Advice for taking care of an Alzheimer's patient.

Specialties Geriatric

Published

Hello all!

I am new to allnurses. I received my LPN license about 3 weeks ago and had my first private duty shift with an Alzheimer's patient last week. She is a fall risk and I'm primarily there to keep her from falling. My patient was very sweet and cooperative for the first 6 hours of my shift, then she started to yell at me for following her to the bathroom and told the housekeeper "there's a woman in my house who's trying to murder me". I tried orienting her and told her I was her nurse. THAT DID NOT WORK! I now need a different approach with working with her. I've been trying to research ways to communicate with those with the disease, and read a few forums on here about the "therapeutic lying vs. validation therapy vs. reorientation". I really don't want to aggravate my patient, but I can't just let her walk around by herself since she's a fall risk. I'm not sure how to convince her I'm not there to murder her but take care of her. I think these feelings might really be her not feeling secure? I'm not sure how to get through to her. Any advice would help. Thanks in advance. :)!

Andie

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Specializes in Gerontology, Med surg, Home Health.

She's going to fall. Unless you sit on her, you won't be able to prevent it. SO...try to keep her from hurting herself if she does fall. Does she want to toilet herself? Perhaps a fluffy bath rug secured to the floor so in case she takes a tumble, she'll land on something soft. Throw a towel over the bath room door...that way she can shut the door but it won't lock.

You might not be able to get through to her. Since you're with her all day, can you do some exercises with her? Even people with dementia can benefit from strength training.

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Specializes in LTC, home health, critical care, pulmonary nursing.

I completely agree that she's going to fall. If someone followed me into the bathroom, I wouldn't be real cooperative either.

Sugar. Give her sugar. Food usually works, and they like sweets. I've avoided many ass kickings with cookies.

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She can make it to the bathroom on her own and use it by herself. She had a pretty bad fall in the bathroom that left her with a broken nose and bruises all over her face. The towel idea is a great idea! LOL and sugar of course!

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Oh, I wait outside the bathroom. She just doesn't like me following her in general, well sometimes at least. Other times she doesn't care. I try to be with her when she's going up/down the stairs, things like that.

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Specializes in retired LTC.

Is she starting to 'sundown' then? That'll complicate things.

Can you occupy her time with some type of activity, like 'busywork'?

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Specializes in LTC.

I attended a wonderfully insightful in-service on Alzheimer's/Dementia. The story: Imagine you're sitting at home, watching TV on you're comfy couch when suddenly, a stranger walks in and begins to rummage through your things and speaks to you in a language you can't fully comprehend. How would you feel? How would you react? That, in a nutshell, is how an Alzheimer's/Dementia pt feels when we enter their room/home. They feel violated, afraid, and very suspicious of your intentions. Because of the language comprehension issue, they are not very likely to fully comprehend what your stated purpose for being there is. Try to put yourself in that scenario. What, if anything, could help you feel more at ease? What body language/movements would cause you to feel threatened or feel like you are likely safe? If the names of family members are known, use them. "Sally wanted me to come by to see how you are", can go a long way with a dementia pt. Familiarity reigns supreme. If she likes to knit, do word searches, anything that she enjoys try to talk about them. If she is able, have her teach you how to do them. There's a lot of trial and error with dementia pts, but I have no doubt you'll find what appeals to her and will help her feel more secure with you around. And cookies never hurt. :)

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I went to do private duty with an alzheimer's patient who lived at an assisted living facility. She told me that she didn't want any strangers in her room and that I needed to leave. I told her I was very sorry but I could not leave. I "lied" and told her that her daughter had called me at home and told me that I had to go and spend the night with her. Once she "understood" that it was her daughter who had sent me we had a good night.

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I work with 25 alzheimers/dementia pts at a nursing home so I know how stressful it can be. I have found that once I have been around them for a few days they recognize me and my voice and are not so intimidated. They still have severe temper outbursts at times, but I talk calmly with them and talk about things they lime and they forget what they were mad about. Patience and understanding are the keys to caring for these patients.

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I meant things they like. Sorry for the typo

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