Elsie & The Boy Who Wasn’t There


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Elsie had been acting strangely for a couple days now. It was our morning meeting, and the team had assembled in the dining room to talk about our residents. 

I liked this practice: it gave us a chance to talk about each resident, which made everyone in the community important. Every resident was spoken about, and every staff member was there to comment.

Elsie had managed to stay in the dining room, and, as was the practice, we didn’t ask her to leave. We carried on with our meeting, using only first names for residents.

Elsie had Alzheimer’s disease and was generally very high-functioning. She could get herself dressed, participate in activities, and walk without much assistance.

Today, however, Elsie was off.

“Can someone get this little boy a glass of water?” she asked, nicely. Elsie patted the invisible boy on the head. “What a nice young fellow you are,” she smiled.

“And…we need to get her checked for a UTI,” I said, nodding to Elsie. “Can someone get her friend a glass of water?”

A couple of the staff members looked at me strangely. “But, there’s no–” one started. 

“Yes, I know, but I’m sure Elsie would like the water, anyway,” I explained. 

One of the CNAs dutifully went into the kitchen and brought out a glass of water, which Elsie held to the invisible boy’s lips. (Thankfully, she didn’t hand it to him.)

Normally, Elsie did not hallucinate, so we knew something was wrong. As it turned out, she did indeed have a UTI (urinary tract infection) and this was causing a good deal of extra confusion. Here’s a quick article with more info on this topic.

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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