Treating residents/patients like idiots

FroggysMom · Nov 11, 2005

And there are regional differences as well. Here in the south, I am called Honey by random people on a regular basis- for example, the bank teller, my Charge RN, and one recent waitress. Honey, sugar and such are in common usage, so they often get used for patients as well, but in areas where a bank teller would not say- there's your money honey...it probably is a no-no...
I do admit though, it is difficult for people to remember that these people were/are productive citizens- some with really interesting lives. When I did clinical at a very ritzy nursing home, the staff life specialist had done up these posters in each room- they described the patients former occupation, family, and many had photos of them as younger selves, doing activites they enjoyed. It was great to see these, and reallyt sparked some talk, helped me to see many patients with alzheimers and constant repetitive behavior and speech as a "real person"

That is a wonderful idea about the photos! :roll

KatieBell · Nov 11, 2005

I wish I could claim it as my own. its such an inexpensive thing to do, but one that really helps- I mean, even the cleaning staff see the posters- and made comments to the residents about "That dog you had is just sooo cute" It really opened up a lot of things.

**RosesrReder, BSN, MSN, RN** · Nov 12, 2005

I call most ppl hun. Will try to get rid of the habit though.

jalvino1 · Nov 12, 2005

The brains of the very elderly process what people are saying much slower. So, while they may not be hard of hearing, you really do have to speak a little slower and wait a little longer for a response in order to give their brains time to catch up. That is a known scientific fact.

Although this is true, every patient is different. I've met 96 year olds sharper than 67 year olds, both categorized as elderly. Are the people talking slowly to those who need it or every single elderly patient?

nurse4theplanet, RN · Nov 12, 2005

I am a person. I am an indvidual. Anyone who addresses me as sweetie, hon or any other term of supposed endearment gets ignored by me. My name is on my chart and you get it during report, as well as it being placed in my room. You want my respect, as your patient, then start treating me with respect, including proper use of my name. And if I am confused, what makes you think I will respond better to being called hon or sweetie? Not on the best day of your life. It is not a term of respect and unless you are a loved one of mine, it certainly is not a term of endearment.
And any physician who calls me sweetie also gets ignored.
Grannynurse:balloons:

Don't come to the south cuz its a whole 'nother world down here honey!:rotfl:

Bipley · Nov 12, 2005

Don't come to the south cuz its a whole 'nother world down here honey!:rotfl:

Same deal in the SW.

jnette, ASN, EMT-I · Nov 12, 2005

Don't come to the south cuz its a whole 'nother world down here honey!:rotfl:

Yep.. sure is. :)

And these "persons" and "individuals" are proud to continue being called honey, sweetie, etc. as well as continuing their tradition of addressing others as such.

It's their CHOICE and PREFERENCE. :) And goes beyond the health care field as well.

rn/writer, RN · Nov 12, 2005

My 23 yo daughter has worked in LTC as a CNA for nearly five years. She started her first job inLTC when she was going through a rough patch and looking for independence with a group of companions that didn't always have her best interests in mind. The job offered paid training and she could earn more than flipping burgers, so she figured she'd give it a summer.

Something clicked when she entered this environment and I saw her begin to soften back up to her old self. She loved the residents and felt she had something to offer to a population that doesn't get a lot of attention.

She started talking about her old people (meant kindly) and called them her babies. She fussed over the residents, did their hair, helped them to freshen up after accidents, and asked about their lives when they were her age. When she worked pms, she would help them pick out clothes for the next day and tuck them in. Some she'd even give a kiss goodnight.

When she left her first job, quite a few of the residents cried. They gave her little keepsakes and told her they would never forget her. This happened again when she changed to her most recent employer as well.

One of the things the residents have liked is that she gives them nicknames. She has one too. Far from disrespect, this is a sign of endearment, a shorthand way of saying, "I see you as a person and you matter to me." Stringbean and Cookie and the rest knew that she wasn't one of the workers who was just counting the hours till she could punch out. She loved these people and had earned the right to speak to them with affection.

Last week, my daughter had a lady in the early stages of dementia sit nearby while she charted. Rosie looked over and asked, "Who owns me?"

After figuring out that Rosie was trying to ask who she belongs to, who she matters to, Lindie said, "I guess I own you, Rosie." The older lady was quiet for a moment. Then she asked, "Was I expensive?" Lindie smiled and said, "You were free. But now you're priceless." Rosie said, "Well good, then," and she was happy.

Some of this might not be technically professional because it transcends that detached demeanor we're taught to have. But if I ever end up in LTC, I just pray I run into someone like my kid, calling me Tootsie and giving me a kiss on the cheek at bedtime.

UM Review RN, ASN, RN · Nov 12, 2005

My 23 yo daughter has worked in LTC as a CNA for nearly five years. She started her first job inLTC when she was going through a rough patch and looking for independence with a group of companions that didn't always have her best interests in mind. The job offered paid training and she could earn more than flipping burgers, so she figured she'd give it a summer.
Something clicked when she entered this environment and I saw her begin to soften back up to her old self. She loved the residents and felt she had something to offer to a population that doesn't get a lot of attention.
She started talking about her old people (meant kindly) and called them her babies. She fussed over the residents, did their hair, helped them to freshen up after accidents, and asked about their lives when they were her age. When she worked pms, she would help them pick out clothes for the next day and tuck them in. Some she'd even give a kiss goodnight.
When she left her first job, quite a few of the residents cried. They gave her little keepsakes and told her they would never forget her. This happened again when she changed to her most recent employer as well.
One of the things the residents have liked is that she gives them nicknames. She has one too. Far from disrespect, this is a sign of endearment, a shorthand way of saying, "I see you as a person and you matter to me." Stringbean and Cookie and the rest knew that she wasn't one of the workers who was just counting the hours till she could punch out. She loved these people and had earned the right to speak to them with affection.
Last week, my daughter had a lady in the early stages of dementia sit nearby while she charted. Rosie looked over and asked, "Who owns me?"
After figuring out that Rosie was trying to ask who she belongs to, who she matters to, Lindie said, "I guess I own you, Rosie." The older lady was quiet for a moment. Then she asked, "Was I expensive?" Lindie smiled and said, "You were free. But now you're priceless." Rosie said, "Well good, then," and she was happy.
Some of this might not be technically professional because it transcends that detached demeanor we're taught to have. But if I ever end up in LTC, I just pray I run into someone like my kid, calling me Tootsie and giving me a kiss on the cheek at bedtime.

Yes, Miranda, that's exactly what I was talking about. Your story brought tears to my eyes, and a prayer that every person in a nursing home be blessed with someone as caring and loving as your Lindie.

Bipley · Nov 12, 2005

... Last week, my daughter had a lady in the early stages of dementia sit nearby while she charted. Rosie looked over and asked, "Who owns me?"
After figuring out that Rosie was trying to ask who she belongs to, who she matters to, Lindie said, "I guess I own you, Rosie." The older lady was quiet for a moment. Then she asked, "Was I expensive?" Lindie smiled and said, "You were free. But now you're priceless." Rosie said, "Well good, then," and she was happy.
Some of this might not be technically professional because it transcends that detached demeanor we're taught to have. But if I ever end up in LTC, I just pray I run into someone like my kid, calling me Tootsie and giving me a kiss on the cheek at bedtime.

There are lots of things that are done that might look questionable to others. Example, if you take a nurse that has always worked ER and put her in a LTC facility to sit and observe for a day, she might not be too thrilled with how things work. Unless you have been in a position to really get to know your patients well and they become family, it might look bad to someone else.

My boyfriend is a psychiatrist and we were talking years ago about a patient that died in my LTC facility. The staff were pretty upset, things were not going well, it was exceedingly difficult. He came in for a staff meeting and we did a debriefing. At that time I was still a newbie of sorts even though I was running the place. But I didn't know how to do this so he came in and did it for me. It was great. But I realized we were missing something. The patient that died wasn't just loved by the staff, there were a couple of close friends/residents that were not doing well either. So, we did it again and involved two patients that were not dealing well with the death. Some staff objected at first but when they had really cool things to add to the discussions, the staff quickly changed their minds and looked forward to the participation of some of the patients.

I think one of the biggest issues that an outsider to LTC facilities wouldn't "get" is the involvement of patients. We look to them for things sometimes. Advice, what have you. I had one patient, a favorite. Gramps. Gramps was more of a grandfather to me than my biological grandparents. I *did* go to him for advice at times and he always led me in the right direction. I fully admit I was very young, very inexperienced, and very much in over my head. I was thrown into a position of administration and I wasn't even an experienced nurse at the time. Lots of scenarios came up that I just didn't know how to handle both on a professional level as well as personal.

It didn't take long, in a short time I was quite good at what I was doing and confident in my decisions. I took a facility that was on the verge of losing their license due to every bloody citation you can imagine and I turned it into a great facility with a fantastic reputation and a waiting list.

I really credit lots of people for that, including gramps.

I had another patient that was a social worker. She had a way of changing the presentation of a concept into something people looked forward to. If I had to set a new policy, I didn't always want to change things so it was harder for the staff but sometimes our licensing authority made it such that I had no choice. I would tell her what I needed to do and she would help me write it up.

EVERYONE needs to be needed and that's just how it works. In a LTC facility people don't have the opportunity to be needed nearly enough. Did I break rules? Probably, but I'd do it again in a heartbeat in that kind of setting.

My point is that in LTC the rules change and we do things we might never do in any other setting. It becomes a family setting vs. a clinical setting and that requires different rules. While there are plenty of folks that will strongly disagree with me, I stand behind my own actions when I was in that position. (7 years)

geekgolightly, BSN, RN · Nov 12, 2005

I'm guilty of that. (Except I say "hon" and "sweetness")

guilty as charged! i am southern, so i also have the southern accent to go along with it. most people seem comforted by me. i can pick up on who doesn;t want to be treated this way.

not only is it a known fact that elderly process slower, but that most people under duress or illness, regress. comforting parental language like "honey" or "sweetie" really does seem to work well with many people who are truly ill.

CapeCodMermaid, RN · Nov 12, 2005

The brains of the very elderly process what people are saying much slower. So, while they may not be hard of hearing, you really do have to speak a little slower and wait a little longer for a response in order to give their brains time to catch up. That is a known scientific fact.

Sorry to disagree. Not all elderly people have slower brains. My aunt who admits to being 93 is still as sharp as ever. No one will play word games with her because she still always wins.