The past few weeks we’ve been talking about dementia and learning a lot about techniques to use while working with individuals with the disease. And I am getting some good experience while working with my particular patient on FW. This week I was so frustrated for my patient. He is on 24 hour assistance which means he is encouraged (forced) into either the activities room or therapy where a staff member can watch him all the times. He is extremely tired throughout the morning and hardly can keep his eyes open during therapy. This week was tough for him and myself because he was adamant on getting in that bed after I was finished with him – not listening to any reasoning. There was no changing topics, talking him down or compromising… he was just plain exhausted. (And that is really hard to forget about!) I was really thankful my instructor stepped and saw the state he was in and overruled the “not allowed to take a nap until after lunch” rule. We helped him back to bed and I think he was asleep before we left the room.
This protocol really bothers me!!! My grandmother went through the same type of situation a few years ago. She was in an ALF which didn’t have an alzheimer’s/dementia unit but was falling quite constantly when out of watch. They were making her go to activities all morning and afternoon so they could watch her. When we would come to visit she would be so tired that she couldn’t hold a conversation and she would cry to us and tell us how much she wanted to go to bed. It was so hard seeing her so frustrated and unhappy. I know what a situation she put the staff members in as well…if she did what she wanted to do and she fell it would be on their watch. ARGH! This is such a hard situation!
I saw another scenario play out at work this weekend. A patient just had hip replacement surgery and had a secondary diagnosis of dementia. I went to get her for therapy and found her trying to take the alarm off her chair as she was standing up. She presented very confused and absent minded. After getting her to the therapy gym, she started to cross her leg! I immediately jumped in and talked to her about her hip precautions. She said she never heard anyone talk to her about them. (They were posted in her room where she could see them). This is some serious stuff! If she isn’t about to follow precautions, then someone does really need to be with her 24/7. BUT…who is taking the responsibility for this? The facility? Do they hire more CNAs? Sitters? Should they even be accepting these patients if they don’t have the staff to watch them all day? And should these patients be subjected to hanging out at the nurses station, or attending activities in which they have no interest just so they can be watched?
I am fired up about these situations and I think that it is only going to get worse with the growing cases of dementia in the US. In 2010, North Carolina alone there are around 170,000 cases of dementia and that number is projected to increase to 210,000 by 2025!!! Those numbers are very intimidating. I think there not only needs to be more education on the disease, but increased funding for specialized facilities and rehab facilities to increase dementia care staff.
Click on the title of this post for more NC Alzheimer’s stats.
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