Dementia patients not getting respect

[ejmonroe]

I work on a hospital ortho unit as a tech (and am in nursing school). We almost always have one or two dementia patients on the unit who have fallen and broken their hips. I have witnessed several instances of what I feel is abusive behavior towards these patients by nurses and techs on the unit. Certain nurses and techs talk to these patients like they are children, joke about them in front of them, refer to caring for them as "babysitting." It happens over and over again.

This is so upsetting and disturbing to me. I want to do something to stop it. Am I fighting a losing battle? Should I just let it go? I need to keep my job for tuition reimbursement.

Any advice appreciated.

Rehgards,

EJMONROE

[wildmountainchild]

If you don't stand for something you'll fall for anything. A nurse at my clinical sight just blew off giving pain meds to a dementia pt b/c the pt could'nt swallow her pills (she had a fractured hip!). The nurse charted that she refused them...how can you refuse something if you can't talk or understand anything?

I suggested crushing the pain meds and giving them to her in applesauce. She agreed to look at the MAR w/ me and, lo and behold, we saw a prn order for liquid morphine. Pt had been w/o pain meds for about 8 hours and the nurse was debating whether to crush the vicodin or give her the morphine. I told her that although the pt couldn't talk to us, I knew that w/ a broken hip that she was in pain and she should have the morphine. She gave the morphine.

Find a way to fight for what is right.

[CHATSDALE]

sometimes i think that people [including nurses] see their own personal future in some patients and it makes them react in inappropriate manner

stand up for patient when you get a chance, you will never regret it

[TazziRN, RN]

Unfortunately there are people who think they can get away with things because the victim is not capable of "tattling". This is abuse and as a pt caregiver you are a mandated reporter. If there are legal ramifications from this abuse and it's found out that you did nothing, you could be in the hot seat yourself.

[VivaLasViejas, ASN, RN]

It has always been my personal belief that inside every dementia patient lives a spark of the person they once were, and that part of them must surely be ashamed and infuriated at having been betrayed by their body, e.g. being unable to control their bowel/bladder functions, feed themselves, take care of their own needs.

That is the person I always address whenever I care for anyone with dementia. For the most part, they respond very favorably, and you can almost see them reach deep down and dust off the memories of how they used to behave in social situations.

I think the thing that gets forgotten so often when healthcare providers deal with dementia patients is that you can't treat them like children, even when they act that way. They are adults and need to be respected as such. It's not rocket science; you just treat them the way you yourself would like to be treated, or the way you would want your parents/grandparents treated.

[leslie :-D]

ignorance is a powerful demotivator.

empathy is a powerful ally.

leslie

[Jo Dirt]

It's pretty low to get satisfaction out of ridiculing a person because of his/her infirmity. These were probably the same kids who made fun of others in school who singled out children who were different and made fun of them.

At the same time, though, I can understand when people may say something out of frustration. For example, I was in the room with a dementia patient and a CNA who was sweaty and flustered from running her rear end off. The patient started whining (yes this person was very whiney and insistent) for something to drink, and the CNA said "here's your water so you can piss all over the place." Of course, that wasn't a nice thing to say, but it was said in a moment of exasperation, the patient didn't seem to notice and no harm was done. No one can be kissey kissey all the time.

But just constantly picking and ridiculing a person who can't defend themselves, no. That's not right.

[TheCommuter, BSN, RN]

Certain nurses and techs talk to these patients like they are children

I am not defending these nurses and techs, but how else are they going to communicate with a demented patient who is functioning at the mental age of a 3 year old? I work at a nursing home with many demented patients, and the psychological evaluations reveal that some are functioning at the level of an 18 month old child. How can you maintain an adult conversation with someone who cannot engage in abstract thinking and becomes confused very easily?

[CritterLover, BSN, RN]

i am not defending these nurses and techs, but how else are they going to communicate with a demented patient who is functioning at the mental age of a 3 year old? i work at a nursing home with many demented patients, and the psychological evaluations reveal that some are functioning at the level of an 18 month old child. how can you maintain an adult conversation with someone who cannot engage in abstract thinking and becomes confused very easily?

kind of what i was thinking, too.

i was going to ask what the op meant by "talking to these patients like they are children."

on the one hand, you have to be simple, concrete. they won't understand complex instructions or abstract concepts.

on the other hand, you can speak to someone in a simple manner and still be respectful (imo).

but i can see how that could be disturbing to someone who is new.

it depends, too, on how advanced the dementia is. dealing with someone in the early stages of dementia is very different from dealing with someone in late stages.

personally, i'm very guilty of calling patients "honey," "sweetie," and "darling," demented or completely a/o. some people consider this to be very disrespectful. i mean no disrespect by it.

(and, actually, i do the same thing with my coworkers, not just my patients. )

but, it does offend some.

[Soup Turtle]

It's pretty low to get satisfaction out of ridiculing a person because of his/her infirmity. These were probably the same kids who made fun of others in school who singled out children who were different and made fun of them.

At the same time, though, I can understand when people may say something out of frustration. For example, I was in the room with a dementia patient and a CNA who was sweaty and flustered from running her rear end off. The patient started whining (yes this person was very whiney and insistent) for something to drink, and the CNA said "here's your water so you can piss all over the place." Of course, that wasn't a nice thing to say, but it was said in a moment of exasperation, the patient didn't seem to notice and no harm was done. No one can be kissey kissey all the time.

But just constantly picking and ridiculing a person who can't defend themselves, no. That's not right.

Yikes...that just seems wrong.

I can understand talking to confused, older adults like children, though. I talk to my own grandmother that way, too.

[nuangel1, BSN, RN]

my mom has dementia and lives with me .sometimes talking simple and given short simple instructions is the only she understands and functions.i have to mix and draw up her insulin she gives it i set her meds out then she takes them .we have a routine that works most times but she needs encouragement and direction.