Was this a wrong approach?

Hopefulstudent333 · Dec 15, 2020

I work in a dementia unit and I do the exact same thing. I always say that they can go in the morning or you could say, come with me I want to show you something and walk them down the hall in the opposite direction. That works for me to because then they usually start talking about something else and forget all about leaving. I usually offer something to eat or drink as well because behaviors such as trying to leave or being agitated could mean that they have a need that is unmet such as they are hungry or they need to be toileted. I think your response is perfect though.

Bubblesx530, CNA · Dec 15, 2020

1 minute ago, Hopefulstudent333 said:

I work in a dementia unit and I do the exact same thing. I always say that they can go in the morning or you could say, come with me I want to show you something and walk them down the hall in the opposite direction. That works for me to because then they usually start talking about something else and forget all about leaving. I usually offer something to eat or drink as well because behaviors such as trying to leave or being agitated could mean that they have a need that is unmet such as they are hungry or they need to be toileted. I think your response is perfect though.

Thank you so much, I'm always so clueless on what to say. Cause they say not to "lie" to them in training. I gave them a glass of milk and some graham crackers then that's when I walked them back to the room after they ate. I appreciate your advice. ♡

amoLucia · Dec 15, 2020

Outright lying is one thing, but 'therapeutic fibbing' is well-practiced by most of us.

I prob would have pointed out the dark nighttime sky outside the window and I'd explain that taxi cabs don't come out at night. So 'waiting until first thing in the daytime would be a really good option'. :))

Just know that 'therapeutic fibbing' is often care-planned for dementia pts. To otherwise argue with the pt would be causing distress. And I truly believe that 'psychic pain' is just as traumatizing as physical pain. Even when they can't tell us 'on a scale of 1 to 10 ... ' how upset they are!

There have been prev posts re 'therapeutic fibbing' here on AN. And many of us agree with the practice. You did fine. Milk also contains a sleep inducer (serotonin ??) and a half of banana would have been extra!

Missingyou, CNA · Jan 17, 2021

If it worked, then it was the perfect thing to say. If you told them them truth, it probably would have agitated them.

Other things that have worked:

°it's snowing out & the roads are bad, we're all staying here tonight. ( I say this even in Summer!)

° I get off work in 30 minutes, I'll give you a ride home, maybe u can wait here( their room) I'll come get you when it's time to leave. (Provide snack or task such as folding towels or baby clothes).

°it's really cold outside, you will need a coat if your going out, your coat is back this way.

amoLucia · Jan 17, 2021

"Therapeutic fibbing' is just a diversionary tactic. Just meant to buy some time and get the pt to refocus energies.

All that phoney baloney stuff re 'reality orientation' just doesn't cut it for dementia pts. And nobody means to further antagonize them. Only upsets them more.

It's a skill that becomes easier when you become more practiced with it.

to Missingyou - you've got it down pat! Perfect examples!

caliotter3 · Jan 17, 2021

“The kitchen is this way, let’s go get a snack first. You can eat it in your room or with me over there.” Snacking material from med room or nurses station.

Queen Tiye, RN · Jan 18, 2021

It sounds like you successfully validated and redirected your Pt. When validating a Pt's feelings/ concerns during confusion, take into consideration their memory. If they will forget what I told them in a couple of minutes, then I tell them just about whatever they want to hear. If their memory is better than that, then I take a different approach.