May 4, 2003
We had something along the same lines in our facility last month. We accepted an Alzheimers patient to the facility for a respite. I do not think our facility was the best place for her, as none of the staff was ever trained for Alzheimer patients and we are not Alzheimers "Proof". I think we did a great job with her, but I just have to wonder if it was too much risk.
Nurse Ratched, RN
Specializes in Geriatrics/Oncology/Psych/College Health.
We kinda do by default. People bring their elderly loved ones to the ED and they get admitted to us with info that family can be reached at (Florida number.)
We have before...not that we wanted to do it, as it's a sneaky way to get your family member admitted (through ER that is) but it was done.
Those of you who have worked on locked special needs units will understand that even though the people may be severely cognatively impaired, their personalities stay intact as well as their social natures. Relationships develop on the units between residents and a pecking order of sorts is formed. Things go well, and a sense of security and wellbeing is attained as long as this equilibreum is not disturbed. These cognatively impaired people are very sensitive to non-verbal cues and the emotions of others (staff or co-residents). Many instances of agitation are caused by them picking up vibes that a situation is not "okay", even though their dementia prevents them from fully understanding what is going on.
Add to this mix another cognatively impaired individual who is "new" and doesn't understand what is going on and why they are not home. These people are not usually accustomed to large groups. They are used to getting 1:1 attention from their caregivers at home, everything is strange and they don't know anyone. Usually these people come to the unit without being on any additional medication (like antipsychotics) because they are much more settled at home. Dropping them off onto this strange unit is like an explosion waiting to happen. This explosion affects everyone, both the respite and the "established" residents on the unit.
I have seen this kind of stress many times over and have been called in on some very catastrophic scenes of agitation.
I don't know how to solve this situation. Obviously these respites need somewhere to go and their caregivers need a vacation sometimes, but I don't know how to make the situation best for everyone.
Anybody have any examples of what they're done to help situations such as these?
Has 15 years experience.
Specializes in Corrections, Psych, Med-Surg.
"I don't know how to solve this situation."
In-home respite care.
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