The intended purpose of this article is to use the written word to capture some lighthearted memories and recollections about the funny and sometimes cute statements that my demented patients have made over the years. Working with the demented elderly population can be interesting.
Anyone who works around the demented elderly population can attest to the fact that they sometimes say the darndest things.
Mr. Rider is a pseudonym for the slightly plump octogenarian nursing home resident who had some cognitive decline due to vascular dementia. Anyhow, I walked into his room with his breakfast tray one weekend morning about six years ago. I naturally assumed he would eat his food after I had gotten finished setting up the tray. After all, this guy was one who never missed any meals.
"I don't want to eat this morning," he earnestly tells me. "I'm trying to lose some weight."
I was taken aback by his response because Mr. Rider was not the type of man who ever worried about maintaining his figure. However, after a few more attempts to offer him the tray, he continued to refuse, so I respected his desire to 'trim down.'
Ms. Lucinda is a pseudonym for the petite septuagenarian nursing home resident who was afflicted with middle-stage Alzheimer's disease. Nursing staff had to be very careful with the manner in which they approached her because she would take a swing at any caregiver who made one wrong move. In addition to punching the person, she would give them a verbal lashing with vulgarities that were on the same level as a drunken sailor.
I had just given her a bolus g-tube feeding one night approximately four years ago. Before I left the room, she studied me from head to toe and declared, "You're getting too fat, girl!"
Her eyes suddenly shift to my round backside. She examines me for a few more seconds and nods her head in agreement before saying, "Yes, girl. You're getting fat! You need to stop pigging out!"
Anne is a pseudomyn for the frail nonagenarian nursing home resident whom I met in early 2006 at my very first nursing job. She had middle-stage Alzheimer's disease and other psychiatric issues. I was a brand new nurse back then, and had learned in nursing school to perform 'reality orientation' when dealing with disoriented patients.
She would ask me every 30 minutes, "How do I get to the fourteenth floor?"
My newbie response: "This building has no fourteenth floor. It only has one floor. You're in the right place."
Of course, she was never happy with my answer and would furiously roll around the building in her little wheelchair until she could locate anyone else who would direct her to the nonexistent elevator or the staircase that would lead to the fourteenth floor.
Nowadays I avoid reality orientation like the plague if the patient has middle-stage or end-stage dementia. Therapeutic fibbing seems to work well with these patients and causes them the least amount of emotional turmoil.
So, have any of your past or present demented patients said anything that was too funny or so cute? Feel free to share!
I saw a post on this thread about reality orientation in patients with dementia and it reminded me of a story from my days on stroke/neuro.
We had a lady who had what I like to call goldfish syndrome: they're only able to remember things for 5-10 seconds, then the cycle repeats. This lady was convinced she was in her "younger days" and get very upset when we told her the year. She had wandered down to the end of the hall where our large windows were. The CNA was attempting to get her back to her room for lunch with no success. The CNA had gotten me and told me what was going on. I went to the patient and struck up a conversation with "HI! Whatcha doing?". She told me she was watching Hitler March across the battlefield with his bombs. I said, "Well, if there are bombs going off, should we move back to your room where it's safer, without these big windows that could break?". The patient got right up and let me lead her to her room. No fuss, no being upset. We chatted while she ate lunch, and things went beautifully after that.
I always thought it had to be difficult to be a patient with dementia, especially if someone is telling you that what you believe to be true isn't. I always looked at the situation, and as long as it wasn't harmful, sometimes it's better for the patient if we go to their reality instead of trying to bring them to ours. It isn't about it being easier, but about being better for the patient, especially in cases where the alteration in mental status is permanent. My own two cents, but it comes from a place of care and respect for our elderly. I always figured if you made it 70, 80, or 90-some years, you earned the right for me to meet you "at your place" in a way.
Specializes in progressive care, cardiac step-down.
96 yo F with advanced dementia wouldn't take her pills from the new grad I was orienting because she needed to ask her mother first. I advised the nurse to tell her something along the lines of "these medicines are to help you be healthy, I know my mom wants me to be healthy, and I bet yours does too". Turns out, pt thought the nurse was a teenager trying to get her to take drugs. Took them right down for me!
cmryan12
11 Posts
I saw a post on this thread about reality orientation in patients with dementia and it reminded me of a story from my days on stroke/neuro.
We had a lady who had what I like to call goldfish syndrome: they're only able to remember things for 5-10 seconds, then the cycle repeats. This lady was convinced she was in her "younger days" and get very upset when we told her the year. She had wandered down to the end of the hall where our large windows were. The CNA was attempting to get her back to her room for lunch with no success. The CNA had gotten me and told me what was going on. I went to the patient and struck up a conversation with "HI! Whatcha doing?". She told me she was watching Hitler March across the battlefield with his bombs. I said, "Well, if there are bombs going off, should we move back to your room where it's safer, without these big windows that could break?". The patient got right up and let me lead her to her room. No fuss, no being upset. We chatted while she ate lunch, and things went beautifully after that.
I always thought it had to be difficult to be a patient with dementia, especially if someone is telling you that what you believe to be true isn't. I always looked at the situation, and as long as it wasn't harmful, sometimes it's better for the patient if we go to their reality instead of trying to bring them to ours. It isn't about it being easier, but about being better for the patient, especially in cases where the alteration in mental status is permanent. My own two cents, but it comes from a place of care and respect for our elderly. I always figured if you made it 70, 80, or 90-some years, you earned the right for me to meet you "at your place" in a way.