those that decline fast

Nursing Students CNA/MA

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I don't know if I will ever get use to my clients that decline really fast. Working in home care i get to know the clients and families on a personal level and of course you get really attached to them. This past spring I said good-bye to a client on Friday and I said i'd see her on Monday. Worked called me Monday morning and said she was brought to the hospital and we were not needed anymore. She was such a sweet person, and I am sad to this day that I never got to say good-bye or know that this was going to happen because you could see her declining and get myself prepared that it was going to happen.

Then this week I went on a 4 day vacation, and then Yesterday I get to a clients home and they had not been out of bed for 4 days and they are having a hard time with speach and eating. It's shocking to me to see them one way one day and totally different the next time I come. Will I ever get use to this? It rattles me and bothers me. How do the rest of you coop with this? Will time just be a factor for me? I know that failing health will happens to all my clients, and after all if they were in perfect health I would not be with them. But I feel so different when it happens so fast. Any words of encouragment?

One of the hardest lessons I had to learn early on when I started LTC was the fact that 99% of my residents weren't going to walk out of the building when it was their time to leave; they were going to leave in an ambulance or in a heorifice. I did what I could to prepare myself but I can't say that I have gotten used to it. The hardest one was a lady who I bonded with from the first day I started working. I'd taken card of her on a Saturday evening, helped her to bed and told her I would see her on Monday morning. By Sunday morning, she was gone. She knew her kidneys were failing and hadn't shared it with anyone. It gets easier but it isn't easy, if that makes sense.

I agree with the previous person. It is something you do eventually come to expect; however, there is always that one resident/client you bond with in a very emotionally intimate way who you will feel the loss of maybe more than another. Allow yourself to grieve, celebrate the great memories you have of time you spent together, talk about your loss, and then try to focus on the person being in a better place. This has helped me immensely.

I agree with the others that you get used to it. It still hurts to lose a resident but I work in Ltc and have to be there for the others.

The single biggest reason I took a CNA course was for this reason - to see what would happen when I faced death again. With both my parents, I was emotionally devastated when they died; with my dad it took me a good 25 years to come to grips with certain aspects of his passing. With my mom, I was a basket case for a good 2 years after she went, but unlike with dad it was all out in the open, so I was able to "grieve it all out", so to speak.

When I went to work as a CNA, I had residents that got transferred out, transferred in, and a few that left with toe tags. For me, that fact that my residents weren't blood relatives helped a bit; also, the idea that they were free of the anguish of being trapped in their bodies, dependent on others for practically everything helped as well. What I try to do is to not get too emotionally attached to them; try to maintain a good professional relationship between myself and the residents, and try to maintain some emotional space. Not easy to do with some, because there's an instinctive need to nurture with some of them ('cause they're just so darn cute!) but when it's your emotional sanity on the line you do what you have to do.

----- Dave

The single biggest reason I took a CNA course was for this reason - to see what would happen when I faced death again. With both my parents, I was emotionally devastated when they died; with my dad it took me a good 25 years to come to grips with certain aspects of his passing. With my mom, I was a basket case for a good 2 years after she went, but unlike with dad it was all out in the open, so I was able to "grieve it all out", so to speak.

When I went to work as a CNA, I had residents that got transferred out, transferred in, and a few that left with toe tags. For me, that fact that my residents weren't blood relatives helped a bit; also, the idea that they were free of the anguish of being trapped in their bodies, dependent on others for practically everything helped as well. What I try to do is to not get too emotionally attached to them; try to maintain a good professional relationship between myself and the residents, and try to maintain some emotional space. Not easy to do with some, because there's an instinctive need to nurture with some of them ('cause they're just so darn cute!) but when it's your emotional sanity on the line you do what you have to do.

----- Dave

One thing I think makes a huge difference is the size of the facility. My facility has a capacity of 55 residents. That gives me more of a chance to really get to know the residents. Plus, my facility is in a very rural community; I personally knew one of our residents well before she was admitted and there are many residents whose families I knew prior to starting there. Had they been anonymous people to me, it would be different.

What gets me the most is the residents that die from a stroke or sudden heart attack. I've seen people nose dive and I've seen people slowly decline. But watching anyone decline seems more painful than knowing they've passed on to a better place and are no longer in pain. I have had to work with personal grief in the past which has strengthened my faith and spirituality.

Specializes in Transitional Nursing.

I think adjust is a better word. You don't ever get used to it, but you adjust to it..... You have to remember that a lot of elderly people require home care in the first place because they are already very sick. I don't know if you are privy to their diagnosis, but if you are I would suggest looking them up to get an idea of what to expect. Someone with stage 4 lung cancer isn't going to have much time left and maybe that way you can mentally prepare yourself for a short assignment. All you can do is take care of them the best way you possibly can and do those little extra things when you can to make their time here more enjoyable. Its a heartbreaking profession at times, but It is totally worth it, in my opinion.

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