Experience taking care of the elderly

Specialties Geriatric

Published

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... :)

NCAMILLE: I didn't say that Dementia makes people violent. I said that inhibitions are gone. Big difference. We had one woman who didn't understand why it was unacceptable to strip off in the dining room. Her family described her as "straighlaced" before her decline (their words).

Usually there are some group activities, hairdresser appointments (our facility had an on site salon 3x/week), physio appointments (walking programmes, etc.), OT appointments, church services. It is very hard to motivate people into group activities and staff are often required to transport them off units to central social areas. But then if you've never done Bingo or been big on those type of activities, why should you suddenly have to do them because you are old?

Weekends are the worst. Most PT, OT and Social Staff work M-F. Volunteers don't want to come in on the weekend and the families are too busy.

Regular care staff try but if people don't want it they can refuse. I remember one family that complained to management that their were no rec. activities on the weekend. We tried, crafts, board games, memory times, current events all to no avail. The next time we heard from the family it was " the staff were all sitting doing crafts on the weekend, what do we pay for?" The residents put it bluntly "what do you do on the weekend, sit, watch TV and nap, well thats what I've always done on weekends too!"

As for IM Ativan, we tried to stay away from injections. Just aggrevates an already agitated patient. Only ever used a sc on a 100yr old that was fitting and yelling like the devil was after him. Woke up the entire floor, took two of us to manage to inject him.

And the question management does ask is "what did you to to provoke him". The only time it was phrased "what can you do manage the situation" was when a patient punched the physio. Guess which patient was discharged the next day? Right, do what you will to the NA's, LPN's, RN's, but don't go anywhere near management.

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.

you are a very understanding and patient caregiver... for how long are u working in the geriatrics care? what better approach do you do to give your utmost care to your patients despite their being violent or unresponsive at times? :)
NCAMILLE: I didn't say that Dementia makes people violent. I said that inhibitions are gone. Big difference. We had one woman who didn't understand why it was unacceptable to strip off in the dining room. Her family described her as "straighlaced" before her decline (their words).

Fiona59 -

I didn't mean to misquote you. There is a type of dementia, Pick's disease, which affects a patient's social skills, and judgment of what is appropriate. That doesn't mean it is the patient's true nature, just that a part of their brain structure, and therefore personality, is now altered and functions incorrectly. I don't believe most violent reactions are a natural part of dementia. I think a lot of violence is a result of a confused, foggy mind and a patient's lack of recognition of the caregiver and environment.

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... :)

Structured daily activites do help with resident's behavior. Some become agitated because of lack of stimulation, and some feel a sense of uselessness. We have a department that provides activities, and the staff on our unit is responsible for additional activities. We have many choices for patient activities. Our unit includes a kitchen area, there a patient can wash dishes, pour a drink, get an ice cream etc. We have laundry baskets with afghans, towels, socks and baby clothes in them. Some residents really enjoy having home-like tasks to occupy them. We encourage them to read books or magazines if they can. We also read to them occasionally. We have music and television available. The unit also has a collection of lifelike baby dolls, some residents like to hold them. The recreation department comes in several times a day and does individual visits, singing, pet visits etc. Unfortunately, even when we do all we can, there is still a lot of down time with nothing to do but sit and stare.

you are a very understanding and patient caregiver... for how long are u working in the geriatrics care? what better approach do you do to give your utmost care to your patients despite their being violent or unresponsive at times? :)

I've been in geriatrics for 7 years. About half of that in dementia care. It's difficult to give good care to someone who is violent. I'm not happy when I get hurt by a patient. I just keep in mind that I'm invading their space, expecting them to disrobe in front of a stranger, touching them in places only their spouse may have been. I'd be mad too. I also know that almost all of the dementia patients I've worked with could communicate to some degree. Many of them can understand what I say, and can respond in some manner. They just need more patience and repetition of instructions. Even so, I must admit I don't always give the best treatment to the violent patients.

Specializes in Education, Acute, Med/Surg, Tele, etc.

I never thought I would be in geri, but my path went there...and while I am still looking for getting out of it (I wanted to work with adults in acute situations..it is what I do best!)...but everytime I do I can just see my patients faces and my heart melts!

Yeah sure, some are downright stubborn, some are mean, some are sweet, and some are cruel, some are introverted, and some very extroverted. Some like to be nudists, some wear so many clothes you can't find them. Some are alert, some not. Some are slave drivers where others don't ask for any help at all (those are the ones you are picking up off the floor all day!). But all in all I have gotten to know each ones unique personality...and I feel I am a better person for knowing them!

I agree with many of the posters when we reffer LTC's as dumping grounds..this is too true even in the most expensive places! Family can't handle grandpa anymore and a home must be better...they send and don't ever look back (hurts families too much). While grandpa wonders what he did to deserve this...'oh why did I leave that stove on and burn the kitchen' or 'why did I fall and break my hip..might as well shoot me instead of putting me out to pasture'. It is very sad, very depressing...and some days you really come home and say "my GOD do I really want to live past 70???".

THe trick is is to understand these reasons..the more depressing side of your clients and their families...oh yes some days it can get you stark raving mad...but we that work in this area must endure these less savory sides of nursing so that we can help a population of folks that deserve respect, dignity, and TLC when they need it the most! It makes you thankful for what you have to be sure, and helps you in the future for what you will do with your loved ones as they age, and what you wish to happen for you when you do! (I started working on my kids early! They know my wishes!!!!).

When I go in to work, I really try to focus on 'what can I do to make at least one person overly happy!' and it is fun to do when you can. Some days I don't have the time, other days I can fit in more than one! It is the creativity of making someones day that thrills me, and I find it is a very positive goal and gives its own rewards!

Will I continue this work 5 years from now...NO, I wish to go back to doing what I do best...get back to the niche I loved...but for now, I feel I am in a situation that can be of serious benifit for me and my future patients...so I learn as much as I can, learn how I deal with the sadder sides of reality, the way I learn that every day is precious, and learn about my communities past (which is really fun actually! I am rural so these people set up the things in my community that I enjoy daily).

And sorry...I am kinda bias on all staff at these facilities...I feel they are extra special indeed to have so much heart and compassion towards a population that suffers so much. They are the best...and I have never worked with a finer group of people in my life. Dedicated folks with heart...and I simply love and respect all of them!!!!!! :)

One thing I always remember is never try to reorient the resident to "My world" or the present. I always try to step into theirs. I'll be their daughter, neighbor, whoever they think I am. I wouldn't trade working with the geriatric population for anything.

i keep it simple....treat em all like they are your very own granny or pap and you'll never go wrong!!!give em respect and TLC!!

I never thought I would be in geri, but my path went there...and while I am still looking for getting out of it (I wanted to work with adults in acute situations..it is what I do best!)...but everytime I do I can just see my patients faces and my heart melts!

Will I continue this work 5 years from now...NO, I wish to go back to doing what I do best...get back to the niche I loved...but for now, I feel I am in a situation that can be of serious benifit for me and my future patients...so I learn as much as I can, learn how I deal with the sadder sides of reality, the way I learn that every day is precious, and learn about my communities past (which is really fun actually! I am rural so these people set up the things in my community that I enjoy daily).

very well said :) ... well, i was just wondering... why do you plan to change your line of work even if you enjoy being in that particular field? is it ok to ask where you will be going back? and I also have another question, how different is it taking care of a normal patient from an elderly patient? please let me know if it's ok... thanks very much for sharing your insights and experiences... hoping to hear more from you...
Specializes in Gerontology, Med surg, Home Health.

Van_Ray....elderly people ARE normal...lol. You don't become abnormal just because you get old.

Seems everyone who posts here works in LTC or a Home for the Aged. Anyone out there work on a Sub-Acute unit? That has stressors and problems all its own.

The facility I started out as a new grad had sub-acute, LTC, Palliative, and specialized LTC (transitional care for those waiting placement in an LTC or assisted living site).

Trust me everyone wanted to work Sub-Acute. Patients were admitted for 30 days and rarely overstayed. They were 99 times out of 100 oriented x3. They took their meds when offered without the LPN having to grovel, plead, or make three med passes. Most were continent or if incontinent would ring for assistance. Their wounds healed. Their families were rational and never verbally abused the nursing staff. The patients were able to take day passes and eventually overnighters to readjust them to their homes and have them manage their own ostomy care or whatever.

Probably 75% of our patients were seniors. We got the odd few who were on IV therapy who couldnt be trusted to return to the hospital for follow up and continuation. Had a few HIV patients (great guys) who needed some TLC due to lack of support in the community. A few that couldn't go home due to stairs, wheelchairs (for a short time) and casts.

I only remember 2 problem patients on a sub-acute unit. An elderly eastern european male who fell on the sidewalk. Some bright spark in ER felt sorry for him living alone and shipped him to subacute for some TLC. I mean the guy had a bandaid on his knee. Turns out he like to show the nurses his equipment if you get my drift. "I, like it here, you girls make my meals and make my bed". He tried it on a young nurse who was so embarrased she didn't want to chart it "he's so nice otherwise". When he did it to me on evenings it was charted, after I explained if he was having difficulties in that area, I would be happy to get a urologist to have a look at it the next day. He went home 2 days later with a social work follow up to see if he would qualify for assissted living. The second was also an elderly eastern european male who point blank refused to care for his own ostomy. He'd had it for three years and was in sub-acute for a different issue that did not hinder the use of his hands. Turns out his wife did the ostomy care at home. She told us that he wouldn't even get his own coffee at home.

A lot of seniors saw sub-acute as being like the old fashioned sanitoriums. "I'm here to build up my strength and you have to look after me" was a common statement. We had to explain that they were partners in that restoration of health and they had to work with us.

Specializes in Gerontology, Med surg, Home Health.

Wow...hardly anyone at my facility wants to work the subacute floor because it's where all the really sick people are. In one bed the guy 4 days postop quadruple bypass, next to him someone with a new hip or pneumonia...and THEIR families are the worst. Honestly I think someone told them it was like going to the spa.

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