Published Oct 26, 2004
avahsmiles
119 Posts
How do you deal w/ dementia patients? I find it hard to tolerate sometimes. I try not to take things personally, but i'm new to alot of this. The LTC floor i'll be working on, has a few dementia patients. How do you as an RN or LPN deal with clients with neurological disorders?
Thanking you in advance for any comments or advice.
merricat
138 Posts
my favorite article on dealing with this is called "Using illogic logic in dementia care" by Susan Hart. my DON gave it to me but i found it on the internet for you. i cant do a link but the address to type in is http://www.nursinghomemagazine.ca/archiveshtm. i hope it helps you as much as it did me-- good luck.
UM Review RN, ASN, RN
1 Article; 5,163 Posts
For those of us attempting the link posted above, it'll work if you add a dot before the "htm."
And the article really is wonderful! Thanks!
Mister Chris, MSN, NP
182 Posts
Good reading from Merricat.
I have found that you need a lot of patience and understanding. Try your best to be mature, calm and patient at all times. You need to get enough sleep and nourishment yourself. Don't be 'shockable'! If you are then learn not to show it - especially in front of relatives as they will need a lot of your support.
Remember that you are 'normal' and the dementure client was once 'normal' too. Their cognitive impairment and behavioural changes that have taken place can be very distressing for them, their relatives and of course yourself. Relatives will say that it is not the sort of thing that their relative ever did in their life. Yes their behaviour will be totally 'out of character' from the days before their dementure.
Some headings to check out include the following:
Memory Loss
Withdrawal
Confusion
Lacking social skills
Disorientation
Lack of judgement
Personality Changes
Lacking inhibitions
Restlessness
Agitation.
Basically and firstly the deterioration is a gradual process and can be a frightening and frustrating experience for the dementia client's family. Something has gone drastically wrong with their thinking and reasoning processes (and that is only just the start of the problem) to the extent that they can get as frustrated with you as much as you get frustrated with them. They do in some cases have a sort of patern of behaviour, but you will need to read their notes and check out any other diagnosis they may have. There are many different behaviours to cope with from withdrawal from life, totally passively resisting all physical assistance and contact, to seemingly out-going interfering, physically active (and doubly incontinent) behaviour and even agressive and destructive behaviour.
There are a couple of old books I found useful:
Dementia with dignity - By B.Sherman (McGraw Hill, New York 1993)
Gerentology a multidisciplinary approach - By V.Minichiello, L.Alexander & D.Jones (Prentice Hall, New York 1992)
And shop around for something more up to date!
Dementia, one of the most challenging areas of nursing I have ever worked in, and I have been working over 35 years in nursing and I'm still learning.
Good Luck.
Mister Chris
thank you all so much for the article & literary suggestions. i really appreciate this. i really want to do my best for these patients. :) god bless them.
txspadequeenRN, BSN, RN
4,373 Posts
I am an Alzheimers nurse and would be happy to answer any specific questions you may have on how to deal with this.....:)
Fiona59
8,343 Posts
Find out if your facility offer a Dementia Workshop. My employer did. Covered most of your questions, and was required for all staff to attend. Everyone from maintenance to management had to go at least once.
ADS RN
38 Posts
Just go in and be yourself.You can learn so much from them if you give yourself a chance. They can be very childlike in many and endearing ways. One seminar at the Alzheimers Assoc. said to equate living with an Alz. pt. to living with an ADD child. It's so true, I could see how my kids lives parrallelled .Patience and patience and let them lead you as you follow where they are at. Don't try to reality orient them all you'll do is bat your head against the wall, they aren't going to change their minds so you had might as well give everyone a break and step into their world, as long as it is not a danger to them.You're the one who has to do the changing, meet them at where they are don't argue that their mother couldn't possibly be alive, but ask them to tell you about their mother, and reassure them that they are safe. They are the best group in the world to work with, be inventive and enjoy!
lovingtheunloved, ASN, RN
940 Posts
learn to duck and take a punch. make care their idea. try again later after they've forgotten they're mad at you. love them.
welshborg
22 Posts
How do you deal w/ dementia patients? I find it hard to tolerate sometimes. I try not to take things personally, but i'm new to alot of this. The LTC floor i'll be working on, has a few dementia patients. How do you as an RN or LPN deal with clients with neurological disorders?Thanking you in advance for any comments or advice.
:rotfl: