“I watched them take my father into the ambulance on a stretcher, and it was then I realized that my mother didn’t make it.” The TV was blaring as I entered the room for my session with Grace, who was being treated for depression.
“WHAT are you listening to?” I asked Grace incredulously, feeling my mood dip from 30 seconds of viewing the show.
“It was on,” she replied.
“Grace, you’ve got to be careful. I don’t know if you’ve noticed, but living in a nursing home can be a little bit depressing.” She smiled at my intentional understatement. “You’ve got to balance life here with happy things. I never watch shows like this because they make me depressed. Although…there was the time when I was feeling sad after the breakup of a long relationship and I rented the movie Alive. You know, the one where the airplane crashes and the people have to eat each other to survive.”
Grace nodded. “I remember.”
“Yeah, I figured, by comparison, my life was going great.”
Graces’s laughter filled the room, and I shut off the TV to take it in.
I remember when I was working inpatient, the TV was on all morning with the news. It’s always about someone being shot or some major disasters happening around the world. My patients actually tolerated it better than I. 🙂
Love it!
Dr. El,
As usual, residents were gathered in the TV room the morning the twin towers fell, staff members stopped by to hear what was going on, some were crying (you could see the towers burning, live, in the distance), when I walked in the room, also visibly upset, a couple of the residents simply asked, “Sue, you gonna get us coffee now?”
C and Sue, perhaps some people are more sensitive to bad news on the TV and radio than others. Regarding 9/11, I rushed from Manhattan, where I had to show ID to armed guards to get to my apartment, to my residents at the nursing home about 15 miles from the attack, only to find them curiously unfazed by what had happened. It was like the nursing home was a cocoon of safety where the things on TV couldn’t get to them. For many residents though, their depression begins to lift when they limit their intake of dreadful stories and get to enjoyable recreational activities instead.
Dr. El,
I totally agree, I just found it fascinating that the world can fall apart and so many remain seemingly unfazed.
Perhaps their brain has become less sensitive to trauma, or perhaps they are better at regulating their emotions…
I do know that depressing and catastrophic events tend to disturb residents with hx of PTSD…
Sue, I knew you’d agree with getting to more recreational activities! 🙂
C, I was thinking that maybe many of the residents are already depressed, so the bad news doesn’t bring them down as much as it does someone who isn’t depressed. I’ve seen the reduced sensitivity you mention in the form of people shutting down emotionally to protect themselves from further emotional pain.
I, too, have observed over the years that elderly folks have a certain resilience that makes them impervious to “bad news”. I’m not sure I would characterize this resilience as a symptom of depression. Cumulatively, these folks have been through more historical and personal tragedy/stressors than we can even imagine. Their coping styles are different. I, for one am always amazed how “well” they cope with a spouses death. Its as if they are “programmed” at this stage in their life to process grief and loss with survival instincts that proclaim, “life goes on”. Plain and simple, I think they cope better than we do. From another perspective, I think they absorb and are curious about “bad news”, changing values “new normal” concepts because they are quite frankly glad that they are not long for this world. It has been “too much with them”. God’s waiting room should be perceived as a springboard!! Their wisdom, stories and life review should be the best portion of Recreation.
Genie,
When it comes to spousal loss and other types of losses, I think it’s easier to cope if it is “on time” rather than “off time.” That’s why it tends to be harder for an older person to see a young family member (a child or grandchild) die– because the death is considered “off time.” For spousal caregivers, sometimes it is a relief when their spouse finally dies after years of suffering, although sometimes there is also a sharp increase in medical problems– they finally have the time to go to the doctor for self-care, and get diagnosed with 101 things…
C and Genie, I’ve had residents say to me that they expect certain losses at their age, so they aren’t as “thrown” by them as I might have thought. I’ve seen tremendous variety in reactions to loss, though. One lady impressed me after her double leg amputation by saying, “I lived until 80 without any health problems at all, and I did the things I wanted to do with my legs while I could, so I’m satisfied.” I felt quite sure I wouldn’t handle it as well as she did. Other people feel that their life is over because they’ve entered the nursing home, and our role is to help them find a new life here.