Mimi Ratner MSW LICSW

Psychosocial Oncology Specialist
Start Date: 1985

Killer Ball

I was a geriatric social worker in 1985 when I began my career at MedStar Washington Hospital Center. At that time, elderly patients would spend days, even weeks, in the hospital before a placement could be found for them in a nursing home. Many of the patients were cognitively impaired and suffered from not only dementia, but medical problems as well. But while they were in our care, I thought we had a real opportunity to work with them to optimize their conditions-both physical and mental. This is how the Geriatric Socialization Group on 4D (the geriatric unit at that time) was first established. Nel Van Beusekom, who was the iconic nurse in charge of the unit, co-founded the group with me. I may have had the creative thoughts behind it, but it was Nel's sheer will and hard word (work?) that brought the group to reality every week. This is also how Killer Ball began-and how both the group and the game became a critical part of the hospital's geriatric services for 14 years.

The group was comprised of the least mobile patients on the unit, which we gathered together in single room. We pushed them in their beds and wheelchairs into one location for some simple games and memory work. In one of the group's activities, we utilized a large beach ball that patients tossed back and forth to one another. One woman had a visual impairment and could only toss the ball from over her head-backwards! Another patient dubbed her toss the "killer ball," and the name stuck. Eventually there was a set of complex rules that the patients developed themselves: one point off, if the ball hit the head nurse; two points off, if the ball went out of bounds and into the hall. It was great fun for all of us, and it was therapeutic for the patients and their families, who often came to watch. It helped us see the patients as individuals, with value as people. We would see them for who they really were.

Because of Nel's dedication, the group and Killer Ball continued long after I left to work in Social Work administration. Nel believed in the Geriatric Socialization Group, and because of her, it was a vital part of the work performed by geriatric nurses and social workers for more than a dozen years. In 1988, a film was made about the work of the group, and presented at a conference. And while it is true that the program had real therapeutic intent and improved outcomes, what I remember most about the experience is the joy. It was joyful for all of us-patients and the staff.