Recently, I’ve asked many patients to name the President of the United States. How patients answer this question provides some information as to their orientation to the world. Some of these patients are delirious; some of them have dementia. Some of them are neither delirious nor demented, though their disorganized thoughts and behaviors suggest to their physicians that they may be cognitively impaired.
Here’s a sample of the answers I have heard. (Keep in mind that Seattle is a liberal city.)
The man with a recent traumatic brain injury.
“Ugh! I hate him.”
“What is his name?”
“I don’t know, but I hate him.”
The man with alcohol-related amnesia (Korsakoff’s amnesia).
“He’s an idiot.”
“What is his name?”
“It doesn’t matter. He’s an idiot.”
“Tell me the name of this idiot.”
“Tricky Dicky.”
The elderly woman with dementia and multiple medical problems.
“Oh, I like him.”
“Who is he?”
“Isn’t it Clinton?”
The older woman who is neither delirious nor demented, but is psychotic.
“George W. Bush! His father was President, too!”
The woman with dementia.
“Carter. He’s a good man.”
Another man with a recent traumatic brain injury.
“Isn’t his wife running for President now? Hillary?”
“Well, that man isn’t currently President….”
“It’s not still Bush, is it?!”
People with dementia vote. One study from 2003 reported that 60 people with dementia (out of 100—researchers asked both patients and caregivers) voted in the November 2000 Presidential election. Another study from 2002 from the same election described that 48 people with dementia (out of 75— researchers asked the caregivers only if the people voted) cast a ballot. A small handful of articles have inquired into the capacity of people with dementia to vote.
(Insert joke about Florida here.)
29 Jan 2008 |
Thanks for posting this, Maria! I think this is the most entertaining political writing I’ve read in weeks.
Comment by girl in greenwood | 29 Jan 2008 @ 10:06pm
This is very reflective of what I see working as an Occupational Therapist on an inpatient behavioral health unit in Portland (Oregon)…one of the socialization activities I use has various questions the patients are asked and can discuss.
One of them is “What positive advice would you like to give the President?”. Until about the second year of the Iraq war, it was generally “He should stop fooling around with Monica!” These days it’s usually “Get out if Iraq!”
Comment by Kathy | 30 Jan 2008 @ 5:08am
During my intake interview for the week I was committed involuntarily, which resulted in the blessing-in-disguise which was by diagnosis of bipolar disorder, I found these kind of questions insulting. I was highly manic at the time and couldn’t believe that people couldn’t see that of course, I knew who the prime minister was and what day it was and where I was. Being omniscient, of course I knew. And I did. But I am sure that my answer was given with the same indignation as seemed to be present in the psychotic woman’s response.
Context and tone I’m sure convey as much to you as the words themselves.
Interesting and insightful post.
Comment by bp_hockey_chick | 30 Jan 2008 @ 10:24am
Very interesting post. I bet voter incompetence extends far beyond just patients with dementia, though.
Comment by Chris, Pharm.D. | 30 Jan 2008 @ 12:16pm
“It’s not still Bush, is it?!”
ROFL
Comment by Abby | 31 Jan 2008 @ 4:28pm
After a head injury many years ago, I was on the receiving end of this question. Every few hours the nurse would ask, and I would respond in frustration that the only presidents I could remember were Washington, Lincoln and Kennedy and I was pretty sure that they were all dead. I was bitterly disappointed when the fog cleared and I realized Reagan was in the White House.
Comment by Marta | 1 Feb 2008 @ 3:02pm
Very entertaining. I feel like I’m back on the psych consult service.
Comment by Kristie McNealy | 6 Feb 2008 @ 8:38pm