After my last back surgery a few years ago, I questioned my wife as to why the nurses were constantly asking me my name, where I was, and what day it was, for the first few hours after I awoke from the operation. Being a nurse herself, she informed me that those questions were just simple, basic ways in which healthcare professionals can assess the general mental status of a patient; not knowing the answer to one or more of the questions would raise a red flag alerting the nurse to investigate further.
This information returned to me later when I met an acquaintance of mine, who works as an EMT at one of the nearby volunteer fire departments. During one of the many training sessions he has to attend in order to maintain his certification, his instructor pointed out that older people sometimes don’t respond correctly to these questions. As an example, his teacher stated that many of the elderly do not work regular jobs anymore, and don’t necessarily have lots of scheduled activities, therefore their answer to the question, “What day is this?” may not have the same response as it would to you or me. He was also taught that older persons may not have known what day of the week or month it was even before the event happened. “Just use caution and common sense before assuming the patient is totally disoriented,” was his teacher’s final instruction.
Only a few days after the classroom instruction on this subject, my friend and his young, new graduate, EMT teammate were summoned to an early morning 911 call where an older lady had been found lying on the ground outside her home. When they arrived, the two men began their initial assessment. Obviously, she was in pain, but she was trying her best to show that stoic, ‘I can take it’ attitude, that is so prevalent of her era. Attempting to establish the patient’s mental state, the younger EMT asked, “Ma’am, can you tell me what day this is?”
Grimacing, the lady replied, “Of course I can, Sonny. It’s meter readin’ day.”
“Pardon me, Ma’am. What day did you say it was?”
With raised eyebrows, she first turned to my friend and attempted to alert him as to the questionable mental capacity of his young cohort by nodding in the young boy’s direction over and over again. When she received a knowing smile from my friend, she too grinned, turned to the young EMT and yelled, “I SAID IT’S METER READIN’ DAY!”
The EMT looked at my friend blankly, moved closer to him and whispered, “I think she may be a little out of it.”
My friend told the younger guy not to be so hasty in his assessment and told him it was the 10th of the month. The young whipper-snapper replied, “I know, but she thinks it’s some kind of holiday.”
“Son, in this part of the county, the tenth of the month is the day we read our electric meters and return the stubs with the readings and our payments for last month’s electric use.”
The younger man was still confused.
“Don’t worry about it,” assured his older cohort. “Let’s just concentrate on stabilizing her hip. She is fine, mentally.”
After getting the woman on the gurney, and just as they were loading her into the ambulance, the elderly woman grabbed the hand of my friend and whispered, “Honey, before we leave for the hospital, could you go over to that light pole and read my meter? Just write the readin’ down on the pole, underneath the meter and I’ll take care of it when I get back home. I’m sorry to have to ask you to go to so much trouble, but it has to be read today and considering your partner over there thinks meter readin’ day is a holiday, I’m not sure he’s all there.”
Jerry Crownover is a farmer and former professor of Agriculture Education at Missouri State University. He is a native of Baxter County, Arkansas, and an author and professional speaker. To contact Jerry call 1-866-532-1960 or visit www.ozarksfn.com and click on ‘Contact Us.’
