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| No. 40 | 
Sep 13, 2008, 11:39 PM
Updated
Sep 13, 2008 at 11:41 PM by joyflnoyz
 Re: Re-directing tips needed for Alzheimer's/behavior pts
Often what I do is use TVLAND channel with all the old shows they would be familiar with- things like Andy Griffith, Bonanza, Lucy, Ozzie and Harriet.
Familiar is good.
I've noticed behaviors increase when the weather is changing to rain and/or thunderstorms. When they want to "go home" I just tell them that there are storms rolling in (the truth btw  ), and every one is staying here for the night. OH! YES! I've got a bed all set up in the guest room, and you DID promise to stay for breakfast...
Most of the time they are worried about getting home- someone is worried about them, waiting for them.
As sweetmagnolia said, you MUST enter their world. I have turned off stoves, taken the cake out of the oven, checked on the baby, turned off the faucet; you name it, I'll do it to settle down my precious ones.
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Nov 15, 2008, 08:06 AM
Re: Re-directing tips needed for Alzheimer's/behavior pts
Hello all!
Yesterday I had with a tough job while working only one rare day with a home health Alzheimer patient! Since this 99 year old,blind,and bedfast patient was not my regular assignment, she was not familiar with my voice --- she became very agitated and combative as I kindly and gently tried to give her care. As joyflnoyz wrote on this site, I tried to "enter her world" and tried to understand that a new nurse which she could not see might be scary to her. As other nurses wrote, I just started kindly responding to her shouting by frequently saying "OK, Ms. Smith" and turned on her TV to a simple garden tip program and that seemed to gradually calm her part of the time.
This patient had a PRN order for Ativan but the son chose not to give her this medication because he said she would sleep the rest of the day and then be up all night. The only time I lost my cool and had to step out of the patient's room to regroup was when this frail little lady suddenly grabbed my finger and strongly jerked my finger---so I pulled back before she could do any damage to my finger!!!
I sincerely salute any of you who have the courage to work long term with any Alzheimer's patients! Take a bow! (Most of my many years of nursing have been in maternal/child health---unfortunately, geriatrics is just not my thing.) Peace to all of you.
| | No. 43 |
Nov 16, 2008, 04:29 AM
Updated
Nov 16, 2008 at 04:32 AM by managing just
Re: Re-directing tips needed for Alzheimer's/behavior pts
icon_hug. In our dementia specific area the nurses are experts at redirection techniques. They find out what makes the residents tick and what they used to like and redirect using this information. We also installed a "bus stop" and waiting seat. This provided the resident with something to do while they waited. They aslo offered a cup of tea or coffee. When the "Bus" didnt' arrive or was late they offered a place to stay for the night and to come back in the morning to cach the first bus. By then they had forgotten that they wanted to get the bus. Dementia is demanding and repetitive at times but so rewarding when intervenions are effective and the resident calms and is happy. We also tried a few drops of lavender oil on colars and some quiet calming music activities in the early evenings this also was helpful. No interventions work every time but a large repetoir of things to try helps.
| | No. 44 |
Jan 01, 2009, 01:41 PM
Re: Re-directing tips needed for Alzheimer's/behavior pts Originally Posted by bluegeegoo2  What tricks of the trade do you have for re-directing Alzheimer's or behavior pts? There are 2 in particular on my unit that drive me up the wall! One is so very fixated on "going home" that it seems no amount of attempts at redirecting will work. For instance, last night the 2 were hell-on-wheels. I had 2 skin issues, a fall, and a med pass to take care of. After 11.5 hrs of hearing, "who can help me move my stuff?", and "I want to go home" and watching her pace up and down the halls, go in others peoples' rooms, "pack" some of her stuff and drag it to the nurses' station from 1 res, then the other who wails like a banshee at any attempt at redirection had me pulling my hair out by the time I (mercifully) left. We offered snacks, drinks, turned on the t.v., radio, gave them pain meds, anti-anxiety meds, and sat with them in their rooms and NOTHING WORKED. I am sooooo very frustrated I could scream!!!  And, naturally, both are up ad-lib. The lady who was trying to move all night sat RIGHT IN FRONT OF ME FOR HOURS going on about wanting to leave, call the police, etc. She, however, was not violent or any other behavior to warrant a chemical restraint. Any tips on keeping my sanity during such occasions would be GREATLY appreciated!  lsebeg:
I have a few on my Alzheimer's Unit that are tough to redirect. My best bet is to keep them busy all day, but especially starting around 2 PM. I have activites and programming going straight time.
If that fails, and sometimes is does, I enter their world. I ask them to tell me about their home, their neighborhood, how long did they live there, where did they grow up? Any pets? Children? Who lives with them? What do they like best about their home? Did they garden? On and on until they move on. This usually works, but not always. Dementia is difficult to deal with, I know. You have to be able to handle repetitive questions.
Another techique that is successful for me--get everybody singing. Old songs, hymns, silly songs, anything. They will all usually join in. Singing is uplifting.
For the resident that wails, that seems a tougher situation. I don't have any ideas there, except hugs, if she will allow. I always think that these behaviors are a way of communicating, since their ability to effectively communicate is impaired.
| | No. 46 |
Feb 02, 2009, 06:33 AM
Updated
Feb 02, 2009 at 11:44 AM by Silverdragon102
Re-directing tips needed for Alzheimer's/behavior pts
or 34 others...
Posted by: adrienurse
Original Content:
"i want to go home" is usually Alzheimer's code for "I'm tired and uncomfortable and don't feel secure here". Looking into fixing any of these 3 issues will usually help. Distraction also sometimes helps but not if the person is pre-occupied with the above 3.
It can also mean that the person is bored. Understanding something about them and what they like to do and talk about also helps to occupy them. No small task though when you're taking care of 20 others, right? | | No. 47 |
Jul 17, 2009, 07:08 PM
Re: Re-directing tips needed for Alzheimer's/behavior pts Originally Posted by achot chavi ... here are some tips= not necessarily a quick fix but we put in a snoezelen sensory room (if you don't know know it is- google it) and it really helps. also we got neighborhood volunteers to take patients for walks. humor is always good ... - try empathizing- remember these patients die twice- first their personality then their body goes. they need our tlc more than ever
Thanks for the tip about snoezelen - what a marvellous idea! I am going to do some research on this. Very exciting.
Best wishes
ps I don't know if there's a later post that already says this, but other "calming" suggestions that work for me (often) are hugs; back rubs; manicures; rubbing moisturiser into their hands+massage
| | No. 48 |
Jul 18, 2009, 01:51 PM
Re: Re-directing tips needed for Alzheimer's/behavior pts
We just got another winner- a neighbor with a dog (with collar, leash and muzzle not to mention shots etc) comes a takes a different pt out while he walks the dog- calmly. The pts love the dog and love going out with them and are calm for the rest of the day!!
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