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?

[mstrick1226]

I recently attended an End 0f Life Care Conference at which Teepa Snow, Education Director for the Eastern Carolina Chapter of the Alzheimer's Association, spoke on caring for patients with dementia. Her method for "enticing" patients to get themselves out of bed or wheelchairs is to sing to them and dance, then extend a hand to them to join you. "You Are My Sunshine" is a popular tune along with many other older songs. I've never tried it...I think I'd feel like an idiot...but, I have seen her do it and it works extraordinarily well. If you don't mind an audience, I'd say try it. Teepa also offers a training video with several actual case scenarios demonstrating some other also very useful techniques for working with dementia patients. I've seen her speak twice and she is full of good ideas (and a very entertaining speaker).

Here is a link to her chapter's website: http://www.alznc.org

Good luck!!

[nightmare, RN]

Sounds like a good idea except that if I sang to the residents it would probably be termed abuse!:lol2:

[suestrav]

We have used both the Gentle Awakenings and Bathing Without a Battle programs and have found them to be wonderful. The residents are far less stressed and the tension level on the unit has dropped dramatically. It takes w a while to get everyone on board, but once it happens it's great. We have much fewer issues with our residents who have dementia.

[lovingtheunloved, ASN, RN]

I recently attended an End 0f Life Care Conference at which Teepa Snow, Education Director for the Eastern Carolina Chapter of the Alzheimer's Association, spoke on caring for patients with dementia. Her method for "enticing" patients to get themselves out of bed or wheelchairs is to sing to them and dance, then extend a hand to them to join you. "You Are My Sunshine" is a popular tune along with many other older songs. I've never tried it...I think I'd feel like an idiot...but, I have seen her do it and it works extraordinarily well. If you don't mind an audience, I'd say try it. Teepa also offers a training video with several actual case scenarios demonstrating some other also very useful techniques for working with dementia patients. I've seen her speak twice and she is full of good ideas (and a very entertaining speaker).

Here is a link to her chapter's website: http://www.alznc.org

Good luck!!

Seriously, singing and dancing is magic. A little "You Are My Sunshine" goes a long way. I have a particular resident who screams and hollers "Help me!" during her showers, but get her singing, and she's all smiles. We put her on the intercom every now and then so she can sing to the whole building. She's very proud of herself afterwards.

[SuesquatchRN, BSN, RN]

I sing and dance all the time, even standing at the med cart pouring. It's unconscious - and we always have the. same. music. DVD. on. Daniel freakin' O'Donnell. Over and over and over again. BUT even the least responsive respond to happiness. The residents really love watching me sing and dance a little to myself as I pop meds. Huh.

I might suggest that we try "dancing" her up. That's a really good thought!

[twotrees2]

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?

i found playing good cop bad cop soi to speak works well in this situatuin and i usually take the task of the bad guy ( unless they already have been in and enjoyed the argument with the resident llol) every day is different with dementias - and unfortuantely sometimes you have no choiice but to be firm and "drag" them out of bed afterward just be the "good guy" and "understand" to her when she verbalizes and likely she will forget about it till tomorrow. its not fun but sometimes for thier healths sake we do have to be the heavy - just be sure its well documented and the family has approved it ( there is a nother idea - call family in to help - often if they "refuse" to allow you to take care of them ( ive seen it where they say oh they dont NOT allow it its your fault - yada yada ) once they get a dose of trying to deal with it they will likely agree to allow yo uto do your job.

[twotrees2]

today many things have changed in ltc, and some things remain the same. we are beginning the pioneer adventure at my facility, in other words, resident choice; we already have resident choice dinning. now we are working on resident's rising on their own and try to create a routine for them that is as close as what it was when they lived at home, well as much as possible. research shows that even demented residents can make consistent choices in regards to adls. getting them to get up sometimes is challenging. assess for pain, because many times they can not verbally express it, give them a time ( i will be back at 10 to get you up), then you will make sure they are kept warm with sweaters and blankets, tell them how long they will up and stick to it. find out what kind of activities they participated in when they were young and try to adapt them for the resident now. there is a video called bathing without a battle, creating a better bathing experience for persons with alzheimer's disease and related disorders by ann louise barrick phd, joanne rader ms, rn, and phillp sloane md, mph from the university of north carolina at chapel hill which provides a wealth of information to help deal with dementia and the problems it presents. keep the spirit up, we are living in a wonderful and adventurous time in long term care, we are changing the way elders are being cared for to make it better for all.

i have heard of this- our va nh in wisconsin is turning to this style- sounds liek a great idea ( id make a horrible patient - i am up all night and slleep all day lol) i look foreward after they get it implemented of my friend letting me know how it works.

[nightmare, RN]

I sing and dance all the time, even standing at the med cart pouring. It's unconscious - and we always have the. same. music. DVD. on. Daniel freakin' O'Donnell. Over and over and over again. BUT even the least responsive respond to happiness. The residents really love watching me sing and dance a little to myself as I pop meds. Huh.

I might suggest that we try "dancing" her up. That's a really good thought!

OMG Daniel O'Donnell !Is he required listening in all LTC's then!:uhoh21: I was once forced to listen to 3 hours of him and only just escaped with my sanity:lol2:

We find that quite often a joke or a bit of banter works quite well to defuse a potentially combative situation but,you have to really know your resident as,used on the wrong person,it can make things worse!That I think is the key,really know your resident.

[SuesquatchRN, BSN, RN]

OMG Daniel O'Donnell !Is he required listening in all LTC's then!:uhoh21: I was once forced to listen to 3 hours of him and only just escaped with my sanity:lol2:

I don't know. But I'd like to kill him AND his perky blonde wife.

ARRRGGGGHHHHH!

[BoopetteRN]

I have never heard of Daniel O'Donnell, we have Lawrence Welk videos and tapes that the residents listen to, some of the videos I know by heart and actually find myself singing at the med cart when I am doing a team. I have to admit that I enjoy the in-service position, but I really miss working on the floor and volunteer to do so when ever I can. Residents really do respond to music.

[SuesquatchRN, BSN, RN]

I have never heard of Daniel O'Donnell, we have Lawrence Welk videos and tapes that the residents listen to, some of the videos I know by heart and actually find myself singing at the med cart when I am doing a team. I have to admit that I enjoy the in-service position, but I really miss working on the floor and volunteer to do so when ever I can. Residents really do respond to music.

Well, mix up Welk with some O'Donnell. They love him!

That's me, bouncing at the med cart to Daniel O'Donnell. Oy.

[nightmare, RN]

Daniel O'Donnell's married!! I thought he was the other way inclined!