You’re a Fat Mole and You Walk Like a Duck

Why we should never forget that laughter is the best medicine

Dementia is a cruel beast.

It devours the best of people. Strips them of their memories, their identities. Dementia is the leading cause of death for women in Australia and is the highest burden of disease amongst those over 75. It’s the thing that scares me most about getting old. It is no laughing matter.

Except sometimes, it’s all you can do.

Working in aged care can be one of the most rewarding environments there is. Helping people at their most vulnerable can deliver job satisfaction like no other.

But for the most part, working in aged care is a tough slog. The work is heavy, chaotic, stressful and at times dangerous. As a historically female-dominated industry, aged care workers have been consistently devalued and are often only making the minimum wage, helping fuel Australia’s gender pay gap.

The privatisation of aged care homes has proliferated a culture of profit over care. Staffing ratios have been ignored and facilities left to rot and crumble under the resident's feet.

Forty percent of aged care residents experience neglect or abuse.

Visiting an aged care facility can be one of the most depressing experiences you will have.

It might feel like the only solution is to cry. Many do.

But amongst the bleakness, moments of hilarity shine through.

A few years ago, I was working on an aged care ward in an acute hospital. This ward was full of patients in various stages of disease and illness. A good portion would recover and make it home. Others would be sent off to nursing homes on a temporary or permanent basis.

Some wouldn’t make it out of their bed.

It was a locked ward, on account of the wanderers. Some people with dementia wander day and night. Some people with dementia are still physically strong, and if not managed compassionately and skilfully can become violent and aggressive.

One of the patients was a man named Oscar*. Oscar ended up in the hospital after his carer left to travel overseas for his wedding. Oscar was found wandering the streets, disheveled, cantankerous and delirious due to a urinary tract infection.

It took several months to find out Oscar’s full story. Well, not his full story, but clues and fragments of a life once vast and interesting. But as his dementia progressed, it narrowed and shrunk. He was a lifelong bachelor — no partner, no family, and no friends apart from the carer who temporarily abandoned him.

Many dementia sufferers experience this shrinking of their world. Diminishing physical and cognitive capacity makes it difficult to form new memories, and the ones they have begin to fade. Eventually, it may only be a few people closest to them that they will recognise. It can be a very lonely existence, for both them and their caregiver.

Dementia can also result in changes to a person’s emotional lability, and a loss of inhibitions. For example, making rude remarks, sexual comments, or undressing in public. At times, this can be a source of great frustration or embarrassment, especially to family and caregivers.

At other times, it can be hilarious.

One thing that had not shrunk for Oscar was his vocabulary, particularly when it came to swearing and insults. He had a full arsenal and a trigger-finger temperament.

Oscar enjoyed being around the staff but mostly ignored the other patients. It was as if he didn’t see himself as one of them, or refused to acknowledge it. He spent most of his time standing or sitting around the nurses' station, ‘chatting up’ the staff.

‘You look uglier than a tortoise’s arse today,’ he told a nurse reapplying her make-up.

‘Your gut’s hangin’ out like a fuckin’ hippo in a heatwave,’ he said to a visiting medical consultant.

Oscar’s insults often included an animal component, and we speculated he may have had a zoology background. Or perhaps he just watched a lot of David Attenborough.

I used to encourage Oscar to answer the phones when other staff were busy, and he was more than happy to oblige. Here’s how he answered the phone to a nurse from another hospital calling to handover a patient:

‘Listen, you dumb piece of shit, I don't want any of your stinkin’ insurance, and if you call back here again I’ll shove this phone so far up your arse they’ll have to send a search party.’

Oscar also loved to dress up. Unfortunately, the aged care ward wasn't exactly a Ralph Lauren warehouse, but he made do with what he had. He was particularly fond of wearing one latex glove, ala Michael Jackson, and would wear the yellow gowns we used for infection control like a summer dress.

Oscar also had a sweet tooth, and any food left lying around was fair game according to him. Chocolates, birthday cakes and lollies had to be locked away to avoid being demolished by Oscar.

One morning, I was taking one of the patients for a walk around the ward while she waited for her breakfast to arrive. Maria* needed a walking frame, and would never be described as fast.

When we arrived back at her room, Oscar was perched in her chair like a geriatric Goldilocks. The remains of Maria’s breakfast tray lay in front of him. He’d already polished off the tinned peaches, strawberry jam and was slurping away at her orange juice.

Maria pointed at him, her gnarled finger quivering with outrage. “That man’s eating my breakfast!”

Oscar, who normally never paid much attention to the other patients, took this moment to deliver one of my all-time favourite lines.

‘Piss off. You’re a fat mole and you walk like a duck.’

Maria was left speechless, as was I. Physically, Maria looked nothing like a mole, but her gait was a little duck-like — I had to give Oscar credit there.

I managed to drag Maria away for another lap around the ward while a nurse lured Oscar back to his own room and sourced a replacement breakfast for Maria. For days afterward, I would spontaneously break into laughter at the thought of it.

A few weeks later, it was officially determined that Oscar no longer had the cognitive capacity to make decisions about his care or accommodation, and it was not safe for him to live alone. His previous carer had started a new life for themselves and was no longer able to stay with Oscar.

And so it was that Oscar found himself being shipped off to an aged care facility. It was a sad day for many of the staff when the transport workers came to collect him. His antics had provided laughter to those who sorely needed it. He had lifted others' spirits even when his were sunk.

It may sound callous to some — laughing at a person with dementia. But what does that say about us, and them, if we don't?

People with dementia are capable of making us cry.

People with dementia are capable of making us think.

People with dementia are capable of making us frustrated and angry.

Why can they not be capable of making us laugh?

Caring for someone with dementia is one of the hardest jobs there is. The physical and mental strain can border on unbearable.

Don't forget to laugh when you get the chance.

*Names have been changed

Thanks to kasey sparks for her editing skills.

More from Age of Empathy: