Should I feel guilty? - page 3

by CapeCodMermaid 6,050 Views | 36 Comments

I work in a large facility. We have many residents with dementia. Most of them continue to say they want to go home. We change the subject and try to distract them until they think of something else.On Friday when I was getting... Read More


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    Quote from TheCommuter
    What the OP did is called therapeutic lying, which is recommended in middle and late stage dementia. It is much more humane than continually reorienting the demented resident to a much more painful reality.

    http://allnurses.com/geriatric-nurse...ia-754397.html
    The one thing that I was recommended... Get to know your patients... You have to know your patients' stage of dementia in order to use the therapeutic lying.
    tayloramaRN2be and nrsang97 like this.
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    I really think you did the right thing OP. I just don't have the heart to reorient them to a painful memory.
    tayloramaRN2be likes this.
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    I usually don't ever feel guilty if I make someone happy even if it's just for a minute. She asked me again today...I told her tomorrow and was rewarded with a glowing smile.
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    I think we've all done it. We had a patient one time in the hospital, who used to be a chef. She was convinced she was in a hotel, and was not happy about the quality of the food. She kept insisting on talking to the chef, and refused to tell anyone else what we could do to improve her food. This went on for like 2 days. We finally had one of the male nurses go in and pretend to be the Chef, and have a talk with her. He told her he'd "put a word in" for her, and we were able to make a couple notations about her meals. From then on she was happy, and even wrote a thank you letter to the "Chef".
    tayloramaRN2be and thenursemandy like this.
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    Sometimes it is less traumatic to them to not tell the truth. You made her happy for however long she remembers. Had you said "you aren't going home" you would have had a different result. Many times it is kinder not to tell the truth.
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    When I first started my career I tried to do what we were taught to do....to reorient. After many pt outbursts I came to the realisation that it gives them peace if I "play along", so I changed my approach. Re-orienting a dementia pt that their spouse is dead or that they can't go home 10+ times a day is like torturing them repetedly.
    sharpeimom, ktwlpn, and tayloramaRN2be like this.
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    Nothing to feel guilty about, you did what's needed for dementia patients and provided comfort and reassurance. Besides, you didn't specify which "tomorrow", it could be the day after today or the day after next Thursday. . .
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    I work in a LTC as an activities assistant (while going through school), and I deal with this sort of thing all the time. Our population is almost all dementia. I have to "lie" to them. I believe that it is the best thing for them. I honestly do. Like Boston said, make 'em great "memories". It is the most humane thing to do.
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    When I was a CNA, I worked in a dementia facility. We had to take a dementia training course. As part of the course, we learned that reorientation, while it has its place (like a previous poster commented), generally makes the individual more agitated rather than less. Other approaches, such as redirection, were recommended. Since redirection does not always work, therapuetic fibbing (as I've always called it) can be very helpful. For the person with dementia, their reality is as real to them as this one is to us. If someone told me that I was not posting on allnurses.com but sitting in the dining room of a long term care facility, I'd think they were crazy and tell them so. We can't change their reality, we need to work with it.
    ktwlpn and tayloramaRN2be like this.
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    Yep..as soon as your mom or dad gets home from work you can leave....hey..lets have dinner while we wait!

    Rats! Where is that cab we called for you? They sure are taking long...let's go to bingo while we wait!

    Hmmm...I don't know where your dog is? Must have run away again...I will have Mrs B (the residents housekeeper/ maid from at home years ago) go look for that dog.

    Shhhh....you will wake my baby. (I'm forever pregnant, haha) She is sleeping in the next room. Lets go for a walk.

    No..you can't leave tonite. Look at all that snow outside. Maybe tomorrow when the roads get better?


    .....all of these are real, actual excuses. I refuse to reorientate and will gladly spend the 5 or 10 minutes calling out for John's long lost dog or walk Mary into bingo while we wait for her cab.
    cwgrlup85 and tayloramaRN2be like this.


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