Treating residents/patients like idiots - page 3

While I was doing CNA clinicals, I've found that so many people talk to elderly people like they're idiots. I'm talking about the people who use excruciatingly s-l-o-w, simple speech in a loud tone... Read More

  1. by   Jessy_RN
    I call most ppl hun. Will try to get rid of the habit though.
  2. by   jalvino1
    Quote from Daytonite
    The brains of the very elderly process what people are saying much slower. So, while they may not be hard of hearing, you really do have to speak a little slower and wait a little longer for a response in order to give their brains time to catch up. That is a known scientific fact.

    Although this is true, every patient is different. I've met 96 year olds sharper than 67 year olds, both categorized as elderly. Are the people talking slowly to those who need it or every single elderly patient?
  3. by   nurse4theplanet
    Quote from grannynurse FNP student
    I am a person. I am an indvidual. Anyone who addresses me as sweetie, hon or any other term of supposed endearment gets ignored by me. My name is on my chart and you get it during report, as well as it being placed in my room. You want my respect, as your patient, then start treating me with respect, including proper use of my name. And if I am confused, what makes you think I will respond better to being called hon or sweetie? Not on the best day of your life. It is not a term of respect and unless you are a loved one of mine, it certainly is not a term of endearment.

    And any physician who calls me sweetie also gets ignored.

    Grannynurse
    Don't come to the south cuz its a whole 'nother world down here honey!
  4. by   Bipley
    Quote from asoldierswife05
    Don't come to the south cuz its a whole 'nother world down here honey!
    Same deal in the SW.
  5. by   jnette
    Quote from asoldierswife05
    Don't come to the south cuz its a whole 'nother world down here honey!
    Yep.. sure is.

    And these "persons" and "individuals" are proud to continue being called honey, sweetie, etc. as well as continuing their tradition of addressing others as such.

    It's their CHOICE and PREFERENCE. And goes beyond the health care field as well.
  6. by   rn/writer
    My 23 yo daughter has worked in LTC as a CNA for nearly five years. She started her first job inLTC when she was going through a rough patch and looking for independence with a group of companions that didn't always have her best interests in mind. The job offered paid training and she could earn more than flipping burgers, so she figured she'd give it a summer.

    Something clicked when she entered this environment and I saw her begin to soften back up to her old self. She loved the residents and felt she had something to offer to a population that doesn't get a lot of attention.

    She started talking about her old people (meant kindly) and called them her babies. She fussed over the residents, did their hair, helped them to freshen up after accidents, and asked about their lives when they were her age. When she worked pms, she would help them pick out clothes for the next day and tuck them in. Some she'd even give a kiss goodnight.
    When she left her first job, quite a few of the residents cried. They gave her little keepsakes and told her they would never forget her. This happened again when she changed to her most recent employer as well.

    One of the things the residents have liked is that she gives them nicknames. She has one too. Far from disrespect, this is a sign of endearment, a shorthand way of saying, "I see you as a person and you matter to me." Stringbean and Cookie and the rest knew that she wasn't one of the workers who was just counting the hours till she could punch out. She loved these people and had earned the right to speak to them with affection.

    Last week, my daughter had a lady in the early stages of dementia sit nearby while she charted. Rosie looked over and asked, "Who owns me?"
    After figuring out that Rosie was trying to ask who she belongs to, who she matters to, Lindie said, "I guess I own you, Rosie." The older lady was quiet for a moment. Then she asked, "Was I expensive?" Lindie smiled and said, "You were free. But now you're priceless." Rosie said, "Well good, then," and she was happy.

    Some of this might not be technically professional because it transcends that detached demeanor we're taught to have. But if I ever end up in LTC, I just pray I run into someone like my kid, calling me Tootsie and giving me a kiss on the cheek at bedtime.
  7. by   UM Review RN
    Quote from rn/writer
    My 23 yo daughter has worked in LTC as a CNA for nearly five years. She started her first job inLTC when she was going through a rough patch and looking for independence with a group of companions that didn't always have her best interests in mind. The job offered paid training and she could earn more than flipping burgers, so she figured she'd give it a summer.

    Something clicked when she entered this environment and I saw her begin to soften back up to her old self. She loved the residents and felt she had something to offer to a population that doesn't get a lot of attention.

    She started talking about her old people (meant kindly) and called them her babies. She fussed over the residents, did their hair, helped them to freshen up after accidents, and asked about their lives when they were her age. When she worked pms, she would help them pick out clothes for the next day and tuck them in. Some she'd even give a kiss goodnight.
    When she left her first job, quite a few of the residents cried. They gave her little keepsakes and told her they would never forget her. This happened again when she changed to her most recent employer as well.

    One of the things the residents have liked is that she gives them nicknames. She has one too. Far from disrespect, this is a sign of endearment, a shorthand way of saying, "I see you as a person and you matter to me." Stringbean and Cookie and the rest knew that she wasn't one of the workers who was just counting the hours till she could punch out. She loved these people and had earned the right to speak to them with affection.

    Last week, my daughter had a lady in the early stages of dementia sit nearby while she charted. Rosie looked over and asked, "Who owns me?"
    After figuring out that Rosie was trying to ask who she belongs to, who she matters to, Lindie said, "I guess I own you, Rosie." The older lady was quiet for a moment. Then she asked, "Was I expensive?" Lindie smiled and said, "You were free. But now you're priceless." Rosie said, "Well good, then," and she was happy.

    Some of this might not be technically professional because it transcends that detached demeanor we're taught to have. But if I ever end up in LTC, I just pray I run into someone like my kid, calling me Tootsie and giving me a kiss on the cheek at bedtime.
    Yes, Miranda, that's exactly what I was talking about. Your story brought tears to my eyes, and a prayer that every person in a nursing home be blessed with someone as caring and loving as your Lindie.
  8. by   Bipley
    Quote from rn/writer
    ... Last week, my daughter had a lady in the early stages of dementia sit nearby while she charted. Rosie looked over and asked, "Who owns me?"
    After figuring out that Rosie was trying to ask who she belongs to, who she matters to, Lindie said, "I guess I own you, Rosie." The older lady was quiet for a moment. Then she asked, "Was I expensive?" Lindie smiled and said, "You were free. But now you're priceless." Rosie said, "Well good, then," and she was happy.

    Some of this might not be technically professional because it transcends that detached demeanor we're taught to have. But if I ever end up in LTC, I just pray I run into someone like my kid, calling me Tootsie and giving me a kiss on the cheek at bedtime.
    There are lots of things that are done that might look questionable to others. Example, if you take a nurse that has always worked ER and put her in a LTC facility to sit and observe for a day, she might not be too thrilled with how things work. Unless you have been in a position to really get to know your patients well and they become family, it might look bad to someone else.

    My boyfriend is a psychiatrist and we were talking years ago about a patient that died in my LTC facility. The staff were pretty upset, things were not going well, it was exceedingly difficult. He came in for a staff meeting and we did a debriefing. At that time I was still a newbie of sorts even though I was running the place. But I didn't know how to do this so he came in and did it for me. It was great. But I realized we were missing something. The patient that died wasn't just loved by the staff, there were a couple of close friends/residents that were not doing well either. So, we did it again and involved two patients that were not dealing well with the death. Some staff objected at first but when they had really cool things to add to the discussions, the staff quickly changed their minds and looked forward to the participation of some of the patients.

    I think one of the biggest issues that an outsider to LTC facilities wouldn't "get" is the involvement of patients. We look to them for things sometimes. Advice, what have you. I had one patient, a favorite. Gramps. Gramps was more of a grandfather to me than my biological grandparents. I *did* go to him for advice at times and he always led me in the right direction. I fully admit I was very young, very inexperienced, and very much in over my head. I was thrown into a position of administration and I wasn't even an experienced nurse at the time. Lots of scenarios came up that I just didn't know how to handle both on a professional level as well as personal.

    It didn't take long, in a short time I was quite good at what I was doing and confident in my decisions. I took a facility that was on the verge of losing their license due to every bloody citation you can imagine and I turned it into a great facility with a fantastic reputation and a waiting list.

    I really credit lots of people for that, including gramps.

    I had another patient that was a social worker. She had a way of changing the presentation of a concept into something people looked forward to. If I had to set a new policy, I didn't always want to change things so it was harder for the staff but sometimes our licensing authority made it such that I had no choice. I would tell her what I needed to do and she would help me write it up.

    EVERYONE needs to be needed and that's just how it works. In a LTC facility people don't have the opportunity to be needed nearly enough. Did I break rules? Probably, but I'd do it again in a heartbeat in that kind of setting.

    My point is that in LTC the rules change and we do things we might never do in any other setting. It becomes a family setting vs. a clinical setting and that requires different rules. While there are plenty of folks that will strongly disagree with me, I stand behind my own actions when I was in that position. (7 years)
  9. by   geekgolightly
    Quote from Tweety
    I'm guilty of that. (Except I say "hon" and "sweetness")

    guilty as charged! i am southern, so i also have the southern accent to go along with it. most people seem comforted by me. i can pick up on who doesn;t want to be treated this way.

    not only is it a known fact that elderly process slower, but that most people under duress or illness, regress. comforting parental language like "honey" or "sweetie" really does seem to work well with many people who are truly ill.
  10. by   CapeCodMermaid
    Quote from Daytonite
    The brains of the very elderly process what people are saying much slower. So, while they may not be hard of hearing, you really do have to speak a little slower and wait a little longer for a response in order to give their brains time to catch up. That is a known scientific fact.
    Sorry to disagree. Not all elderly people have slower brains. My aunt who admits to being 93 is still as sharp as ever. No one will play word games with her because she still always wins.
  11. by   casi
    Quote from Mirai Kangofu
    Actually, I was referring to some of the other people in clinicals, as well as the teen volunteers who would come around. Most of the staff were pretty respectful and would converse with the residents in their normal voices, repeating or slowing down as needed. It's one thing to slow down your speech a little bit to give time for your words to be understood. It's another thing to sound like a voice recording played at half speed while deliberately using broken English. My point is better illustrated by this comic.

    My nursing instructor is the model I use for conversing with patients and residents. She always treated the residents with dignity, and was a great conversationalist. She spoke German, Spanish, and English, and could always brighten someone's day. She didn't slow down as much as she simply emphasized. There was nothing fake or insultingly obsequious about her manner of speaking.
    You have a talent that I admire you for. One of the hardest things for anyone new in patient care is trying to hold a conversation. We all have certian private aspects to our lives that we don't know how to open up to conversation. Have you really ever contemplated what you would want someone to say to you if they asked you if you had to go to the bathroom, or if they were going to help you change your soiled clothes?

    I'm currently a CNA and I remember clinicals. I was like a scared little bunny who mainly just watched, I was even like this for most of my training for my current job. I'd watch everyone else to see how they interacted. I was bad at just jumpping in and doing things because I didn't know what language was appropriate and was a bit afraid of how people would respond to having me, a complete stranger helpping them.

    Now that I have been working as an aide for over a year it's a completely different story. I know how to approach people and have seen the many different responses that they can give me and am comfortable with handling anything negative.

    On the note of term of endearment, I find myself using them on occassion. I think that a big thing is when your working in any environment where you work longterm with a person, you become attached and comfortable with addressing eachother differently. I've been working with many of the same residents for a year now. Hugs and affection really don't bother me. The connections I have with my residents is amazing, I never thought a possition such as this would be so rewarding.

    I've had a nights where I was working my unit alone, had to send someone to the hospital and the paramedic almost had me in tears due to their rudeness. I kept my composure and went on with my rounds. While helpping one resident back into bed she grabbed my head and plantted a kiss on top of it. Almost like she knew what I needed. Another resident I had, I had to call out the paramedics due to low Blood Sugar that we weren't able to handle as we don't have a liscensed nurse on at nights and he was only semi-responsive. I was somewhat distressed because he just wasn't doing to well at all. Once they got him sugared up he looked across the room and pointed at me and told the paramedics "That's my girl." So if I accidently call them sweety, dear, or some other name that shows my affection, I'm not going to fret over it.

    I can understand the concerns in a short term setting. If I'm spending the night at the hospital, and I'm not comfortable with those kind of terms and a nurse I've never met before in my life starts calling me sweety, I might be a little uncomfortable. I'd also be uncomfortable if they refused to call me anything but Ms. ________. What I think it comes down to is we have to address the resident or pt. as they want to be addressed. One of the aides I use to work at use to work with a resident that insisted that everyone in the facility called her Mama D. and they respected that.
  12. by   grannynurse FNP student
    Quote from Tweety
    You're very entitled to your opinion. I'm sure your ignoring people or asking them to call you by name works for you.

    I automatically respect my patients and treat them with respect. I'm not trying to earn their respect if after intimate care and establishing a rapport I say "hon or sweetie". I often get called sweetie by patients too. Especially when I go above and beyond and they notice and appreciate it.

    I have always tried to move beyond formalities, and at the very least get on a first named basis with patients if I can. Especially as I age and a lot of patients are younger than me, I ask their permission to call them by their first name. Saying seeing like "hon, sweetheart, partner, good friend, even 'dude"" is my nature. It's not disrespectful. Never upon first meeting do I use terms of familiarity, maybe even not the first day we're together. But if I give you a bath, discuss your personal life, your bowel movements, etc. and we've established a rapport and like each other, then I move beyond the formalities of Ms. So and So. If someone can't tell by my actions and demeaner the sincerity and think it's disrespectful, then that's o.k. It's how I choose to relate. I always appreciate another opinion and will respect that however.
    You may think and treat your patients with respect despite calling them sweetie or hon. Have you ever asked them what they prefer? I seriously doubt that many would tell you they prefer to be addressed by their name because they would not want to risk making the wrong choice or being 'labeled'. You ae not a relative and in most cases, not even a close friend. Most nurses bemoan the lack of respect they precieve not receiving but they persist in addressing their patients in terms that they define as endearment, something that quite a few of their patients do not.

    Grannynurse
  13. by   nurse4theplanet
    Quote from grannynurse FNP student
    You may think and treat your patients with respect despite calling them sweetie or hon. Have you ever asked them what they prefer? I seriously doubt that many would tell you they prefer to be addressed by their name because they would not want to risk making the wrong choice or being 'labeled'. You ae not a relative and in most cases, not even a close friend. Most nurses bemoan the lack of respect they precieve not receiving but they persist in addressing their patients in terms that they define as endearment, something that quite a few of their patients do not.

    Grannynurse
    The more I read some of the responses, the more I believe this has alot to do with culture. As many people have said, in the south this is a very common thing from both pts and nurses...I have been call hon and sweetie by nearly ALL my patients. I could get my panties in a wad and insist they call me Nurse so-and-so, but what is that going to accomplish? It may even offend then and hinder open therapeutic communication. If I had a pt that did not want to be referred to in such a manner, then I would speak accordingly. But I do not run across that very often. Does this mean I think my patients are ignorant? H*** no! That's just silly. Do I see it as a term of endearment? Depends on how well you know the pt. Do I have to be a family member to be endearing to my pt? Again, H No. Is this form of address part of my southern culture? I would say yes. If I travel outside my area, I realize that I will need to be conscious of this difference.

close