Dragging 'em out of bed

[SuesquatchRN]

Demented resident - we'll call her Mary - is always cold, often combative with care. She's freezing when she first wakes up. Incontinent of bladder. Her saturated chuck gets nice and warm.

She. will. not. get. up. The other nurse - I will NOT do this - tells the aides to get her up regardless. She's fighting and cursing and an aide ends up hurt and Mary ends up weeping in the nurses' station and asking me, "Why did you let them do this?"

She thinks she's been beaten up. Well, she kinda has been.

Now, I know she can't lie in her own waste all day and needs to get up. But how do we do this? (My co-nurse is pissed at me for suggesting that fragging her out of bed isn't the way to go. "They didn't DRAG her out of bed!" Of course they did, numnutz.)

Any suggestions?

[lovingtheunloved, ASN, RN]

That's my feeling as well.

As a long-term care nurse myself, I actually pray that I'll kick the proverbial bucket before I get stuck in a nursing home. The way we treat the sick and demented elderly in this society is a crime. At an age when they should have earned the right to get up and go to bed whenever they please, eat whatever they want, DO whatever they want, we warehouse them and treat them like the children they once were, long before we were a glint in their eyes.

Lord help anyone who comes in at some ungodly hour to haul my old bones out of bed against my will, on someone else's schedule, for someone else's convenience. (And if they gang up on me, armed with a 'silver bullet' and a packet of K-Y at five AM, they're REALLY gonna get it!!) I can't imagine anything more frightening---or degrading!---than to be surrounded by a bunch of people I don't know, then manhandled, stripped, rushed through a cleaning, forced to change positions rapidly while my arthritic joints are screaming in pain, plopped into a chair, and then wheeled to another chilly room where I just fall asleep again, only to be awakened once more for a meal I don't want, at a time of day when my body is used to being in a comfortable warm bed. Phooey!!:angryfire

Yes, this poor woman needs to have her Chux changed, and yes, at some point she should get out of bed. But why does it have to be done at six o' clock in the morning? And where does the staff get the nerve to be surprised when she resists care?

Dementia patients don't stop being PEOPLE just because their brains don't work as well as they used to. Their former habits must be taken into consideration when planning their care, and if they conflict with staff convenience or a facility's lockstep routine, too bad---it's time to get creative and learn to think outside the proverbial box. The world will not end if Mary or John doesn't come to breakfast at 8 AM. But everyone concerned with them could save themselves---not to mention Mary and John!---a lot of grief, hard work, and even injuries if they would learn to integrate residents' care needs with the residents' own preferences.

I've seen it done.........developed a lot of care plans myself.........and I know it works! With dementia patients, successful care hinges on their ability to trust their caregivers; how can we expect them to behave "appropriately" when we force them into routines they neither like nor are able to understand?

I'm sorry for rambling, but this is a subject I am absolutely passionate about, and it continues to amaze me that so many nursing homes and other LTCs utilize so little of the common knowledge that is out there about caring for residents with Alzheimer's and other dementing diseases. It's not rocket science; I don't understand how professionals supposedly versed in geriatric care can fail to realize that someone with dementia just MIGHT feel threatened by being awakened too early by a gang of people, who then proceed to do things to her without her permission, and that she MIGHT take a swing at somebody to defend herself from what she interprets as an invasion.

To the OP: Thank you for caring enough about this resident to try to find a solution for her. She doesn't want to be combative or a "problem child"---she just wants to be left alone in the mornings, apparently. And to the person who 'suggested' using a pacer: My sense of humor is as warped as they come, but I didn't see anything even remotely funny about that post. Again, I'm a LTC nurse, and I'm all about respecting and honoring this elder generation.

A-freaking-men.

[nightmare, RN]

Totally agree! I wish it could be so.I'm going to get tattoos saying "no I don't want to get up at 06.00,no I don't want a bed bath at stupid o'clock in the morning,no I don't want my tv on with cartoons at 06.00,and yes I will be combative if you try to get me up before breakfast" Like mjlrn I hope I go before that time!

[bklynborn]

Have you read any info on the Gentle Care Method.......we used it in the Alzheimer's facility were I used to work and it was very successful. You may want to read it and pass it along to your staff and management.

[Blackcat99]

My mother has alzheimer's-moderate stage. Luckily, she has never become violent. The only thing that has worked for me is to tell Mom that everything I want her to do is " a doctor's order". I have to always speak in a stern authority- type voice. "The doctor said you have to get up". "The doctor said you have to wash up between your legs". "The doctor said you have to go to the adult day care center". It's the only thing that works with my mom. Your situation is different and much more difficult. Good luck.

[SuesquatchRN, BSN, RN]

This was close to lunchtime,mljrn. :)

I'm going to research Gentle Care, brooklyn bron! I'm from Staten Island, BTW. DH is the one from Brooklyn.

Blackcat, my situation is difficult, but yours has to be a hard row to hoe.

Thanks for the insights, all.

[nightmare, RN]

Anyone got a link to the Gentle Care method?

[bklynborn]

I believe the author's name is Moira Jones?

[SuesquatchRN, BSN, RN]

I can't find her.

I can find homes using "gentle care," and a symposium in Italy referencing Moira Jones' method of gentle care, but that's it.

[bklynborn]

strange ....she did a seminar here a few years ago

[SuesquatchRN, BSN, RN]

No, she certainly exists, but apparently hasn't published.

[bklynborn]

maybe try the alzheimers association

[bklynborn]

Ah.her name is Moyra Jones and she is published.