Dragging 'em out of bed

  1. 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?
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    Joined: Jan '06; Posts: 13,193; Likes: 17,908
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    118 Comments

  3. by   rigmedic
    You could hook her up to the monitor, start pacing her, and increase the millivolts until she decided to get up.........
  4. by   SuesquatchRN
    Quote from rigmedic
    You could hook her up to the monitor, start pacing her, and increase the millivolts until she decided to get up.........
    *snort*

    Now, that might constitute real abuse.

  5. by   Psqrd
    What I have seen nurses do is set a "get up out of bed" appointment.
    Start the day before and keep announcing "at such and such time your going to get up" "OH I can't wait to see you up tomorrow at 2pm" and keep up this talk until the moment and follow through the best you can...maybe even a cardiac chair might be helpful if you have access to one.
    I've seen the reward method..promise something like ice cream/favorite food if they get up or even a hot shower.
    Good luck
    P
    And rigmedic...that was worth a chuckle I must say. p
  6. by   jodyangel
    Problem is..when they're demented you Can't bargain with them. So I have to say that getting her up is just what has to happen. Now you want to remind the aides to be as gentle as possible. But she can't just lie there.
    It sucks to live old enough to be in such a position. Sometimes death is not such a horrible thing. I've gotten this view after working in LTC.
  7. by   Kim O'Therapy
    Since she complains of being cold; would offering her a warm blanket in the chair get her out of bed? Substitute the warmth of the urine-soaked pad for something else? Good luck. You sound like a very caring nurse.
  8. by   SuesquatchRN
    Thanks, all.

    Y'know, I'm going to try getting a couple of nice, warm bath blankets and coaxing her up.

    I dunno. I know she has to get up. It just breaks my heart to see her so distraught over being "attacked."
  9. by   Jo Dirt
    Quote from jodyangel
    Problem is..when they're demented you Can't bargain with them. So I have to say that getting her up is just what has to happen. Now you want to remind the aides to be as gentle as possible. But she can't just lie there.
    It sucks to live old enough to be in such a position. Sometimes death is not such a horrible thing. I've gotten this view after working in LTC.

    Boy, you got that right. I've learned after being in this business there are definitely fates worse than death.

    I agree, when they get to that point there is no reasoning with them. My main concern is not the patient here, but that she will hurt one of the aides. Better to have as many people as needed to see no one gets hurt and like it or not she will NOT be happy about getting up. That is just the way it is going to be. Yes, life sucks when it gets to that point. All you can do is tend to her as best you can until it is time for her journey on this earth to be over.
  10. by   GingerSue
    there must be things that she likes, that she would be willing to get up for
    - the idea of food, as mentioned above, is a good idea, or a warm & comfortable place in addition to the bed
    - what about something to do while she's up in a chair - would she watch TV or listen to music. Could she work at crafts?
  11. by   allantiques4me
    I am so glad I dont do LTC anymore.
  12. by   txspadequeenRN
    after being a alzheimer's nurse for a long time my recommendation is leave her alone then come back later and try again with a different approach. do not take a lot of people in the room and make her feel ganged up on or someone will get hurt cause she will be scared. as a matter of fact i would send one aide in to talk to her first and see what kind of mood she was in then go from there... dementia patients require different approaches then other geri patients. one of my pet peeves is ripping a elderly person out of bed at 4 am to sit there until breakfast at 7am..i know why we have to but on my floor if they don't want up they don't have too..it is just plain a$$ disrespectful...
  13. by   knockandhello
    Quote from txspadequeen921
    after being a alzheimer's nurse for a long time my recommendation is leave her alone then come back later and try again with a different approach. do not take a lot of people in the room and make her feel ganged up on or someone will get hurt cause she will be scared. as a matter of fact i would send one aide in to talk to her first and see what kind of mood she was in then go from there... dementia patients require different approaches then other geri patients. one of my pet peeves is ripping a elderly person out of bed at 4 am to sit there until breakfast at 7am..i know why we have to but on my floor if they don't want up they don't have too..it is just plain a$$ disrespectful...
    i agree.if more than 1approaches to test the waters some can feel quite threatened.speak calmly and soothingly if they are distressed .i can usually get them to respond and agree by introducing someone into the request that they respond to well, such as "your daughter/doctor wants us to do this for you".i always take time to explain procedures to them.as for suppositories well i always discuss "blockages" with them and usually have no problems.if they refuse i never force, never manhandle.theres nothing worse than distressed ederly with skin tears.besides then you have all the paperwork with incident reports.
  14. by   SuesquatchRN
    Again, thanks.

    I think she's just going to have to be distressed. We'll tell her it's time and tell her again and then just get her up. Quickly.

    txspadequeen, I FEEL the same way you do but she simply can't lay there in her own urine while her skin is macerating for the entire day.

    Well, this helped a lot. It simply has to be done and she just has to be distressed for a bit.

    Thanks again, all.

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