Wednesday, 20 April 2016

Care Partner Wednesday--Death by Toilet

Anxiety is nothing to laugh at.

Anxiety--real anxiety in the form of an anxiety disorder--can be something to cry over, stomp your feet in frustration about, tear at your hair when it is happening and leave you wanting to bang your forehead against a wall.

Let me be specific. I am talking about an anxiety disorder in an elderly person, and the reactions I am describing are those of the care partner. Anxiety of this type requires patience beyond anything you have ever experienced before, wisdom that would rival Solomon's and a sense of humour. The latter is not only essential, but is often the care partner's salvation.

Margaret has an anxiety disorder. She has some memory loss, but not dementia, and can still defeat all foes at cribbage on a good day. She is on several medications for this, and many days she functions well and has a decent quality of life. She enjoys her friends, her family and her life. But there are a whole series of issues that can trip her into anxiety mode. Just a few of these are
*any physical ailment, even the most minor
*an appointment, especially a medical appointment, outside the building
*any new care partner who isn't totally familiar with her routine
*any aspect of washing. She is obsessive about cleanliness.

Now, it seems there is a new issue. Or perhaps it had never occurred before, so I didn't know it was an issue. I do now.

It began one morning after breakfast when Margaret came to me with a wild look in her eyes saying her toilet wouldn't flush. I removed the tank, thinking it would be an easy fix and one I'd performed many times in the staff washroom. However, the do-hickey (please excuse my use of technical terms) which performed the flushing action was completely broken off. The repair was beyond my limited ability. I put in a requisition to the maintenance department.

Margaret began to pace the hall. To the nursing station, to my desk, to her room. Look in the hall for the maintenance guy, back to my desk. It was during one of these visits that she told me she couldn't "go" anywhere else.

I'll admit it. I was getting a might anxious myself.

The nurse and I chatted while Margaret had her lunch. The nurse had a walkie-talkie, and I suggested she call the maintenance guy after he finished his lunch at 1:00. At 1:01, after three visits to my desk post-lunch, I dialed her extension. "Have you called him?" No, she hadn't yet. "Please. Do. It. Now."

About 1:30 he arrived. Then he left. It wasn't fixed. Had he gone to get a part?

He had, but he didn't seem to grasp the seriousness of the situation. When he hadn't returned by 3:00 (or so I thought) I asked our receptionist to radio him again. "Oh, it's all fixed." was his glib reply. I ran down to the room to try it, with Margaret hovering near me. True, the do-hickey was replaced, but the tank wasn't filling, so it wouldn't flush.

Now Margaret was in full anxiety mode. Her head filled with the problems she could see, driving all reasonable thought out of her head.
"What if everyone leaves me and I'm all alone and there's no toilet?"
"I need a private caregiver tonight because my toilet is broken."
"Nobody cares about me because they aren't fixing my toilet."

And so on.

I knew that the maintenance guy leaves at 4:00, and it was now 3:30.  I was preparing to lie prostrate across the doorway, refusing to allow him exit until he fixed that toilet. I wanted to see a flush and I wanted to see it now!

Margaret was pacing, talking to anyone who would listen about her toilet. She was short of breath. At one point, she phoned her daughter for the umpteenth time. As her daughter listened to Margaret's scrambled, breathless thoughts, she said, "Mom, you've got to calm down. Everyone is doing the best they can. If you keep this up, you are going to have a heart attack, and I will have to tell everyone it was death by toilet!"

She was hoping to lighten the mood, but Margaret was not amused. In her tone you could almost hear the pursed lips and see the deep frown. "Well that's what you'll have to tell them, then." The phone hung up rather suddenly.

The end of this story is not nearly as dramatic as the rest. The maintenance guy came and figured out the problem, I didn't have to lie prostrate across the door, and Margaret went happily off to dinner, the epoch of the toilet nearly forgotten.

Most of the advice I have for care partners in dealing with someone who has an anxiety disorder is focused on taking care of yourself. Come back next week for some practical thoughts on surviving an issue such as "death by toilet." *

Have you ever faced severe, unreasonable anxiety in a loved one you care for? How did you handle it? Share some of your strategies with us.

"My body thinks something is gravely wrong, but my brain doesn't have a clue what to do about it, so it starts racing to the worst possible conclusions."

*story shared with permission. Names changed.

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