Alzheimers and cancer

YellowFinchFan · Sep 1, 2007

Hi there,I have been issued a challenging patientand I am reaching out for some tips and tricks to help this gentleman . I am a hospice home health aide,and I do home care. My newest pt is 93 yrs old , has bladder ca,and Alheimers. He is quite excitable,and has a tendency to hit,kick,and bite.Very little in the way of family support.Little old wife,totally overwhelmed,and one 60 ish dtr who thinks daddy will get better....he is on albsolutely no medicine,because the dtr believes that with Alzheimers you feel no pain.....

If you are part of a hospice team there must be a Home Hospice RN involved who you can report to and address the pain issues. Of course the patient can still feel pain and his behaivor will lead to him getting hurt/his wife or even you! He needs pallative care and it sounds like he's not getting proper treatment at home yet.

Dolce, RN · Sep 1, 2007

You share my big pet peeve--family members who think that their Mom or Dad doesn't need pain medication. They are so concerned about their parents overdosing that they are not receiving adequate pain control. It makes me really, really mad when I ask a patient how much pain they are in and they tell me 7-8/10. Then you ask the daughter about pain med use and she says, "Well, I only give her a 1/2 a vicodin twice a day 'cause I don't want her to overdose.":angryfire This patients daughter needs to be notified that cancer pain is often excruciating and that the behaviors of her dad are likely compounded by the fact that he is very uncomfortable.

nightmare, RN · Sep 1, 2007

We had a similar problem which eventually was sorted by using Fentanyl patches.The family were adamant that mam didn't take tablets,mam had bladder cancer and bleed all the time,everywhere ,and was obviously in pain.We went down the road ,with doctors permission ,of covert medication,but that was unsuccessful.The family eventually relented and allowed the Fentanyl but the poor woman had months of unnecessary pain before that.

Hospice Nurse LPN, BSN, RN · Sep 7, 2007

Kuddos to you for picking up on this! I agree with the other posters...under medication is a big problem for many elders because of lack of knowledge (either the family or the doc). :angryfire

marjoriemac, LPN · Sep 8, 2007

Perhaps the kicking etc may be because of pain???

SuesquatchRN, BSN, RN · Sep 8, 2007

I am going to bet that he is kicking because he is frightened of all of these strangers in his house.

Try getting his attention before you approach. Big smile. Face him. Look him in the eyes. Kneel down and look into his face if you have to. Soft voice. Call him by first anme.

I'm not magical or "better" than my co-workers, but I very rarely had a combative resident become combative with me.

Even the most demented peole respond to respect and kindness. That little spark of the soul, or whatever it is inside of each of us that makes us unique, still lives in him and will ignite if gently fanned.