Re-directing tips needed for Alzheimer's/behavior pts

  1. 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:
  2. Visit bluegeegoo2 profile page

    About bluegeegoo2, LPN

    Joined: Feb '07; Posts: 712; Likes: 1,511


  3. by   bluegeegoo2

    I tried to hide, but they followed me around! Besides, I couldn't stray far for long anyway.
  4. by   vashtee
    Have you tried asking for their help with some menial task? Maybe folding towels or something? It might help just to give them something to do.
  5. by   UM Review RN
    One day, I got so tired of hearing a resident tell me, "I want to go home. I want to go home," and it was just such an awful day, I just blurted out, "Well, so do I."

    From then on, we were buddies conspiring to get home together.

    This might not work for everyone but it worked for me and my dear, dear friend Rosie. (She finally got to "go Home" a few years later.)
  6. by   nightmare
    Aye this is a difficult one! Sometimes what works one day(or night) will not work the next. The simplest one is to look really sad and say 'oh but we've a room all ready for you,your (insert relative here) knows that you are staying the night with us' this works sometimes! Sometimes giving them space and no input helps as they sort of reprogramme and forget what they were doing.Then you can go back and say 'are you tired/cold,let's get you to bed ' this only works if they are NOT following you about.Walking with them up and down corridors helps if it tires them out.You really need to get to know them to find something that works.Have you ever asked their relatives what they used to do at night? Sometimes it's a need to go to the toilet that makes them restless but they can't tell you .
  7. by   Baloney Amputation
    Sometimes, if I knew what their career was, I'd role play to redirect them in relation to that just to send their mind away from where they were at, but it didn't always work. (Of course!) For example, one guy that sticks out in my mind was an insurance salesman. I'd tell him I needed some crop insurance (I had no idea what I was talking about!), and he would start trying to sell it! It was actually really fascinating to hear him be a salesman again, and it redirected his mind for a while when it worked.

    I totally agree with doing a job like folding towels or dusting with a damp towel or something on those lines.

    Alzheimer's residents are a challenge, but there is nothing out there like them! :heartbeat
  8. by   me_daffy
    My LOLs can be the same way. I tell them they have a room rented and one of their family members payed for it. They wanted them to stay so they could have a nice relaxing night away. Usually that works, but not always. Good luck...
  9. by   handyrn
    How about this: "We are waiting for the car to come pick you up, it is too far to walk. While we wait, can I buy you a cup of coffee?" That is a magic phrase because they were always having coffee with each other at the cafe. Heck, they still are. Go to any cafe and what do you see? Retired people having coffee, LOLs having coffee, etc. Point is, don't argue, always agree but make an excuse as to why they can't do it now, and then offer coffee. Doesn't always work, but 80% of the time.
  10. by   Thankful RN,BSN
  11. by   nightmare
    Quote from Thankfulnurse
    Not a great idea,The risk of falling because balance is impaired is greatly increased.
  12. by   bluegeegoo2
    Quote from Thankfulnurse
    For me or the resident? Just kidding. The one who wants to go home was a server for most of her life, and the other was a noc nurse for a long, long time. She doesn't remember being a nurse, though. I've had the former fold towels and such, but she was very fixated on "home" last night. I've never seen her that excited for that long before. She is a sundowner and will usually settle in by 2230. I guess they will just have nocs like that. I feel bad, though, because she was obviously very agitated and there was nothing I could do to help her. She even has a steno pad her daughter brought her filled with info on where she is, why she's there, etc. She kept saying, "Well, I just don't believe THAT" and on and on. Well, it's a new day, and a new opportunity to try again!
  13. by   adrienurse
    "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?
  14. by   adrienurse
    On the issue of "sundowning", there is thought that this is more related to fatigue then the disease itself or the time of day. The person just cannot express what is bugging them so it sets off a host of behaviours. Schedualing afternoon rest periods may work. Of course there are no quick fixes or absolutes when working with these guys.