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?

[nightmare, RN]

found this link but it is Italian! Anyone translate?

http://www.terzaeta.com/med/congressi/21_03_01/approccio_ma_fam.htm

Found better link!

http://www.gentlecare.com/consistsOf.html

[SuesquatchRN, BSN, RN]

Hey, I ordered the book! $31 American. Not bad.

Great research job, nightmare! And bklynborn, thanks for a great resource.

[nightmare, RN]

Tell us what you think of the book once you have read it,Suesquatch.Should be interesting.

[SuesquatchRN, BSN, RN]

Will do. I'm quite intrigued, now.

[jenn2004]

I to deal with residents on a daily basis like that but, being demented does not mean that she does not have rights. Yes, she does HAVE to be clean and dry but, I do not feel that dragging her out of bed at that very moment is the answer. In my experience it is all about approach, if she dosn't want to get up at that time maybe try again in 30min or so? She also doesn't have to get up at all as long as she remains clean and dry as well as safe.( but you know they also have the right to fall)

[Jo Dirt]

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

Again, I'm a LTC nurse, and I'm all about respecting and honoring this elder generation.

At the same time when you try to run a nursing home like Burger King where everyone has it their way nothing will get done, either.

Getting old is terribly sad and it is degrading and hellish. People live longer than they should nowadays, and I don't think this is calloused to say because it isn't that they don't have the right to live but look at the quality (lack of) of life once they get into a shape where they are confused and incontinent and have the indignity of not even being able to feed themselves anymore.

I'm not going to take a bunch of medications to try to keep me alive. They can keep their Seroquel and Namenda and Exelon and HCTZ and Altace and Cardizem and the rest of that junk. I want nature to take its course. I don't want my last address to be Shady Pines Nursing Center. Let me go.

[nightmare, RN]

Amen to that!

[bklynborn]

if you google her name you can go check out the book online

[SuesquatchRN, BSN, RN]

if you google her name you can go check out the book online

Nightmare's link did that - I ordered it.

And :yeahthat: to motorcycle mama and mjlrn. There's a time to go and we keep ignoring it. Although people's kids get a lot of blame - and I do mean blame - for that. We have a new lady, 90s, moderate dementia, has broken both hips in the past, O2 dependent 2 COPD, bed sores - just came in directly from the hospital early last week. Daughter wants to know, although it's a holiday weekend and no physical therapist or charge nurse is around, should she get her mother back onto the walker. She's not, and I quote, "ready to see her in a wheelchair yet." Hoookay. We'll have her doing the cha cha next week, cookie.

[VivaLasViejas, ASN, RN]

That's why I've made sure MY kids understand that nature is not to be tampered with..........if and when I get to the point where I can no longer take care of myself and have no quality of life (per my definition), they are to let me go. No tube feedings, no IVs, not even antibiotics---NADA.

In my grandmother's day, they called pneumonia the "old man's friend" for a good reason; it usually did them in before they got to that point. And for those who did become frail, a hip fracture usually spelled the end. I just don't think God intended for His creations to go on and on, well past the time when we can tend to our own needs and enjoy life. A touch of arthritis, slowing down a bit mentally, maybe a few aches and pains.........that's one thing. But as much as I love the elderly, I can't believe how many people demand complex treatment for their 98-year-old great-grandma who's been blind, deaf, incontinent, and bedridden for fifteen years, or their father who is in the final stages of Alzheimer's and cannot even remember how to swallow.

I don't see this as being a loving, dutiful family member; in fact, I consider it torture, and I've made it crystal clear to my children that the way NOT to love and honor me is to force me to live longer than God intends. I made myself a DNR twelve years ago after participating in my first code, an 89-year-old NH resident whose vital signs went in the dumper four hours after an ORIF for a broken hip. She was so delicate that I fractured her sternum and probably most of her ribs with the first compression; we coded her for over twenty minutes while the family stood over us, insisting that we do "everything possible for Mother". Needless to say, the poor woman did not survive, and I'm sure if she'd been able to she would've thought she was better off.

Now, I am NOT an advocate of any sort of euthanasia or even physician-assisted suicide; I simply believe that each of us is meant to live within a certain range of years, and while modern medicine can do a lot to help us make the most of those years---as well as extend our lives to the outer limits of that range---it goes too far trying to "save" people whose good years have come to an end. For what? To exist in the shell of a body that once knew love, good food, sexual pleasure, warmth and comfort? To be a burden on the society to which they once contributed?

I've always believed that inside every dementia victim, there lives a tiny spark of the person he or she once was, and that person knows the truth........and is absolutely HORRIFIED at the indignity of having to be fed, bathed, turned, and changed like an infant. Not to mention being vulnerable to the tender mercies of caregivers who handle their frail, aching bodies as casually as they would flip a burger on the McDonald's grill. Or being forced out of bed at an hour they slept through for their entire lives. Or always being cold and sensing that nobody cares.

OK, that's my 2 cents' worth.........and then some.

[Levin]

In Australia we used to call Pneumonia, "Deaths little helper".

Levin

[WoWChick, BSN]

You could hook her up to the monitor, start pacing her, and increase the millivolts until she decided to get up.........

....I think I just wet myself.