[linzz]

Urine check for sure. I have seen a patient go from semi confused to almost delirium with a UTI. Great post ktwlpn.

[nckdl]

I agree on checking urine and blood work to rule out anything. We had a resident that did the exact same thing day after day. She ended up being harmful to herself and other residents and staff. She was moved to a geriatric/psych facility that has a smaller unit with more 1:1, which did help some from what I heard. Sometimes nothing is going to help and all you can do is keep her safe from harm.

[squeakykitty]

This is a great thread. I think it needs to be a sticky.

[applescruffette]

Another thing that worked sometimes was to tell the resident that the room was already paid for that night. If they worried about who paid, I told him or her, "It's on the house." Sometimes it put the resident's mind at ease to know they were somewhere he or she could stay for the night without worry of money. I had that happen a lot of times, oddly enough.

[nightmare]

Originally Posted by squeakykitty

This is a great thread. I think it needs to be a sticky.

Thank you for the idea,this thread is now a sticky.

[linzz]

Yes, I agree that it needs to be a sticky. I have also used the your room is all paid up and you need to use it story. Works quite well most of the time.

I worked as an aide years ago and had a patient that would take things from other residents and not let them go and one of the nurses there would give him one of his own things as a trade to get back the item that he took without permission. Just thought I'd mention this.

[squeakykitty]

Originally Posted by nightmare

Thank you for the idea,this thread is now a sticky.

Thanks, I'm glad it is a sticky, since there are a lot of good ideas here.

[Furwillfly]

I work in a facility with many alzheimer residents and like the other poster said, you need to do labs if this is a sudden or pretty gradual onset. We use behavioral intervenions first, before we medicate. If 3-4 interventions don't work, we medicate. I also deal with those who have mental/pysch disorders. We have a list of 10 rule outs we do.
I worked with a resident with alzheimer's who was a nurse. We put M&M's and med cups on her table and this woman sorted them all into these med cups for 'her patients'. (she wasn't a diabetic) She did this for hours! Find nurse related things. Even though she may not remember, her soul may still know.
I have a resident who continually wants to leave and we just give her bags. The woman has tons of clothes. She tires herself out when she realizes they are put up and she re-packs and tires herself out.
You just need to be creative. Family can help with projects. But their behaviors are usually worse when something is physically wrong.
If you do medicate, you need to use the least medication with the least possible side effects. Most facilities don't like to use some of the meds we use cause it is a charting nightmare.
Our facility accepts those with violent, aggressive, and unpredictable behaviors that are hard to manage. Not many places take them anymore. We have behavior sheets we have fill out on everyone when they first come in, and then periodically after that. To justify the use of the meds we give.
Sometimes its as easy as soft music, to giving them lotion they can rub in their hands, to making them feel useful, or special. I have one resident who doesn't like me for whatever reason, and I brought stuff like 'lotion, perfume, soaps, old gaudy necklaces' and when she takes her meds, she gets to pick one. Sometimes, it's sugar free candy. You can tailor to their needs.
If I can think of anything else, I'll contribute.

[bluegeegoo2]

Yesterday I called the Dr. of the woman we were giving Ativan, and he rx'd Xanax instead. When I called the daughter w/the update, she said "That's what I always used to give Mom and it worked like a charm". ??????? We've had this lady at our facility for a couple of months now, (she was on the skilled unit when I was), and NEVER, not ONCE did the daughter mention that Xanax worked for her mom. We began using it last evening and her anxiety level has dropped tremendously. She still voices concerns about being "lost", but they only last maybe 1-2 hrs tops and she's off to bed at a reasonable time. I did ask for a lab order, but the NP that works for the Dr.s didn't see cause for labs at this time. The NP is a whole different issue. She didn't order a tx for a man whose u/a came back with <100,000 something or other, but still present, and guess who developed a full blown UTI? Anyway, I'll keep trying. After awhile maybe she'll get sick of hearing from me and do it just to shut me up. I'm rather persistent like that. Anyway, keep the tips coming! I (and others) will be in this field for a long time, and anything I can learn to be a better nurse will only help my current and future residents that much more.

[dbsn00]

Originally Posted by Furwillfly

I work in a facility with many alzheimer residents and like the other poster said, you need to do labs if this is a sudden or pretty gradual onset. We use behavioral intervenions first, before we medicate. If 3-4 interventions don't work, we medicate. I also deal with those who have mental/pysch disorders. We have a list of 10 rule outs we do.
I worked with a resident with alzheimer's who was a nurse. We put M&M's and med cups on her table and this woman sorted them all into these med cups for 'her patients'. (she wasn't a diabetic) She did this for hours! Find nurse related things. Even though she may not remember, her soul may still know.
I have a resident who continually wants to leave and we just give her bags. The woman has tons of clothes. She tires herself out when she realizes they are put up and she re-packs and tires herself out.
You just need to be creative. Family can help with projects. But their behaviors are usually worse when something is physically wrong.
If you do medicate, you need to use the least medication with the least possible side effects. Most facilities don't like to use some of the meds we use cause it is a charting nightmare.
Our facility accepts those with violent, aggressive, and unpredictable behaviors that are hard to manage. Not many places take them anymore. We have behavior sheets we have fill out on everyone when they first come in, and then periodically after that. To justify the use of the meds we give.
Sometimes its as easy as soft music, to giving them lotion they can rub in their hands, to making them feel useful, or special. I have one resident who doesn't like me for whatever reason, and I brought stuff like 'lotion, perfume, soaps, old gaudy necklaces' and when she takes her meds, she gets to pick one. Sometimes, it's sugar free candy. You can tailor to their needs.
If I can think of anything else, I'll contribute.

I think we work at the same facility (ha ha). I too have several residents who are former nurses, including my former supervisor. I ask them to "help me" with paperwork & I've done the candy in med cups so they can "pass meds". I also "buddy up" with them if they are asking to go home - I tell them I want to go with them, we can wait for the bus together or that we can't leave for at least x amount of hours...usually something will distract them from continuing with the behavior. Most of my "packers" will forget what they are doing by the time they're done packing their belongings (thank God). I always try to find out what the residents did for a living & asking questions can also distract them for awhile. But in night shift...one determined LOL can really mess with your entire night, just pray that you only have to deal with one at a time! If we notice a sudden change in behavior & no interventions are working as the others have said it's wise to do labs & a U/A C&S - UTIs in the elderly cause some major behavior changes.