Interventions for a Terrified, Disoriented Resident

Published

She has been with us for years. She does not know here she is, she is constantly looking for her parents and husband, and she wants to go home. Cries and moans all day. Breaks my heart.

She is on a low dose of an SSRI and Ativan 1 mg QAM, 0.5 QD at 4 pm, and 0.5 a day PRN.

Does anyone have any ideas> When I mention it to the floor nurses they blow it off with, "She's always been like this." Well, maybe she doesn't have to be.

Thanks.

Up Vote Up Vote ×
Specializes in Cardiology, Oncology, Medsurge.

1.Controversial method that has been spoken of: Mention to her that her husband is in the room next door trying to get some sleep and by the way it's 10 o'clock at night; it's time for you to get some sleep. Yes, this is lying, however you are doing good to keep her from worrying herself from attaining sleep. (I understand you're a day nurse!) ;-)

2. Get her out of her room at the nurses station to observe everyone.

3. Take her on a long walks.

4. Encourage social exchange outside her room.

5. Encourage family to visit and if they show up encourage them in ways to help with her care.

Late stage dementia is difficult to deal with, lying is a last resort. This subject had been debated in earlier threads on this very forum

Up Vote Up Vote ×

I keep trying 1 but it has absolutely no effect. She hasn't the short-term memory to retain the information.

She is always at the NS with us and cries and moans non-stop. She's only in her room to sleep.

I've never seen a family member.

Up Vote Up Vote ×
Specializes in Cardiology, Oncology, Medsurge.

I usually spend most of my day with that type of patient and end up cheating the care of my other patients. Perhaps a sitter is in order.

I did want to mention that I didn't look at who started this thread. I know you've probably read all the other threads regarding this subject!

https://allnurses.com/general-nursing-discussion/advice-dealing-dementia-324469-page2.html

Up Vote Up Vote ×

Sue, do you guys do animal therapy?

Up Vote Up Vote ×
Specializes in Utilization Management.
She has been with us for years. She does not know here she is, she is constantly looking for her parents and husband, and she wants to go home. Cries and moans all day. Breaks my heart.

She is on a low dose of an SSRI and Ativan 1 mg QAM, 0.5 QD at 4 pm, and 0.5 a day PRN.

Does anyone have any ideas> When I mention it to the floor nurses they blow it off with, "She's always been like this." Well, maybe she doesn't have to be.

Thanks.

Has anyone tried a pain med? Dementia patients who have pain will often act like that.

I'm glad you're trying for her, Sue. It never hurts to have a good workup done. If it was me, I'd sure rather be medicated than miserable. ;)

Up Vote Up Vote ×
Sue, do you guys do animal therapy?

We have animals come in, but not therapy per se.

Up Vote Up Vote ×
Has anyone tried a pain med? Dementia patients who have pain will often act like that.

I'm glad you're trying for her, Sue. It never hurts to have a good workup done. If it was me, I'd sure rather be medicated than miserable. ;)

She has terrible stomach pain all. of. the. time. I have told the doc. The other nurses blow it off. "She's always had that."

I'm going to see if we can get her on something.

Up Vote Up Vote ×
Specializes in Hospice & Palliative Care, Oncology, M/S.

I'm so sad for this lady, and for you for having to hear "Oh, she's always been like that." I HATE that answer!

When I worked with residents with all levels of dementia, we would often have a resident who cried for her/his family. When I could, I would sit with them when I charted, and encourage them to tell me all about their family, or what they like to do. Sometimes just having (although a short-term) conversation with someone would help these people to calm down for a bit. It's amazing that when they feel a connection, the person might be more likely to say quietly, "I hurt." even if they're late-stage. I would run off to the nurse if I thought they were in pain and argue their case.

I agree with an above poster who stated that pain can be expressed in the same manner as this lady is doing.

I hope she gets things resolved for her and is able to live as peacefully as possible. :redbeathe

Up Vote Up Vote ×
Specializes in LTC, Hospice, Case Management.

How about a psych eval. Maybe psych MD can regulate meds better. It's not about trying to "dope" them, it's about enhancing their quality of life.

Up Vote Up Vote ×
How about a psych eval. Maybe psych MD can regulate meds better. It's not about trying to "dope" them, it's about enhancing their quality of life.

We FINALLY have a psychiatrist on board. We are a classical medically-underserved rural area and the social workers have been searching for a YEAR to find a psych. He will be in on Monday and will be addressing the most pressing residents first but I do want her seen. And another miserable woman who's "always been like that."

:uhoh3:

Up Vote Up Vote ×
Specializes in Cardiology, Oncology, Medsurge.

I really like this thread, how it mimics real life in nursing. How no one knows everything and it takes a team to come to a common solution. Hey, that's why I like coming here. Keep it up everyone!

*wine:anpom:*wine

Up Vote Up Vote ×
+ Join the Discussion