Never Argue With Dementia (and Other Nuggets of Nursing Wisdom) - page 5

by VivaLasViejas Guide | 17,247 Views | 67 Comments

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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    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.
    Viva that is beautiful brought tears to my eyes
    VivaLasViejas likes this.
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    Viva I have to say this one of the best articles I've read on dementia in a long time. I can recall years ago when I worked as a CNA with dementia patients the big thing was to do reality orientation, and how it just upset them. Now I am a charge nurse on a dementia unit, how things have changed,I recall one little old man who would come up to the Nurses station and say I think you girls should get back to work, We would reply yes sir,
    not.done.yet and VivaLasViejas like this.
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    Thank you!! =)
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    What a great topic. I have been a nurse for 38 years and have never understood trying to orient a dementia patient. I have always gone with them instead. That saves so much time and effort. I once went with my Great Aunt to visit my Granny. We walked in and she began telling us about her wonderful day at Galvestion Beach and the picnic she had. My Aunt stopped her and told her she was in a nursing home that my grandfather was dead. She began to just sob. I just sat next to her and ask her to tell me about every little detail and how my grandfather treated her on that day because I never got to meet him. My Aunt wanted to leave and I just told her to leave me there. I slept on a cot and we talked for hours. The cafeteria even made breakfast for me. That was the last time I spent so much time with her. She died a few months later. Now I am sitting here boo hooing over it. That night she eventually cleared up and came back to reality, but she was happier than I had seen her for years.
    She told my dad over and over what a wonderful time we had. He said he heard that story every single day until she died. Never underestimate the power of going to their reality.
  5. 2
    Quote from Pepper The Cat
    I had an 85 year old woman convinced she was in labour now night. She streamed, she yelled. Finally, at 2 in the am, I "delivered" the baby, showed him to her and then took him to the nursery. She slept the rest of the night!
    I "made" a baby for a patient out of towels once.

    Anyway, Marla, I don't know how you do it and with such joy. I guess we were all meant to enjoy different fields of nursing, huh?
    kattycakes and VivaLasViejas like this.
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    I find that I can deal with my pts that are confused and think it is 1952, but not my own mom. I find myself arguing with her when she tells me these tales. I know that I shouldn't but she is my mom. I miss the mom that she used to be and I will never get back.
    VivaLasViejas likes this.
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    An absolute joy to read this!!! Well done!
    VivaLasViejas likes this.
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    Absolutely spot on. When I was working as an aide I found that I got far more cooperation when I wasn't challenging their perception of reality.

    I remember one resident I worked with who was noted for being a bit verbally aggressive. It turned out he had been an officer in WW2. I never figured out what rank he was but things worked far better when you called him 'sir'. He seemed to take being called by his first name or even Mr [Surname] as a personal affront. I presume he saw us as lower ranking soldiers and thought we were being insubordinate. He would go along with anything that needed to happen providing we both kept low. According to him there were 'd**n [insert one of a selection of impolite terms for a German] snipers' everywhere. Working with him was relatively straightforward once you knew the rules - explaining to the facility manager why your resident was bent over double in the wheelchair and you were pushing at a quick pace whilst crouched down behind was less so. The look on the manager's face when he starting yelling "get down woman! Are you trying to get us all killed?" and then launched into a rant about how that d**n woman had no d**n sense at all and had no business being there was well worth the price of admission.

    There was one aide I worked with (eighteen, maybe nineteen years old?) who insisted on trying to reorient everyone and was forever leaving residents in tears. One evening I tried reorienting her. I kept insisting that it was really 2064 and she was an old lady and should act her age. The RN we were working with, who hadn't shown any hint of a sense of humour previously, joined in and confirmed that was indeed 2064 and added that we were in a lunar base as 'no decent person has lived on earth since the late twenty-forties'. I don't know if she got the point we were trying to make but she did start to get fairly angry after a couple of hours of this story. In hindsight it probably was a bit juvenile but I was getting so fed up with her upsetting people who were off in their own little reality, happy, and not hurting anything.
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    "take-home lesson: arguing with dementia is like trying to teach a pig to sing---it never works, and it annoys the living daylights out of the pig."

    "here are a few more nuggets of nursing wisdom for you, if you want them."


    want them??? ... in one word "yes". thanks so much for the nuggets... i'm guessing you have many more nuggets rolling around in your head to share... bring them on
    RNperdiem and VivaLasViejas like this.
  10. 4
    Quote from ixuzus
    There was one aide I worked with (eighteen, maybe nineteen years old?) who insisted on trying to reorient everyone and was forever leaving residents in tears. One evening I tried reorienting her. I kept insisting that it was really 2064 and she was an old lady and should act her age. The RN we were working with, who hadn't shown any hint of a sense of humour previously, joined in and confirmed that was indeed 2064 and added that we were in a lunar base as 'no decent person has lived on earth since the late twenty-forties'. I don't know if she got the point we were trying to make but she did start to get fairly angry after a couple of hours of this story. In hindsight it probably was a bit juvenile but I was getting so fed up with her upsetting people who were off in their own little reality, happy, and not hurting anything.
    Maybe we ARE all in a lunar base in the year 2064...:uhoh21:

    I actually think that this was an ingenious technique!!
    tayloramaRN2be, teeniebert, SHGR, and 1 other like this.


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