Mcgill model questions for long term care resident help

[norb7]

Hi ,

I am a first year nursing student, i am in my clinical practices in a long term care facility. I am having a hard time asking my resident the questions due to him having slight dementia, and the resident's family never visits when i am on my shift.

How can i queue and answer these questions for my assignment?

1. What is the (family/resident) dealing with?

2. What does the (family/resident) want or what is the (family/resident) working towards?

3. How are they going about it?

4. What is their potential to develop and find healthier ways of living?

5. What resources/positive forces are they making use of and what other forces could they mobilize?

Some info about my resident is he has been admitted to the facility in OCT2012, he takes antidepressant, he talks about how he wants to go home, he's usually really sweet and talks about other things. Today was his birthday , and he was talking about how i might not see him next week cause he might be dead. (which was a big shock, and i didn't know what to say)

I just don't know how i am going to answer these questions. I just feel like the questions wasn't aim towards long term care clients. It would be a big help to me if you guys give me a baseline answer to those question. ( so i can follow them)

[nurseprnRN, BSN, RN]

I used to find it helpful to tell students to take questions like this and think about some older person they knew really well, like a grandparent or other older relative or acquaintance, and imagine how he or she might answer them. That usually got the students to a place where they could see their patients as people with histories, just like your grandpa. That, in turn, made it easier for them to engage in a conversation.

Even if demented, people have memories, feelings, and the same sorts of goals they had before. Ask about them.

If he says, "I might be dead," your next response might be (remembering that at his age he has seen many of his family and acquaintances die and as a consequence might not view death with as much horror as you do), "Tell me some more about that."

[CC Wisconsin]

When I was a CNA in a LTC facility, I did just as GrnTea said...Imagine that you are caring for/talking to a grandparent. Remember that this is where your patient is living. You wouldn't want someone to come into your home and start asking you questions, so work the questions into a genuine conversation. In my experience, the elderly in LTC facilities love having someone to talk to. By having a conversation, you will build a trusting relationship with the resident and you will find out way more than you would simply by asking the questions.

When he states that he wants to go home, that's where I would go more in-depth. Ask about his home, does he live alone? How long has he lived there? Most of the older population that I have dealt with love talking about this and will talk for a while about memories.

Does he say that he is frustrated with his dementia? That would be another thing that he is dealing with right now. You could do some patient educating on how to manage...such as reminiscing about his life.

Hope this helps! :)