Resident in a vegetative state

[JenniferRobert]

My name is Jennifer and I am just starting a CNA program in Pennyslvania and I need some advice. A few years ago my uncle overdosed and is now in a vegetative state at a local nursing home. My father just expressed to me that he wants to go visit him on Saturday and that he feels real guilty for not going in a while, and i'm scared. I know this will be really hard for my Dad and I want to be strong for him. My question is, is there anything I can do to there to make everyone comfortable? I was thinking of bringing a comb and brushing his hair. Is there anything else I can do or are there things I need to be aware of when visiting someone in this state? I was even thinking I could ask for one of those sponges on a stick and a glass of water and help moisten his mouth, is that a good idea? How about buying a chapstick to get his lips moist? Any advice would be greatly appreciated. Please be kind to me as this is a sensitive subject and the situation is completly out of my control. I tried to ask my teacher and she was really incosiderate, and I want to make my Dad proud. Thank you!

[JDZ344]

First of all, I am very sorry to hear about your uncle

Hopefully the staff will be doing the mouthcare on him, but I'm sure they will appreciate you doing it whilst you are there! I normally show family members how to do it, and ask if they are comfortable doing it, and usually they say yes- it gives them a feeling of "doing something".

You could comb his hair, you could even try to get one of those shampoo cap things to wash it? Brushing teeth might help, too, but again, I am presuming tha tthe staff at the facility do that for him.

You will already know this, but talk normally to your uncle as though he will respond and encourage others to do the same.

[bla3911]

I am sorry that something like this has happened to your family. I don't know what will make your dad or you more comfortable but I can suggest some things that I have seen brought to patients where I work. Soft blankets, 'real' clothes(sometimes with the sides cut out and velcro used to attach back together like a hospital gown), good toiletries (body wash, lotion, tear free shampoo, deodorant), cd player and cds, pictures or posters for the wall. Make sure his name is on everything you bring and please don't bring anything that you mind getting lost. Of course, the most important thing is that you will be there.

[VivaLasViejas, ASN, RN]

You also may not wish to 'assume' the facility is doing a perfect job of keeping your uncle's mouth clean and fresh. I work in one of my state's very best nursing homes, and I'm sorry to say that oral care is one of the first tasks to be forgotten when things are busy, which is most of the time.

For example, we have a young lady who's been 'vegetative' since she was in a car crash at age 19 (that was 18 years ago) and her teeth are atrocious, despite the fact that I nag/beg/plead/cajole the aides to do mouth care at least once a shift (it should be done no less often than every 2-4 hours, but that's asking the impossible). When I'm on, I'll grab the mouthwash and toothettes and give her mouth a thorough scrubbing myself, but it really needs more attention than that......and again, this is in a GOOD facility where the care is otherwise better than average.

Kudos to you for wanting to do the right things for your uncle. He's lucky to have you!

[nursel56]

That's very sweet and sensitive of you to ask this in advance of your Dad visiting his brother in the nursing home. I don't know why your Dad hasn't visited- guilt, anger, fear- just got too busy and life got in the way, so I think you may tailor your actions with regard to making everyone feel comfortable based on that.

I think that your Dad should know what to expect to see- if he doesn't know already. I'm thinking of things like whether or not there is eye contact, vocalizing or contractures in his arms and legs. Encourage him not to be afraid to talk to and hold your uncle's hands. You are correct in that it could get very emotional, and try to tell your Dad it's OK to cry and you are there to support him.

You might be able to ask the staff at the home what your uncle responds positively to and what bothers him. Even patients in a vegetative state have "likes" and "dislikes". For example, there may be a way of touching him that he finds soothing. Some people have areas of their body that they will grimace if you move or touch. The most important thing is the fellowship with family, and even if your uncle can't actually eat with you, or talk- you and your Dad might be able to share one of his favorite foods, or reminisce together about your Dad's life growing up with his brother.

Who really knows what is or isn't communicated when a person is locked into a state like that, but there's really no reason to feel afraid or nervous. It's so hard on the remaining family- so bless you for being such a supportive daughter and niece. :)

[JenniferRobert]

Thank you all for the great advice and support. I really do appreciate the insight and your kind words. Truly, I thank you.