CNA - Any thoughts on pre-occupying a dementia patient?

sallyrnrrt, ADN, RN · Jan 8, 2015

? therapeutic distraction

CrunchRN, ADN, RN · Jan 8, 2015

It is called "going into their reality" and it is a lot kinder than arguing or trying to orient them.

They love having something to accomplish and feeling useful. Try giving a stack of unfolded wash clothes and ask if they would mind helping you fold them. Or try other things like that.

xoemmylouox, ASN, RN · Jan 8, 2015

What you are doing is the right thing. Constantly re-orienting people to the current situation is just cruel in my opinion. Keeping them busy doing things that they did when they were younger like folding clothes, listening to older music, etc is the kind thing to do. If I have dementia I sure as h#ll don't want to be reminded that I have it and am living in LTC.

turtle0206 · Jan 9, 2015

hey there this is a great question.

i worked in a nursing home for 2 years doing activities while i was in nursing school (am now an RN).

I too, at the beginning, felt guilty but it isn't cruel if used correctly. for example we used to have patient's constantly trying to get out saying stuff like "i'm calling a cab, i'm leaving." we used to say things like "we called the cab for you, lets go wait for the ride in the dining room." Once in the dining room we could start an activity- cards, coloring, etc. after a few moments doing the activity they usually forgot about wanting to leave. if you are able to assist the patient in becoming happy again then that is a good thing

toomuchbaloney · Jan 9, 2015

Discover what your patient did for a living or for fun/hobby. These people are often experiencing life through the perspective of a historical era in their lives and we can sometimes engage them there. If we can give them the sense, sometimes, that they have "work" to do they become less anxious and restless for a spell.

When you are caring for me you could try having me tan hides or tie mushing leads when I am acting out, or maybe I need to play the guitar, or sing.

icuRNmaggie, BSN, RN · Jan 9, 2015

A member of my family who had dementia loved watching tapes of the Jackie Gleason show and Red Skelton, the Dirty Dozen and Bridge on the River Kwai.

He liked to sit with the kitchen staff and read the newspaper. The kitchen ladies kept an eye on him and gave him coffee and cake. They gave the little old ladies tea and cinnamon toast. Anytime they wanted and then they nodded off like it was naptime.

amoLucia · Jan 10, 2015

It's not lying - some of us have identified it as 'therapeutic fibbing'. And it is the kinder approach to confused pts' care than hitting them over the head with some ineffective and psychically distressing 'reality orientation'.

All it is is a diversionary tactic.

ICURN3020 · Jan 10, 2015

Agree with pp's. You are NOT going to convince them of the current time or place or snap them out of their fog. You will exhaust yourself and likely anger them.

Remember, their thoughts and their mind ARE their reality. I believe it is kinder to let them live in "their" reality versus trying to force them to live in ours, as they are truly not capable of doing so. Trying to convince or force them only instills fear and uncertainty in them, which can then manifest into hostility and uncooperativeness. Can you imagine someone trying to convince you that it's 2056 and your closest, dearest relatives have since passed, you no longer are a nurse and that man with a white beard visiting you is indeed your grandson? You'd be baffled, confused and scared.

Dementia and Alzheimer's are such tragic diseases. They literally strip a person of their core, their personality and their essence. It steals their memories and their ability to think rationally. These unfortunate souls deserve our kindness.

tyvin, BSN, RN · Jan 10, 2015

You're doing fine; as long as they're happy and not hurting themselves creating a world that will make them calm and out of danger is absolutely alright.

Libby1987 · Jan 10, 2015

Who's insisting on reorienting those who un-orientable (new word?) without creating or increasing anxiety? I haven't run into this.

Pondmud · Jan 10, 2015

In so many ways, we do best when we meet people where they're at. If your patient had trouble with "furosemide" but is comfortable with "water pill", I don't think it's wrong to call it a water pill.

So let's say you've got a Dementia pt who believes she's in an airplane and you're a stewardess. She freaks out and gets anxious whenever you reorient her - what's the harm in being a stewardess, and what's the benefit of giving her the truth?