Sad conversation today

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i have a home care pt that i've been seeing for quite a while now, and she and her husband are really sweet. she has mild dementia...remembers me in between visits but doesn't remember my name, etc. she often asks me repetitive questions or tells me something she's already told me several times...you know how it goes.

today she asked me if the "forgetting" is normal for people getting older. with her husband's permission i told her that she was suspected to have early alzheimer's. her face got sad and she asked me if she would get better. i told her that one of her meds would slow down the progress but she would get worse, not better. i literally saw the light go out of her eyes and she very quietly said "oh."

i know that she won't remember the conversation the next time i see her, but it was so sad to see the realization in her face.

Nurz2be your story touched me and brought tears to my eyes. God Bless you

:yeahthat:

You're a good daughter. And person.

A mensch.

as stated by the above poster, that i did not consider tazzi's feelings is a misunderstanding of where i'm coming from on this issue. cancer patients have a reversal of their disease not following the trend in science books without medical interventions, drug abusers stop taking the drugs without medical interventions, miracles happen. and to put me in a box of having no compassion makes me feel insulted likewise.

tele, do you have any links that show alzheimer's is reversible through diet and exercise?

i'm hearing this for the first time...

leslie

Specializes in LTC,Hospice/palliative care,acute care.
what good does it provide a patient to tell them realistically that his/her condition will worsen? how are we to know really? scientifically yes we know patient's with dementia worsen with time, the statistical trend is there plain as day. but, could we not say there must be someone who has reversed this trend through diet, through exercise, through digging through one's closet for that long lost crossword puzzle. anyway, sorry tazz, but you know how i like to kick up the dust!

i don't believe in lying to any patient.no matter what the diagnosis may be that person has the right to know and make their plans....we all have the right to plan our final trip -what good does it do to hold out false hope?what good does it do to whitewash the truth and never discuss issues like advance directives,tube feedings etc? in the early stages they are capable of coming to terms with their diagnosis and taking care of un-finished business.....often in the later stages it may be better to re-direct when this type of thing comes up...but it depends on the patient and the situation.

i agree w/you, ktw.

an early-stage alzheimer's pt has the right and a need to know (if they ask).

it is during the early stages, they will be able to plan accordingly for their future.

perhaps they may want to write letters to loved ones.

or put together a scrapbook.

maybe spend 1:1 time with family & friends, knowing they'll be creating memories for THEM.

oh, yes.

these and all pts have a right to know THEIR truths.

it affords them opportunities to act accordingly.

leslie

Specializes in Med-Surg.

It may not be headlines, but diet and exercise's role in Alz. is not new news. The role of diet in Alz. is in it's infancy and nothing is concrete. I'll try to find some links.

People are wondering why Asian Indians have the lowest rate of Alz. in the world and they are thinking it's the tumeric they eat almost daily in their curries. There's an ingredient in tumeric that is anti-inflammatory.

As it stands today there is no cause, nor cure understood for Alz. and any claims that diet and exercise cures or prevents Alz. is false because there are no certainties yet in Alz. other than it's an incurable progressive disease. However, one should not dismiss the role of lifestyle in chronic diseases, Alz. included. Naturally there are plenty of examples of people with stellar diets and exercise that give Alz. just like there are smokers who live to be 100.

Edit: Links: http://findarticles.com/p/articles/mi_m0ISW/is_2002_Nov/ai_93736450

http://news.bbc.co.uk/2/hi/health/1668932.stm

http://www.drweil.com/drw/u/id/QAA400096

http://alzheimers.about.com/od/healthyliving/a/exercise.htm

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I don't know if it's reversable or not. I sure wish it were.

What I have done for Mama is write a series of short essays about how she met Daddy. About each of us girls, all the pets I can remember, about her parents coming over on the boats. About her high school girl friends. About her living with Daddy's parents during WWII. About one of my sibs throwing the fork at the other and leaving her a tattooed eyebrow. Whenever I think of something, I write it down and take it over and put it in her book. She can find the correct page and seems to get a kick out of reading "the story of her life."

A brief tear came to me last Wed. I bought her a red cardigan because it gets cool in the evenings now. She said her Mama was wearing a red housecoat the day she died. (1935) Ohhhhh chilllllls. Now I know why when my cousin gave her a red one for Christmas, she secretly passed it on to me. There are things in her mind that pop up randomly. I know that alzheimers is raging, but I'm doing my bit part in trying to quench some of the flames for a while at least.

very interesting links, tweety.

the turmeric and ibuprofen sound more preventative than reversible.

but still, food for thought, as it seems to prevent other notable comorbidities.

leslie

Specializes in Med surg, cardiac, case management.

I'd like to second those who suggested discussing happier times with the pt. It often seems the case in Alzheimer's and other forms of dementia that the older memories seem to last longer than the more recent ones.

And older people like to talk about the old memories too. Since my mom died my dad has told me a lot of stories from when they were younger, stuff I had never heard before.

don't you think that if someone out there did that, reversed alzheimers with diet or what ever. it would be in the news!!! and maybe your right about what good it would do to tell, but what good did it do for you to say that to tazzi but hurt her feelings or make her feel worse.

as stated by the above poster, that i did not consider tazzi's feelings is a misunderstanding of where i'm coming from on this issue. cancer patients have a reversal of their disease not following the trend in science books without medical interventions, drug abusers stop taking the drugs without medical interventions, miracles happen. and to put me in a box of having no compassion makes me feel insulted likewise.

jmg, i appreciate your sticking up for me but i wasn't offended by tele's statement. tele and i go back a ways, and i saw her statement as she meant it: pointing out another way of thought. thank you for coming out of your corner on my behalf, though!!

Specializes in Lie detection.
"Mom, you saw me take my first breath and I will be with you when you take your last." I will hold to that. Alzheimer's truly is harder on the family than the person once it reaches the place where they start asking who you are and who they are. It is hard...It is an AWFUL disease. I pray has a cure one day in the near future.

Your post made me tear up and you are so right. It IS harder on the families. I've had several pt's on homecare with it and seeing the families go through stuff just breaks my heart.

Hugs to you...

we were taught in nursing school that B12 def was a deferential dx for dementia.....if this hasnt been ruled out, and it is almost impossible to do without out a trial of supplementation, the dx should be questioned

Specializes in cardiac/critical care/ informatics.
as stated by the above poster, that i did not consider tazzi's feelings is a misunderstanding of where i'm coming from on this issue. cancer patients have a reversal of their disease not following the trend in science books without medical interventions, drug abusers stop taking the drugs without medical interventions, miracles happen. and to put me in a box of having no compassion makes me feel insulted likewise.

i understand you were trying to put another thought there. but, there has not been any evidence of reversal of alziemers. sometimes cancer is cureable, imo it isn't even comparable... apples and oranges.

i didn't say you didn't have compassion, just showing the other side of what you had said. "what good does it provide a patient to tell them realistically that his/her condition will worsen?"

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