Should I feel guilty?

[CapeCodMermaid]

I work in a large facility. We have many residents with dementia. Most of them continue to say they want to go home. We change the subject and try to distract them until they think of something else.On Friday when I was getting ready to leave, one of the residents wheeled up to me and asked "When can I go home?" I her "Tomorrow". Her face lit up, she grabbed my hand and told me she was going to light a candle for me and tell the big man upstairs to watch over me. I thanked her and off she went down the hall smiling until she ran into another staff member and asked him when she was going home. Thank goodness he said "Tomorrow." i hate to lie, but I'm pretty sure God'll forgive me this one.

[SaoirseRN]

Sometimes it is less traumatic to them to not tell the truth. You made her happy for however long she remembers. Had you said "you aren't going home" you would have had a different result. Many times it is kinder not to tell the truth.

[thenursemandy]

When I first started my career I tried to do what we were taught to do....to reorient. After many pt outbursts I came to the realisation that it gives them peace if I "play along", so I changed my approach. Re-orienting a dementia pt that their spouse is dead or that they can't go home 10+ times a day is like torturing them repetedly.

[T-Bird78]

Nothing to feel guilty about, you did what's needed for dementia patients and provided comfort and reassurance. Besides, you didn't specify which "tomorrow", it could be the day after today or the day after next Thursday. . .

[tayloramaRN2be]

I work in a LTC as an activities assistant (while going through school), and I deal with this sort of thing all the time. Our population is almost all dementia. I have to "lie" to them. I believe that it is the best thing for them. I honestly do. Like Boston said, make 'em great "memories". It is the most humane thing to do.

[Kittypower123, BSN, RN]

When I was a CNA, I worked in a dementia facility. We had to take a dementia training course. As part of the course, we learned that reorientation, while it has its place (like a previous poster commented), generally makes the individual more agitated rather than less. Other approaches, such as redirection, were recommended. Since redirection does not always work, therapuetic fibbing (as I've always called it) can be very helpful. For the person with dementia, their reality is as real to them as this one is to us. If someone told me that I was not posting on allnurses.com but sitting in the dining room of a long term care facility, I'd think they were crazy and tell them so. We can't change their reality, we need to work with it.

[CoffeeRTC, BSN, RN]

Yep..as soon as your mom or dad gets home from work you can leave....hey..lets have dinner while we wait!

Rats! Where is that cab we called for you? They sure are taking long...let's go to bingo while we wait!

Hmmm...I don't know where your dog is? Must have run away again...I will have Mrs B (the residents housekeeper/ maid from at home years ago) go look for that dog.

Shhhh....you will wake my baby. (I'm forever pregnant, haha) She is sleeping in the next room. Lets go for a walk.

No..you can't leave tonite. Look at all that snow outside. Maybe tomorrow when the roads get better?

.....all of these are real, actual excuses. I refuse to reorientate and will gladly spend the 5 or 10 minutes calling out for John's long lost dog or walk Mary into bingo while we wait for her cab.

[lee2012]

I think you did good.

[Dezy]

I was wondering, if someone is suffering from dementia, could you make up a false reality and have them believe it?Eg. It's so snowy outside today! (When in fact it's summer out). Or telling them their someone famous and this their house or something with lots of guests?

[CT Pixie, BSN, RN]

I was wondering, if someone is suffering from dementia, could you make up a false reality and have them believe it?Eg. It's so snowy outside today! (When in fact it's summer out). Or telling them their someone famous and this their house or something with lots of guests?

I've used the 'its snowing' on many occasions when in reality its 90 degrees out and July. Works well as long as they don't decide to look out the window.

I wouldn't make up something about them being famous. But if they are thinking they are..then I'd go along. But to make it up without prompting from the patient, I wouldn't do it.

[BostonTerrierLover, BSN, RN]

I would like to be told I'm famous, Lol! But I know that's probably pushing the envelope for the Nursing Home I'll be able to afford:)

[chrisrn24]

I think reorienting is kind of a waste of time. Doesn't help the person to realize that they're stuck in the nursing home. I always say, "I think it might be tomorrow" or something similar if someone asks me that.

[cwgrlup85, ASN, RN]

In our dementia classes we are taught to use therapeutic fibbing, as they call it. It is much better than trying reality orientation. Bwsides, you made her smile and seem at ease at least at that one moment in time :)