Patient Attachment Help!!

CoffeeRTC, BSN, RN · Oct 6, 2005

Bless you for caring. We had a resident like this who became attached to another nurse. It was difficult, but used some techniques that moms sometimes have to apply when leaving for work. Distraction is a big one, sneaking out the back, be firm when saying good by, I'll see you tommorrow, etc. and just letting them cry for a few minutes.

renerian, BSN, RN · Oct 6, 2005

Wow that is tough. I will have to think on that a bit...........

renerian

fluffwad · Oct 7, 2005

Sounds like this man might be anxious and might benefit from an psych consult / antianxiety agent...........is he able to explain why he wants to be will you all the time and gets upset when you leave? Do you look like one of his relatives? Does he do this to others? Or did something happen in the past ( like his wife left him?)

Some dementia patients are anxious for no apparent reason and always want someone with them, but they don't know why. Anxiety is not uncommon in dementia.

casi, ASN, RN · Oct 7, 2005

Need your advice.
I work in LTC Facility. One pt with Dementia has really embedded himself in my heart. He follows me wherever I go from room to room. He sits with me when I chart. Basiscally he has become my shadow I don't mind BUT when it is time to leave at the end of the shift he cries. He is at times unconsolable. The staff have tried to redirect him or keep him busy closer to the end of the shift but he always seems to sense when I am leaving. I have asked that I be moved to another unit but the D.O.N wishes me to remain where I am. I really do like this fellow but I believe that him being upset to the point of crying on a regular basis cannot be good for him.Lately he has become non compliant with care when I'm not there. His previous history is pretty sketchy, we know that he held a doctorate in Biochemistry/physics. Any suggestions?

How good is his short term memory? When my residents start to get upset that I'm going to leave, I've learned that with some of them a simple, "I have to go help someone else right now, but I'll be back to get you for breakfast." Normally works really wells. First off, it settles them down to know I'll be back and helps them get engaged with something else and by the time breakfast rolls around they don't noticed that I've slipped off.

Is there anyway that when you work that you don't specifically work with him? Have another person do his cares, so he gets use to other people? Have you encourage him to let others help maybe?

txspadequeenRN, BSN, RN · Oct 12, 2005

I have several of those ( they dont cry when I leave though, but one is so concerned that I have to drive a night he wants me to stay in his bed and he will sleep on the floor ... wreck prevention I guess). One follows me everywhere, on med pass and she will stand at the locked doors until I come back to the unit if I leave. So I just let her tag along and get her a chair at the nurses station , she has severe dementia and does not speak many words but she rarley parts from me. I work just weekends and my other little man will scream through out the week ... "WHERE'S RED , HAS ANYONE SEEN RED!!!" Red s my nickname. I got called off another unit because he was screaming so loud he was disturbing the other residents. Come to find out he just wanted to make sure I did not leave with out saying good bye. When this man went to the hospital for surgery not long ago ,he pulled me aside and told me he loved me like a daughter and I was the reason he keeps going... :crying2: I guess he thought he would not make it. It was a tearfull seperation until he came back.

To the OP , this patient may remind him of a close relative that he loves dearly. I personally would not leave the unit but thats me. Have you tried involving him in activites ? I understand this is hard for you and I just dont have the answer other than you have made a great difference in this man's life. For that you deserve a pat on the back.

Daytonite, BSN, RN · Oct 18, 2005

This behavior is partly his dementia. Make sure whoever does the social/psych evaluations in the facility is aware of this behavior particularly the crying and now the non-compliance. If he is on any psych meds a psychiatrist should be visiting him on a regular basis and needs to be notified of this change in his behavior (the non-compliance). Otherwise, this patient's doctor needs to be notified of this behavior change or your facility may get into trouble with the state for not addressing this behavior change. Perhaps the MDS nurse along with the DON and any family he has can put their heads together to get a psych consult. We had a group of psychiatrists whose practice included geriatrics. I'm not in favor of any kind of chemical restraint, but some sort of medication may be necessary to help prevent him from having the crying attacks as these are a great stress on the body. He is also at risk since he is becoming non-compliant.

achot chavi · Oct 23, 2005

I have worked with many like those. It breaks my heart to see and as a nurse we think we have to be everything to everybody. But in truth its never a good idea for a patient to get too attached to a health care member. Try sending him on small (not so important errands) like delivering a 'letter' or throwing things out in the garbage. Give him small jobs to do to keep him busy and not focus on his attachment to you. Like punch holes in papers or fold papers or napkins, etc. Before you plan on leaving -tell him that you have to leave an hour before in order to give him time to make the adjustment,AND REMIND HIM EVERY TEN MINUTES THAT YOU ARE LEAVING AND WILL RETURN!

Ask a family or friend or his to distract him in order to leave with little notice from him. Explain that you have to leave but will leave him a letter or a pen of yours that you will retrieve in the morning so that he knows your coming back.:roll

Try hard to be empathetic but firm It isnt a good idea to encourage this kind of attachment or you'kll never get your work done.LOL:coollook: