really are officers.”
”Yes of course we are. Come on out, and let’s talk, Mr. Snow,” the officer said.
”They’ve killed everyone in here,” Richard said, “Look in the rooms. See for yourself. My wife and I are the only two still alive.”
”Mr. Snow,” the officer said, “They’re not dead. They’re sleeping.”
Richard looked inside one of the rooms, and saw the patient stirring in bed.
”Well I’ll be darned. I thought they were dead,” Richard said.
”No one is dead. You and your wife are safe. These people are here to take good care of you. Why don’t you go on and go back to bed, now. Everything is okay. Can you see that, now?” the officer said.
”Yes. Yes. They do seem to be okay. I must’ve been dreaming, or something. I thought we were in danger,” Richard said.
”Nope. No danger. You’re very safe here.”
Richard and I went back to our room. We talked about things for a little while, then went to sleep.
Richard had just started taking Aricept, which can cause side effects of nightmares and paranoia. I had a UTI which can also cause paranoia.
Richard was taken off the Aricept, and his behavior returned to normal. My UTI was not discovered at the rehab, so my agitation and paranoia continued. I finally got tested and treated for my UTI after I was released from that rehab, and hospitalized again a few weeks later for more cellulitis wounds.
Moral to this story: Be wary of using Aricept, and check for UTI when delirium is present.
And here’s an awesomely powerful video of Teepa Snow which demonstrates how to calm a crisis with a person living with Alzheimer’s (recommended by Susan Macaulay of MyAlzheimersstory.com).