Anyone taken care of a confused patient?

stressgal, RN · Mar 16, 2006

Take a trip to your school's library. You can find the journals there, free of charge.

Daytonite, BSN, RN · Mar 16, 2006

Suggest you search for information on dementia and Alzheimers. Use the search feature at www.medlineplus.gov for information listed under confusion, dementia and/or Alzheimers disease. You should get a return of links to check out. Also check for information on this website http://www.dementia.com/home.jhtml?_requestid=5750151

cksl · Mar 16, 2006

if it's a dementia case, its good to figure which type of dementia it is.

ask the patient if he/she is hallucinating or hearing things.

the ward must be well guarded.

dunegirl84 · Mar 16, 2006

I am not sure that the patient had dimentia she just could not orient herself. But i am starting to think that i need to talk primarily about dimentia and other such disease processes. Thanks for the great ideas!

dunegirl84 :nurse:

Daytonite, BSN, RN · Mar 17, 2006

You are not likely to find much doing a search using the word "confusion". Dementia is a more useful search and medical term to use. That is why I listed it for you. Go with dementia. You will find much more information. Don't use the stuff that doesn't pertain to what you are wanting to put in your presentation. It's your presentation and you have artistic control of the content. When it comes to working with Alzheimer's patients who have a lot of confusion and dementia, the Alzheimer's caregivers have made huge strides in how to approach the treatment of these patients. When I was in nursing school 32 years ago we were taught to re-orient confused patients. That is not necessarily done today as attempting to re-orient a confused patient will often only aggravate them to the point of aggressive behavior.

Let me give you an example of caring for confused patients. We had a confused man who was ambulatory and kept hanging around the nurses station at one LTC I worked. It was irking several of the nurses (???) mostly, I think, because he was patiently waiting for someone to turn some attention his way. Which I finally did, asking him what I could do to help him. He wasn't able to say it very well, but he was worried that he wasn't going to get a place to sit in the dining room for dinner and he didn't want to miss dinner. Now, all of us who work in LTC know that the residents get their 3 squares a day and those who eat in the dining room have assigned seating. I made a point of telling him I was going to take care of it right then and there. I let him see me pick up the handset of the telephone (while I held the button down which he could not see) and pretended to have a one way conversation with the dining room staff and let him hear me make a reservation for him for dinner, give his name over the phone and even ask him to confirm the time he wanted. I hung up and told him that he had a reservation for 5pm. That satisfied him and he went happily on his way with a smile on his face, still confused, but his self-esteem intact. Just one more little fire I stamped out in the course of my day as a charge nurse. However, had I not done that, the scenario could have played out much differently.

dunegirl84 · Mar 17, 2006

That was my main problem. I could not find much of anything in books or journals. But when you start talking about different dieases and ways to help the patient be happy and keep their self estem intact it could be invaluable to me and my classmates. Thank you for the story, I think I learn better by examples like that. When my teachers tell stories it is the best part of class. They still do teach us to try to orient the patient but I think as we have gone along you start to realize that unless they ask or are really going to hurt themself/others there is no reason to keep orienting them when they do not want to be. I greatly appriciate the advice! It has given me a direction to go with that is much better then what i started with!

dunegirl84

jschut, BSN, RN · Mar 17, 2006

Let me give you an example of caring for confused patients. We had a confused man who was ambulatory and kept hanging around the nurses station at one LTC I worked. It was irking several of the nurses (???) mostly, I think, because he was patiently waiting for someone to turn some attention his way. Which I finally did, asking him what I could do to help him. He wasn't able to say it very well, but he was worried that he wasn't going to get a place to sit in the dining room for dinner and he didn't want to miss dinner. Now, all of us who work in LTC know that the residents get their 3 squares a day and those who eat in the dining room have assigned seating. I made a point of telling him I was going to take care of it right then and there. I let him see me pick up the handset of the telephone (while I held the button down which he could not see) and pretended to have a one way conversation with the dining room staff and let him hear me make a reservation for him for dinner, give his name over the phone and even ask him to confirm the time he wanted. I hung up and told him that he had a reservation for 5pm. That satisfied him and he went happily on his way with a smile on his face, still confused, but his self-esteem intact. Just one more little fire I stamped out in the course of my day as a charge nurse. However, had I not done that, the scenario could have played out much differently.

Daytonite~ You're a doll...

Too many times people have been ignored or had attempts to reorient failed...with these people, I try to just go along with them for the most part..it makes them more comfortable, and helps their days go better.

UM Review RN, ASN, RN · Mar 17, 2006

For a real wealth of information and stories, try doing a search using the term "Florida". :lol2:

JK. Sorta.

Here's an interesting resource. It's the e-zine for caregivers from the Alzheimer's Foundation of America website.

http://www.alzfdn.org/?src=overture

http://www.alzfdn.org/publications/ca_w06.pdf

Daytonite, BSN, RN · Mar 17, 2006

here's a pamphet on dementia i ran across during my surfing this morning.

http://www.postgradmed.com/issues/1999/10_15_99/pn_dementia.htm - information on dementia

the reason i've listed it is that at the end of it is a listing of diseases that are known to be a cause or have dementia as a symptom, something you might want to mention in your presentation.