Thursday, January 7, 2010

ALZHEIMER'S BLOG

I just came from a call to a nursing home for a 86 yr old female with history of dementia and aphasia. Was told this patients H&H on Dec 23 was 11.3 and today her H&H is 8.5. The doctor at the nursing home wants to rule out a GI bleed. I am writing this to let you see what it is like for this patient with dementia / Alzheimer's.

We got on scene to find this patient in PT/OT at the nursing home. She has no idea what is going on and when my partner wants her to come on to our gurney she refuses. So the nursing aids help and transfer her to our gurney. I am with the nurse taking a report and I don't see what is going on. Finally my partner comes up to me and tells me that the patient does not want him to touch her. I thank God that he gave me such love and compassion for elderly people. I find her on the gurney scared. I take her hands in mine and get to her level looking at her in her eyes to get her attention. She is not sure at first she wants to talk to me but after my kiss on her check she starts to trust me. She can tell me her name but has no idea how old she is or what her birthday is. I ask her if she knows what is going on, and she tells me no, and that she wants to go home. I reassure her that if she was not loved by her doctor we would not be here and that she needs to come to the hospital with us. I ask her if I can take her vitals and put on a pulse ox and she shakes her head yes. She is quiet while en route to the hospital but as we are reaching our destination we are told that this hospital is on divert and not taking ambulances right now. So we have to take her to a different hospital 15 minutes away. She is confused as I try to explain to her what is going on. As we get her to the hospital she quietly awaits to see what is next. My partner tries to take her temperature but she won't let him. We bring her to her room and two male nurse aids come in to take care of her. I remind them that she has dementia, and is frightened so to use gentle gloves with her. As I am finishing my paper work by the nurse station the two nurse aids come out frustrated telling me that she won't let them take off her blouse to put on a hospital gown and she is trying to hit them. So I go into the room, take her hands in mine and explain to her that I have to change her and ask the men to leave the room.

Remember the stages of Alzheimer's. Memory loss, difficulty with familiar tasks, confusion with time and place, trouble with vocabulary, with drawl from social activities, changes in mood and personality.

Now imagine how you would feel in this situation. First you are told to go to a hospital and don't understand why, yet really want to go. Next as you get to one that is across the street you find you are in the vehicle longer than it should be. Now some young men are trying to take off your clothes. Just put your self in her shoes.

Alzheimer's is just as scary for the patient as it is for the caregiver. Remember to have patience, and try to remember who they were before the disease took over their mind.

Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press an Imprint Of James A Rock Pub., Co.
www.mariefostino.com

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