Never Argue With Dementia (and Other Nuggets of Nursing Wisdom) - page 4

by VivaLasViejas 16,180 Views | 66 Comments Guide

It never fails....you're walking down the hall to check on your new patient when you hear an aide loudly attempting to persuade sweet, confused, deaf-as-a-post Ethel to get into bed "BECAUSE IT'S NIGHTTIME AND EVERYONE IS GOING... Read More


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    I always wondered as well, why in the world we try to bring them back to our world? It's not like it's so great lol, but anyway, and we know for a fact that they will only go back; does that rollercoaster not cause them more stress?

    Even in class when it was discussed it seems no one has a real answer as to what to do when a dementia pt takes a vacation, some of our instructors said to re-orient, some said to just try to ignore it and dance around the truth without bring them current or validating their delusion...I say that's where they want to be, then might as well join them.
    VivaLasViejas likes this.
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    Quote from VivaLasViejas
    In my way-back days, there was a 100-year-old lady in the LTC where I worked who had been a night-shift LTC nurse herself. The poor thing had outlived two husbands, all five of her children, and even a couple of grandchildren. But she'd worked nights for 50 years, so she went on rounds with me, making her "nurses' notes" on a clipboard and advising me on when I should go find the doctor. I'll never forget the night she greeted me with a big hug and a kiss on the cheek, excitement in her eyes, and a packed suitcase: "My daughter's coming for me! She's picking me up after I get off duty and taking me home with her, isn't that wonderful?" She passed away three nights later.
    Wow. Goosebumps and tears on that one!! My goodness. You are the awesome, Viva!!
    avuteli, Altra, and VivaLasViejas like this.
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    Quote from VivaLasViejas
    In my way-back days, there was a 100-year-old lady in the LTC where I worked who had been a night-shift LTC nurse herself. The poor thing had outlived two husbands, all five of her children, and even a couple of grandchildren. But she'd worked nights for 50 years, so she went on rounds with me, making her "nurses' notes" on a clipboard and advising me on when I should go find the doctor. I'll never forget the night she greeted me with a big hug and a kiss on the cheek, excitement in her eyes, and a packed suitcase: "My daughter's coming for me! She's picking me up after I get off duty and taking me home with her, isn't that wonderful?" She passed away three nights later.
    Love this and the original article! Thanks, Viva!
    VivaLasViejas likes this.
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    They do teach this in my nursing school now. With dementia patients we call it "living their truth" but we ALWAYS reorient mental health patients with no history of dementia.
    VivaLasViejas and amoLucia like this.
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    Quote from VivaLasViejas
    In my way-back days, there was a 100-year-old lady in the LTC where I worked who had been a night-shift LTC nurse herself. The poor thing had outlived two husbands, all five of her children, and even a couple of grandchildren. But she'd worked nights for 50 years, so she went on rounds with me, making her "nurses' notes" on a clipboard and advising me on when I should go find the doctor. I'll never forget the night she greeted me with a big hug and a kiss on the cheek, excitement in her eyes, and a packed suitcase: "My daughter's coming for me! She's picking me up after I get off duty and taking me home with her, isn't that wonderful?" She passed away three nights later.
    one thing i've learned is that when people start begging for god or saying they see loved ones who have passed.....brace yourself bc it's getting ready to happen! if they're a DNR it's not so bad, but if they are....not good times ahead.
    VivaLasViejas likes this.
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    Great article and responses. I did find it really interesting that so many people had recent instruction that required reorienting demented residents to the present. My instructor demanded just the opposite. She told us to take that trip with them and appreciate all the experiences/stories you hear and become a part of.
    tayloramaRN2be and VivaLasViejas like this.
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    Quote from Hygiene Queen
    Oh...
    That is the worst!

    I did have one patient who got excited when we told her that her husband, Joe, was coming to visit.
    She would giggle and get in a dither and insist she had to "put her face on" for Joe.
    We would help her put some lipstick on and reassure her that she looked pretty.
    It was so cute!
    But Joe was her second husband and she would sometimes forget that.
    So, she would have periods where she would travel back to when she was married the first time (to a man who had cheated on her).
    She would fret and, literally, wring her hands over how she thought he was cheating on her.
    Reassurances otherwise did not work. This was a real experience and she was time-warped right back into it... not even remembering Joe.
    The pain she was experiencing was heart-breaking and there was nothing we could do, but she did get a lot of hugs.
    It is so rough when their reality is not one that is comfortable to stay in. I'm very early in my first LTC job and had a woman who was reliving fear (related to what my gut tells me was a very real long-past sexual assault). I've been encouraged to redirect without making up lies that might compound the situation so when she told me to warn the CNA in the hallway to be careful I said that we in the hall looked out for each other and were looking out for her to keep everyone safe, and howabout your evening peanut butter sandwich? She gave me a great big kiss, stopped fretting, and settled down with her snack. It gave her a few minutes of peace, at least :/
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    Quote from Maremma
    Now if we can just convince the schools to start teaching this preferred method of handling dementia we would ALL be in a much better place! I do the same thing with all dementia patients. It is such a drastic difference in the way they respond to others that try to force them "back into reality" than the few of us that do not.
    I wish my school had given me info about it! My first day on the floor for Med-Surg I, I was in the hospital before daybreak with a sundowners lol. She was distressed: she was outside, she was in the wrong hospital room, there was a hallway in her bathroom with a janitor inside, her clothes weren't in her closet. When I asked my instructor how I should handle it, she replied "How do you think you should handle it?" Umm, I've had no training in dementia care and was hoping you could provide me with some evidence-based care info. The best anyone could suggest was to reorient her.

    I learned more about dementia care in the 4-hour orientation video at my LTC employer than I did in my entire nursing education.
    VivaLasViejas likes this.
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    Thanks you Viva!! This reminded me of an event in a LTC when I was doing clinicals.We had a resident in the dinning room suddenly go catistropic, saying " I've lost my baby" and the regular staff telling her she didn't have a baby, which really cranked her up. Our instructor went over to her, took her hand and calmly said "it's ok, we found your baby. It's safe". She wnt form 60 to 0 in 2 seconds. All she needed was reassurance that her baby had been found. It's amazing what getting into their world will do to help them.
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    Viva that is beautiful
    VivaLasViejas likes this.


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