“I’m home.”: An Alzheimer’s Tale

My wife will sometimes work with Alzheimer’s patients at her workplace.  She’s a physical therapist at a nursing home and she often dreads working with them since they are the most combative and non-compliant patients on her caseload.  She understands it’s part of the nature of her work, so she puts effort into being professional no matter how impossible a situation might be.

She has worked at a few different locations over the last eight years, one of which is close to our home.  This particular nursing home sits off the main road and is surrounded by acres of farmland on each side.  Up until three years ago the farm’s landowners grew corn in those two big fields.

One Saturday morning my wife gathered her caseload and noticed she had a new patient in one of the rooms.  “Betsy” was an old, frail silver-haired woman in her late 70’s.  She had been recently discharged from the hospital after a fall at her daughter’s house.  Betsy had moderate signs of Alzheimer’s disease and was in the nursing home to rehabilitate her broken arm.  My wife prepared her usual choice of words before entering Betsy’s room.

“Hi Betsy, how are you today?”

“I’m home.”

“Well, I’m here to help you get back home.  I’m here to help your arm get better.”

“I’m home.”

Not surprised by the answers she received, my wife simply continued with her assessment of Betsy and was shocked at how easy-going Betsy was for her condition.  Betsy complied with my wife’s requests and even said goodbye to her when she left the room.  Nurses and aides also commented on how pleasant Betsy acted despite having advanced dementia.

The following Saturday Betsy’s daughter stopped by to see how her mother was progressing.  My wife informed her that Betsy was doing very well and should be ready to come home soon.

“Betsy is doing great, but she keeps saying that she’s home.  When she says it, she’s always smiling and in good spirits.  Does she say this at your house as well?”

Betsy’s daughter was stunned to hear this news.

“I’m amazed she can tell that this is the location of the old family farm.  The only landmarks that have stayed the same since the 1950’s are the bends in the road, the tall trees in the front, the cornfields and the rusty old mailbox that is somehow still standing across the street from the nursing home.”

Betsy had an uncle and aunt that lived in the “country” (the property is only fifteen miles outside of central Pittsburgh) when she was a little girl growing up in the city of Pittsburgh during the 1940’s and early 1950’s.  They didn’t have any children, but during the summer months Betsy would come out to their farm house and stay with them, sometimes for a few months.  When the couple got older, they sold the property and the house was eventually torn down.  Betsy’s daughter remembers the stories her mother told her about staying on the farm and how much she enjoyed the visits some sixty to seventy years ago.

Obviously my wife was equally as stunned to hear the explanation as to why Betsy called this morbid environment “home”.  Betsy will probably end up as the best Alzheimer’s patient my wife will ever encounter in her caseloads.  She stayed for a total of three weeks, and went home to her daughter’s house.

Nursing homes are associated with illness, disability and the final chapter of one’s life.  Betsy’s stay in a nursing home was an opportunity to see a place that she longed to return to.  To the people around her, the residence was a three-story, three building campus set on twenty acres of land.  To Betsy, the residence was a one-story, four room house surrounded by cornfields along a dusty country road.  Betsy was home again.

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