Experience taking care of the elderly

Purple Princess · Nov 29, 2004

old people have the ability to make you laugh, or cry, get embarassed, upset or whatever. At my place we have " Grandma" that walks around and often parks herself in other people's rooms or will try to go through their drawers.She also likes to clean the handrails, fold clothes sort of, and pick up crumbs off the floor. I try to change her for bed and she will start to cry saying no honey and i say dramatically yes honey!!!!! we have to do this and i promise i'll leave you alone the rest of the night. She had a money sweatshirt on one day and i said are you gonna share any with me? she sais no honey i was like awe your not going to even share a little and she tells me no. she's cute! and we have a food artist named "gallagher". she plays with her food more than she eats it. and some are down right nuts and trying to take care of them is like a murder scene each time. they will try to hit, bite, slap, grab at you, kick their legs and all i can say is wow that resident really is psychotic, not even ativan helps her sometimes. and one lady likes to read trashy romance novels, sing, and do crossword puzzles. another lady taps out the tunes on her tray table over her geri chair. it's sad sometimes to see these competent people completely loosing their marbles, lonely even for the holidays. there's this one guy we call tiger cause he used to serve our country and was a fighter pilot in the airforce. he serves in the war many moons ago. now he's just a tiny thing, confused, helpless, he gets visitors but not real often.

Van_Ray · Nov 29, 2004

wow, that's a very enlightening experience... thanks for sharing it with me, i really appreciate it... well, can i ask u something? what happens if the elderly patient gets a bit violent or what if they don't follow the doctor's order? how are u able to take care of them if they are getting a bit uhm, how can i say dat... uhm, stubborn? i will be going to the Home for the Aged this coming weekend and I know it will be a new experience for me. i am collecting more experiences to be included in my term paper... are their SOP's/guidelines to follow when an elderly patient acts irrational and stubborn? pls let me know.. thanks vmch... :)

CoffeeRTC, BSN, RN · Nov 29, 2004

All I can say is...It isn't easy getting old. If you have time..you should volunteer in nursing home. At least for a day or so. That would give you a good look.

Fiona59 · Nov 29, 2004

I agree with PurplePrincess, working with the elderly can be wonderful. Dealing with with management and families can be a nightmare.

Dementia units take special staff and its not for everyone. I admire those staff that can work for years in that enviroment.

The main thing to remember is that they are people just like you and me just at a different end of the life scale. I've worked with people that I would chose for friends and others that are best left undescribed. I miss many of those people.

When I was a student, I had an elderly eastern European patient in active treatment. For some reason he seemed to take a shine to me. One morning he wanted to show me something on his arm. I was expecting a tatoo of numbers on his arm. Turns out his tatoo was in his armpit. He had been in the SS and it was the markings for his blood group. I had to explain it to my instructor. No, it didn't affect my treatment of him. My personal opinions have to remain out of care. He was still a frightened 80 year old who had surgery. Its not my business what he did 60 odd years ago.

I had women whose families were too busy to spend five minutes visiting on the weekend but could spend 20 minutes complaining that her nightgown had shrunk in the wash. They would praise those children to the heavens.

Somebody had a bumper sticker that is true. Be nice to ur children, they pick ur nursing home.

It can be very rewarding, working with the elderly but emotionally draining if you bond too well.

ncamille · Nov 29, 2004

hi everyone! i'm new here... i'm a nursing student and i'm making a term paper about the experiences of nurses, caregivers, or medical pracitioners on the field of gerontology... pls. share to me your negative encounters and/or dillemas(if u have one) when taking care of the elderly and how you were able to overcome them... anything written here will be printed and included in my study! i'd appreciate to hear from u guys.. thank you very much... :)

Hi Van_Ray,

Working in geriatrics can be very fulfilling, for the same reason caring for a newborn is fulfilling. Many elderly patients would not survive without their caregivers. When I am able to provide for their needs, and individualize their care to humanize them, I feel like I've done my job. Purple Princess' experience seems to describe dementia patients. Caring for dementia patients is a world away from common geriatrics. Giving care to most dementia patients is a fight. Some dementia patients are unresponsive to your attempts, some respond by biting, pinching, punching, and verbal abuse. It can leave you feeling unappreciated at the very least. It is very sad to see someone change from being a well-groomed, independent, confused person, to being unkempt, incontinent, and combative. My goal with dementia patients is to cause the least amount of stress in keeping them safe and clean. Other geriatric patients do appreciate the help they get, some can be a bit demanding though. It's understandable that they are demanding, most caregivers are overloaded. I try to let them know I am available to them, and that they won't be overlooked. Hope this helps.

PBAJS · Nov 29, 2004

as you requested negative encounters and/or dilemmas, not sure if this is what you are looking for -

example: "quoting from purple princess - they will try to hit, bite, slap, grab at you, kick their legs ..." --- sometimes they do make contact when you least expect it. while getting someone ready for bed, i had a resident suddenly and forcefully punch my arm. another resident quickly grabbed my lower arm and her fingernails caused bleeding. another time after getting a resident into bed and was removing the socks, the resident unexpected kicked resulting in bruised ribs. solution: knowing which ones do strike out and learn how to jump faster.

example: "quoting from purple princess - i try to change her for bed ... and she will start to cry saying no honey and i say dramatically yes honey!!!!! we have to do this and i promise i'll leave you alone the rest of the night." --- my charge nurse has said to encourage the resident to change, however, "the patient/resident has the right to refuse". solution: rather than have a battle and upset him/her, it's better to let the resident sleep in his/her clothes. tomorrow is another day.

example: a resident eats very little mostly staring at his/her food. from questioning, she/he dislikes gravy and spicy foods. (a co-worker was putting pepper on everyone's food) and the resident had previously lived on a farm. solution: requested no gravy from the kitchen, place butter on his/her trayand replace chicken patties with uncoated chicken.

encounters and dilemmas can be overwhelming or trivial depending on how we handle the situation.

Van_Ray · Dec 1, 2004

:) well it seems pretty interesting and enriching to work in dat kind of environment, even it has its ups and downs... would u guys prefer working in the geriatrics or pediatrics?which one is more difficult to handle...

Van_Ray · Dec 1, 2004

as you requested negative encounters and/or dilemmas, not sure if this is what you are looking for -
example: "quoting from purple princess - they will try to hit, bite, slap, grab at you, kick their legs ..." --- sometimes they do make contact when you least expect it. while getting someone ready for bed, i had a resident suddenly and forcefully punch my arm. another resident quickly grabbed my lower arm and her fingernails caused bleeding. another time after getting a resident into bed and was removing the socks, the resident unexpected kicked resulting in bruised ribs. solution: knowing which ones do strike out and learn how to jump faster.
if the patient gets so violent and physical, do u result in giving them injections to calm them down? do most of the elderly patient there have psychological problems thats why they act thay way? and what are the reasons/factors why they are being left in the home for the aged? thanks for d reply and sharing to me ur experience... hope to hear more... :)

Fiona59 · Dec 1, 2004

You can't give anyone an injection with out there being a Drs order somewhere on the MAR. Usually its sl Ativan.

There can be alot of staff abuse by geriatric residents. Scratched, kicked, bit, punched, and verbally abused. These were patients in a normal LTC. Dementia of some type present in probably 50% patients. I once heard that Dementia makes you loose all your inhibitions and the "real" you comes through, because you are unable to filter it.

There is a loss of control in the elderly in nursing homes. There lives are now run by the units clock, personal belongings reduced to what will fit into shared rooms, pets gone.

Many families don't want their elderly medicated but these are often the first families to deny that their aged would abuse anyone. Often LTC is a dumping ground. The family cannot care or manage soandso at home and feel that "the home" will be a better place.

Getting someone admitted to a psychogeriatric unit can take forever and depending on the facility the care manager doesnt want an empty bed on the unit and face it, they don't want to call the family and tell them that soandso is so violent they need specialized treatment.

Staff are then asked "what did you do to provoke X" when they report and incident involving them being abused by an elderly patient. I know one person that walked into a room at 2330 to do a bed check and had the old girl leap out from behind the door and whack her with her cane. Tell me how you can avoid that?

Working with the elderly can be enriching and enjoyable but also dangerous. You just have to pick your area with a great deal of care. If your gut tells you to leave a unit, listen to it.

ncamille · Dec 1, 2004

Yes, some patients get IM Ativan PRN. The trend is to reduce restraints, physical or chemical. So in the facility I am in, Ativan is rare. It's a good point that patients schedules are dictated by the unit clock, and that they suffer from a lack of control. This results in lashing out. To be more precise, the question isn't "what did you do to provoke a violent reaction?" but, "what was happening that may have contributed?" I find that if I'm looking for a fight, I can easily find one. But I can easily avoid the fight by returning some control to the patient. Many are resistant, but I have run into very few geri patients that are just plain violent. There is almost always a better way to approach a patient and give care. Sometimes, I just have to do what I have to do. These are the times when I expect to get a pinch or a punch, and if I look from the patient's point of view, these are the times that I deserve it. I don't believe demented patients are showing their true personalities when they are violent. They are confused, don't recognize caregivers and feel threatened. Nothing odd about that.

Van_Ray · Dec 1, 2004

Staff are then asked "what did you do to provoke X" when they report and incident involving them being abused by an elderly patient. I know one person that walked into a room at 2330 to do a bed check and had the old girl leap out from behind the door and whack her with her cane. Tell me how you can avoid that?
Working with the elderly can be enriching and enjoyable but also dangerous. You just have to pick your area with a great deal of care. If your gut tells you to leave a unit, listen to it.

i can't imagine that working in the geriatrics can be that dangerous too on the part of the caregiver/nurse! even if the caregiver/nurse is the one already being harmed, i guess she still needs to be patient and understanding about the patient... can i ask you, what are the daily activities of the elderly at the Home for the Aged? they can't just stay around their rooms all day ryt? so what are their daily activities? are there any mental, social activities to enrich and help them overcome these tantrums? pls let me know... thanks... :)