1. I am a new grad and just got my first nursing job yesterday! I will be working in a SNF as a charge nurse in a locked Alzheimer's unit. I'm very interested in psych nursing, have experience working with DD adults and completed a minor degree in psychology in college. I want to know what I can expect. I've never worked with Alzheimer's patients before. Does anyone have an experience that they can share with me? I know it will be challenging and I would like to have some tried "tricks of the trade" before blundering in cold turkey. Then again, that may be the best way to learn those "tricks of the trade".
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    About lesliee

    Joined: Jul '00; Posts: 46; Likes: 2


  3. by   erezebet
    I am a neuro nurse on a busy unit. I have a Bachelors in psychology and in nursing. I guess the only way the psych degree has helped me deal with alz. patients is that I have a strong background in how neurotransmitters work. Its important to understand the pathology of the disease and know that It is progressive, debilitating and lessens the quality of life for these people. With you being on a locked unit, I assume the patients will be critical. Its hard to treat patients who continually work against almost everything you try to do for them. But they are sick, not ungrateful. It takes a very patient and caring nurse to care for an alz. patient. Know that what you do is greatly appreciated by family members and friends. At the end of the day you will often feel as though you have accomplished nothing, but just keeping these patients clean and safe will be an accomplishment. They like to tug at lines, wander off, and engage in purposeless activity. They cannot be cured but drugs like aricept may slow the progression. Good luck to you!
  4. by   km rn
    Working with Alzhimer's residents can be challenging but it can also be so rewarding.

    Key elements - you must enter the resident's reality. Forget reality oreintation with this group of residents. Focus on the feelings behind what the resident is saying to you. So much of the resident's behaviors are driven by needs they can't express.

    Man wander in/out of everyone's room for 45 minutes until he finds a room with the bathroom door open - he sees the toilet, uses it and is then content to sit in the day room. He couldn't express his need for a toilet and couldn't recognize the bathroom without the visual cue of the toilet.

    It is sometimes helpful the have a staff person pose as a rescuer. if a resident is upset with staff members and verbally or physicall abusive, approach the resident and state - "jane, what are these awfull people doing to you, come with me and I'll help you. You don't need to put up with this. This has worked very well for us.

    Keeping Alzheimer's residents occupied in activities they can suceed at is a great help. Having resident fold baby clothes and thanking them with coffee, cookies, etc.
    Having them wash dishes, roll yarn, dust, etc. These activities can be great self-esteem builders for the residents and help them occupy their time and feel productive.

    Telling resident you would be happy to give them a ride, but you need to finish a few more chores first has worked for me. In the winter time, I tell residents that traffic is not recommened and that the train/bus station is closed down. I reassure them that their family is safe and wants them to stay here for the night.

    Mary Lucero (?sp) has multiple tips for managing residents with dementia.

    Remember to not ask the resident if they want a drink - state please drink this. Or I sometimes say I am thinking of buying this drink, could the resident please try it and tell me if it tastes good. I often say - please drink it all - I need to know if it has an aftertaste. Or I will say - I am trying a new recipe - can you tell me if I added enough seasoning to this soup, etc.

    Good luck.....I believe that we are caring for a great generation of people. Utilize their need to help others, etc. to help them suceed.
  5. by   egmillard
    My number one tip, is that during the middle and late stage of the disease, you need to enter into their world. If someone asks you where there husband is, and he is dead, simply say that he is away on business. Therapeutic fibs work wonders, and reduce anxiety greatly, it is better to think that your husband is away rather than dead, because of short term memory deficits, they forget easily what you say, so be kind and not cruel. I work with Altzeimers clients in various stage of the disease, and it is a cruel disease. Activities are also fundamental in their care, and helps to redue bordem and keeps the client stimulated, however you dont want too much stimulation as they will become agitated easily. Routine is important, and well as diet, little and often is good. A late stage dementia client will never ask for food and drink, so that needs to be prompted. It is a rewarding field, that I enjoy, I work in a small setting with 6 clients, whom I am very fond of. They need alot of support and patience. Good Luck, I am sure that you will enjoy this field of nursing......
  6. by   lesliee
    Thanks to all for the practical tips and advice. I will keep all in mind when I start on the unit tomorrow. Thanks again!