Dragging 'em out of bed

[SuesquatchRN]

Demented resident - we'll call her Mary - is always cold, often combative with care. She's freezing when she first wakes up. Incontinent of bladder. Her saturated chuck gets nice and warm.

She. will. not. get. up. The other nurse - I will NOT do this - tells the aides to get her up regardless. She's fighting and cursing and an aide ends up hurt and Mary ends up weeping in the nurses' station and asking me, "Why did you let them do this?"

She thinks she's been beaten up. Well, she kinda has been.

Now, I know she can't lie in her own waste all day and needs to get up. But how do we do this? (My co-nurse is pissed at me for suggesting that fragging her out of bed isn't the way to go. "They didn't DRAG her out of bed!" Of course they did, numnutz.)

Any suggestions?

[SuesquatchRN, BSN, RN]

Daniel O'Donnell's married!! I thought he was the other way inclined!

Nah. Just one of those slight, gentle Irish guys. Not my type.

:trout:

[lovingtheunloved, ASN, RN]

Suesquatch, you're so stinkin' cool. I think you should come work with me in the AZ.

[SuesquatchRN, BSN, RN]

Suesquatch, you're so stinkin' cool. I think you should come work with me in the AZ.

Thanks. :)

NW AZ. Mountains? Or desert? We visited Grand Canyon and it was some of the most magnificent country I've ever seen. Like it stops your heart beautiful.

[bradleau]

We get some of the same type in regular hospitals. I have seldom had much of a problem with very confused patients. I enter the room more like a favorite friend or family, not as a nurse. Our good techs, most of them came from a nursing home environment, do the same thing. NO AUTHORITY figures here. Also we do not push the issue, just come back later. Do not your techs make the rounds and keep this person dry? We round on ours every 2 hrs. That usually takes care of the sopping wet part. Our "warm"

blankets come from CCU which is down the long hall. But I have had nursing homes put in blanket warmers. Between a beer at bed time and a warm blanket, I did not have problems with any of them. Of course I now have worked many years on Med-Surg. But I do remember my LTC days. One nurse that I work with still talks about running away from nursing home care and the "witch" that ran the place. Best thoughts and wishes with your problem. Maybe YOU will have to do the honors of taking this lady out of bed. With you kindness and good technique it may make the difference for this little old lady. I have done this in the past and still do. It can make a difference.

[fighter07]

I don't drag them out of bed, I simply say "brush your teeth so you can taste your food better, and getting up of your bed is the best." I don't give extra strenght in doing so, if I broke my back no one can ever pay my pain.

[pumpkin92356]

If the nurse in charge is ordering the aides to get this lady up regardless then the aides are committing a violation of this residents right to choose. Also the nurse that did this should be removed from this type of work environment. I work with a nurse who plays bulldog with my co-workers when it comes to making residents do things they dont want to do. I told her that a patient refused to get up and I wasnt going to break the rules by forcing her up or in tub etc. Nurse backed off she knew that this was against the residents rights.

[mercy1975]

Demented resident - we'll call her Mary - is always cold, often combative with care. She's freezing when she first wakes up. Incontinent of bladder. Her saturated chuck gets nice and warm.

She. will. not. get. up. The other nurse - I will NOT do this - tells the aides to get her up regardless. She's fighting and cursing and an aide ends up hurt and Mary ends up weeping in the nurses' station and asking me, "Why did you let them do this?"

She thinks she's been beaten up. Well, she kinda has been.

Now, I know she can't lie in her own waste all day and needs to get up. But how do we do this? (My co-nurse is pissed at me for suggesting that fragging her out of bed isn't the way to go. "They didn't DRAG her out of bed!" Of course they did, numnutz.)

Any suggestions?

What time do you get her up?

[SuesquatchRN, BSN, RN]

What time do you get her up?

10, 11.

[amanda1229]

I personally think I deal very well with residents like this. We have a couple, but one in particular. She refuses to get up for breakfast almost everyday, and gets really delusional and combative when upset. As most dementia residents, your mood affects theirs. I love to walk in and say, "Helloooo, Vivian!" and make her as excited as possible, give her a kiss on the forehead, the brown-noser works. I just start moving her around a bit, and talking to her about her grandkids, or about how nice she looks, and saying lots of "Guess what!" things that go nowhere, just things to make her really excited.

Sometimes Vivian will get really, really upset, flipping out because she wants to leave (she can be a wanderer sometimes). We have to put her in bed because she goes around and tries to hit residents and staff, and ruin things. When another aide, myself and a nurse get finished putting her back in bed, all of us bruised by now, she's sobbing. I just take her hand and get really close to her face and say, "Oh, no! What did they do to you?" and TOTALLY sympathize with her. Say things like, "These girls are nuts!" I even say, "I tell you what -- you and I are leaving today, when I go home at 2:30!" She calms down, and gets cooperative and says, "I'll see you then!"

Of course, she forgets, but is nice and well-behaved for the rest of the day!

[nightmare, RN]

"I tell you what -- you and I are leaving today, when I go home at 2:30!" She calms down, and gets cooperative and says, "I'll see you then!"

Of course, she forgets, but is nice and well-behaved for the rest of the day!

Not always!!:lol2: Carers who have done this have been known to have to sneak out the back door because Mrs.X is camped at the front door waiting for them! Try talking your way out of that one!:lol2: otherwise I agree that the way you come across to a demented resident has a lot to do with how they treat you. It's always the bossy ones that seem to get into combative situations.

[Dixiecup]

we are implenting almost the exact same program at my facility. are you an americare home by chance?

today many things have changed in ltc, and some things remain the same. we are beginning the pioneer adventure at my facility, in other words, resident choice; we already have resident choice dinning. now we are working on resident's rising on their own and try to create a routine for them that is as close as what it was when they lived at home, well as much as possible. research shows that even demented residents can make consistent choices in regards to adls. getting them to get up sometimes is challenging. assess for pain, because many times they can not verbally express it, give them a time ( i will be back at 10 to get you up), then you will make sure they are kept warm with sweaters and blankets, tell them how long they will up and stick to it. find out what kind of activities they participated in when they were young and try to adapt them for the resident now. there is a video called bathing without a battle, creating a better bathing experience for persons with alzheimer's disease and related disorders by ann louise barrick phd, joanne rader ms, rn, and phillp sloane md, mph from the university of north carolina at chapel hill which provides a wealth of information to help deal with dementia and the problems it presents. keep the spirit up, we are living in a wonderful and adventurous time in long term care, we are changing the way elders are being cared for to make it better for all.