I worked on a psychiatry unit of a hospital in NY for 11 years. It was unofficially a Geriatric Psych unit because our Head of Psychiatry was a Geriatrician, so most of my patients there were senior citizens, although we’d occasionally get people in their 50’s, 40’s, 30’s and, very occasionally, 20’s and even late teens. Some of our patients were old people who were experiencing worsening of their run-of-the-mill mental illnesses like Schizophrenia or Bipolar Disorder but a lot of them had Dementia with “something”….agitation, depression, hallucinations or a mixture of those.

“Paul” was one of our earlier patients – I think he came through our doors in the first year we were open and he had Dementia with Agitation. He was a cute little guy, “old” old, probably in his early 90’s. He walked with a cane, had a little shuffling gait and looked a little bit like George Burns. I remember he had been born in Greece and had an adorable accent. He called every female staff member “Mrs.” (“Hello, Missus!”). However, most likely as a part of his anxiety, Paul was also needy. Very, very needy. And very forgetful too. So even if you helped him, he didn’t remember it after a very short period of time and he’d start being needy again.

Here’s one conversation I remember having with Paul, which started out as just a polite greeting in passing as he was standing in the middle of the hallway and I was going from the Nurse’s Station back to our Activities Room.

Me: Hi Paul, how are you doing?
Paul: Hello Missus! I am fine. I want to sit down.
Me: (pointing to the chair about 5 feet away) OK well, there’s a chair right over there.
Paul: Good. Thank-you. I want to sit down.
Me: Soooo…theeeeennnn…go to that chair.
Paul: You help me please, Missus. I want to sit down.
Me: Sure OK, I’ll help you.
(at this point I take his arm and we make our way to the chair. Slowly, because he’s old and shuffling and there is just no way to get an old guy with a cane to shuffle quickly)
Paul: (as we’re walking/shuffling) I want to sit down.
Me: Yes Paul, I know.
Paul: (still shuffling) Missus, I want to sit down.
Me: Yep, that’s where we’re going. See that chair over there? That’s for you to sit down.
Paul: (with continued shuffling) Missus, please let me sit down. I want to sit down.
Me: We’re almost there Paul.
Paul: (still shuffling) OK Missus. I want to sit down.
Me: I know, Paul. OK look, here we are at your chair.
Paul: (facing the chair) I want to sit down.
Me: I know you want to sit down. But you have to turn around so you can sit on the chair.
Paul: (still standing, still facing the chair) Please, Missus, I want to sit down.
Me: Yes, I know Paul. But you’re going to have to turn your body so your butt can go on the chair.
Paul: Please help me Missus. I want to sit down.
Me: Here Paul, let me help you sit down.
(with that, I slowly pivot him around so his butt is facing the chair)
Paul: I want to sit down.
Me: OK Paul, go ahead.
Paul: Missus, I want to sit down.
Me: You can sit down now, Paul. You’re at the chair. You can sit.
Paul: I want to sit down.
Me: Paul, SIT (with that, I carefully push him down so that he’s sitting)
Me: Hooray, you’re sitting!
Paul: I am sitting.
Me: Yes you are!
Paul: It is here I sit.
Me: Yep!
Paul: I am sitting down.
Me: You sure are!
Paul: I want to get up.

I loved working in Psych 😉