Confused residents are upsetting to me - page 2
Just started at a ltc facility. I have previous nursing experience in L&D and in psych, but I have never worked with the older, confused population. The patients who are confused are upsetting to me.... Read More
0May 28, '11 by Pixiesmom, BSNQuote from SherribluExcellent advice!Remember they are just people and the more time you are with them the more you will get to know them. Give yourself some time to get used to it . You cant fix the confusion and watch how other nurses and aides handle it and it will help you learn.. We are all nervous in new areas. Good luck.. Some days it is frustrating and other days you will laugh alot..
You will soon learn more about them and know how to better interact with them. Caring for people with Alzheimer's and dementia can be tiring and frustrating at first but as you get to know them and their personalities it will be easier.
2May 28, '11 by CompleteUnknownQuote from raincitynurseSometimes a lil creative thinking can make a big difference. One ladies anxiety issues (manifested by"help.help.help."repeatedly) were calmed by the addition of a soft stuffed dog. (a pet lover she was!)
Music from his younger years helped soothe another agitated elder.
Finding out that Mrs"Smith"needed regular sips of water..
The solutions are as varied as your residents.If you have an activity department, try picking their brains for ideas and clues.Find your most sensitive and devoted aide, ask their advice. Somethings work some of the time, and not others.
Good luck, happy thinking! It will take some time, but I hope you grow to love dementia as much as I did !
This is great advice.
Here's a link to a powerpoint about the 'Need-Driven Dementia Behaviour Model' and person centred care.
0May 29, '11 by SneakySnakeThanks for all the links and advice! I am already feeling better about work Still have a lot to learn but its getting better.
1May 29, '11 by arabstarRNWhile in my Geri rotation and doing clinicals at the LTC facility, there was a patient who CONSTANTLY yelled "NURSE!", and I am not saying this is the case with all yellers because it obviously isn't, but she had a BAD UTI that had gone undiscovered (This place wasnt exactly a 5 star facility) and once she began treatment and it started to clear up, she decreased her yelling and became happier... she couldn't tell anyone she had a UTI, she didn't know she did. She was confused, as UTI's often cause older people to be, she felt the pain but she couldn't pinpoint where it was so some didn't take her seriously on her pain (which is just UNACCEPTABLE IMO, confused or not, pain should be investigated to try to find a cause if a patient states they are in pain but can't pinpoint where) Sadly, the UTI returned shortly after it cleared up and I heard from my instructor that the person died within a couple months of our clinical ending. The staff was annoyed with her because of her yelling, Many of the students would stop and talk to her, try to assess her and help her out, it was my instructor who recommended she be tested for a UTI. So sad that this lady had an issue for so long and no one seemed to know.
Anyway, kind of lost track there. Some just yell because of their disease causing them to be irrational, and some yell because they have an issue that may not be known, and some yell because they are simply irritated and don't want to be there lol, is what my findings have been.
5May 30, '11 by gentlegiverQuote from XXWeaponXYou can not reorient a dementia patient, you can redirect, but, not reorient. As dementia takes them, it removes the last years to the earliest years. I have had many patients ask where thier parents are, it would be beyond upsetting to tell them thier parents have been dead for X number of years and that they are 89 years old, when in thier minds they are in thier teens or younger. I usually just go along with thier conversation, ask them questions about what ever thier talking about. I never lead the conversation, just follow.When patients are in confused states, the best way to approach them is the same way you would work with a psych patient who is in a psychotic break, or a manic or delusional state. You want to reorient and redirect. You want to be a calming presence, and ask simple "yes or no" questions. Reorient to person, place, and time. Sometimes, often times, these patients just need a caring hand to hold, or some assistance to get to a group activity. You don't need to and can't actually solve their problem, the dementia. It's there and it's getting progressively worse, they may have issues with medications like risperidone, like restlessness or sedation. Don't try to solve these issues, just try to be a calming presence, and do your best to meet their needs.
0Jul 13, '11 by HurricaneCasRNQuote from gentlegiverMake sure you have a history. As as aide I had a patient with Parkinsons and alzheimers. Late70s or early 80s I think. The first time she asked for her mom, I thought she was clearly having behaviors. Of course, duh. The woman herself was in LTC.Her mom MUST be long gone, right? Yeah, her mom died LAST WEEK. She was approaching 100 years old. But, she was in better shape, so I understand, than her daughter. There was a picture of the giant cake that she sent to her daughter in the facility for her birthday.You can not reorient a dementia patient, you can redirect, but, not reorient. As dementia takes them, it removes the last years to the earliest years. I have had many patients ask where thier parents are, it would be beyond upsetting to tell them thier parents have been dead for X number of years and that they are 89 years old, when in thier minds they are in thier teens or younger. I usually just go along with thier conversation, ask them questions about what ever thier talking about. I never lead the conversation, just follow.
Overall though, I'm all about feelings not facts. Except when they ask. I PERSONALLY have a hard time with not being honest when they ask direct questions. "Where am I?" "When do I go home?"