...all you have to do is lose your mind.
Currently, I'm working with a resident who went to the hospital as one person and came back as another. Before they left, they were sociable, aware, and the village gossip. If you wanted to know anything about anyone in the facility, staff or resident, this was the person you went to see. You would routinely find their room occupied by other staff or other residents when you went in to care for them.
One day they found this resident unresponsive and sent them to the ER. They stayed at the hospital overnight for observation. And when they came back, something was obviously wrong.
Now the resident thinks their spouse is still alive and is looking all over the facility for them. They wander the halls asking for help. They cut holes in their catheter with fingernail clippers. Any stories they tell you aren't reliable in the least. Something in their head went "pop" and because they are nearly 100, there's no hope for repairing it without doing further damage.
Sadly, no one really knows how to deal with this. Instead of gathering in the room for a good gossip, folks are avoiding it like the resident has MRSA. Somehow, the resident still knows our names, but when they call for us, they don't know what they want, or they ask about their long-dead spouse, or they can't think of the word they need. When we can't figure out how to help them, they get angry and tell us we don't care.
It's heartbreaking and frustrating. I've worked with my share of residents with Alzheimer's Disease. This is nothing like that. This is like they've had a lobotomy. It's impossible to find the person they used to be and impossible to relate to who they are now.
I know we need to learn to work with the "new normal". It's just hard when the change is so sudden.