If She Yells ‘Help Me’ – Poster Therapy to Convey the Needs, Identity of an Ailing Parent

Joan Melton, MSN, lives in Indiana.

Photo by Ann Gordon, via Flickr

Photo by Ann Gordon, via Flickr

I am a geriatric nurse practitioner and have also been the daughter to an ill, aging parent. I felt well trained for my professional role but struggled with the latter.

I joked that, despite my logical understanding of what was going on with my mother, it could be hard to accept her physical and functional changes, which sometimes seemed to fly in the face of logic. There were days Mom’s hospice nurses spent more time with me than with my mother. They’d sit and allow me to vent my frustration at watching my mother slowly leave me, at feeling overwhelmed and “losing my cool” with her, at not being able to practice the advice I’d so readily handed out to so many other families over the years, not being able to “fix it” and successfully comfort all of Mom’s fears and ailments 24 hours a day, seven days a week.

Yes, I know how unrealistic that last statement sounds. Thank goodness for hospice nurses, who reminded me that I was “the daughter” and did not need to be “the nurse practitioner.” They reminded me that as the daughter I had amazing insight no one else had.

So, when Mom spent a week in the nursing home to give my family some long-overdue respite time, her hospice nurses suggested I share all of my rich, personal, daughterly insight.

Their idea was brilliant. It made me feel useful and allowed me to feel less guilty about taking Mom to the nursing home. Most of all, it reminded me of who my Mom really was behind the mask of her dementia.

Mom’s health issues had begun with chronic, recurrent atrial fibrillation. Placed on Coumadin for stroke prevention, she fell, hit her head, and had a cerebral bleed. She was taken off Coumadin, and during her recovery had another episode of atrial fibrillation, this time suffering a thrombotic stroke that left her with memory problems and expressive aphasia. In addition, Mom was blind from the effects of glaucoma and macular degeneration.

In summary, Mom was unable to walk by herself, couldn’t find words to say what she wanted to say, and could only see shadows. Naturally, she became fearful and frustrated as her world closed in on her. Confusion and anxiety were side effects of her condition(s). At times, she was so anxious that she became short of breath. Her oxygen levels would drop, and her confusion would get worse. In addition, her appetite changed. She lost weight, and like many elderly patients, she had recurrent urinary tract infections from not drinking enough fluids.

Two posters. Before it was time to take Mom to the nursing home, the hospice nurses suggested I make two posters to display in her room. They suggested that on the first I list who my Mom was behind the mask of her dementia. What did Mom love to do before she became ill? They also suggested I put photographs of Mom on the poster to show what she’d been like before she became so frail.

On the second poster they suggested I write things to help the staff at the nursing home take better care of Mom, tips that only I knew from my past experiences as her caregiver and her daughter. Seeing these things written on a poster and displayed in her room would serve as a reminder for the staff, and would provide an easy way to share important information about her to all the different staff members who would be involved with Mom’s care.

I took the nurses’ excellent advice and began making the two posters. The entire family helped. Mom’s posters were the talk of the nursing home. People would come into her room just to read them. Here are a few examples of what we wrote:

Poster #1
Mom loves flowers, especially zinnias.
Mom’s was married to Dad (name) for 51 years. Dad went to heaven eight years ago.
Mom had five children (we listed their names). Mom calls out for her oldest son.
He and his wife took care of Mom at home.
Mom loves to waltz and old-time country music.
Mom loves to talk to her sister (name) on the phone every day. Mom is extremely close to her sister. Their mother died when they were only four and six years old.
Mom loves cooking for her family. She makes the best fried chicken.
She loves listening to the Catholic mass on TV or praying the rosary.
Mom loves going to the country, raising cows and bottle feeding the baby calves. She would give the cows names like pets.
Mom loves having her hair fixed and putting on make-up and looking nice every day.

Poster #2
Mom’s appetite is not very good, but she loves mandarin oranges and puffed
popcorn. She calls these foods ‘the good stuff.’ She will eat them like they are going out of style. She has a special supply at the nurses’ station.
Mom drinks most of her daily fluids during the night. She always had a bottle of water at her bedside at home, and whenever she got up to the bathroom during the night would take a drink. Offer her ‘water’ during the night whenever she wakes up. Even if you are giving her another type of fluid, if you call it ‘water,’ she will drink it.
If she yells ‘help me,’ she just wants to know someone is there and she is not alone.
Hold her hand and she will stop yelling ‘help me,’ or try to put her rosary in her hand. She will start to pray out loud and slowly fall asleep.
Since Mom cannot see, always tell her who you are when you enter the room and what you are going to do before you do it. If you give her medicine, push on the palm of her hand first so she knows she has a pill in her hand to take.
Help Mom dial the phone to talk to her sister. She will forget to ask. She likes to have the speaker phone on if possible.
And last, but not least, do not forget to tell Mom how beautiful she looks! Who doesn’t love to hear how beautiful they are?

The staff at the nursing home told me they found this information invaluable in relating to my mom. It also helped prevent her from getting dehydrated, having another urinary tract infection, as well as from feeling more confused and anxious.

I hope the idea of making posters like this for a loved one can be as therapeutic for other families as it was for me and my family.

Mom died at home six days before her 86th birthday. We were all by her side, and she died peacefully. I learned things through this experience I would have never
had the opportunity to learn in a classroom, big and small miracles, things that I want to share with other families, and things that will be a part of me forever.

I want to dedicate this article to all her brilliant, ultracaring hospice nurses and hospice nurses everywhere who help patients and families find their way along the difficult journey of caring for and saying goodbye to someone they love.

2016-11-21T13:04:15+00:00 July 23rd, 2014|Nursing, Patients|7 Comments

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7 Comments

  1. Jacob Molyneux December 1, 2014 at 9:45 am

    Thanks for the thoughtful, heartfelt comment. We will pass this along to the article author.

  2. Christopher Rice November 28, 2014 at 4:07 am

    This article was wonderfully written, and very thought provoking/heart breaking when I think about the current naivety that I am newly approaching the field, and the manner that I feel that I have bent to the pressure of colleagues who would rather see the residents (Somebodies Grandmother, Mother, Father, Brother, or Sister) given medication that makes them calm, rather than try to find the actual issue the person is attempting to communicate. Do you feel that this intervention would lose the therapeutic value with the family if the posters were phrased more bluntly? For example if they said “When I cry for help: Offer me your hand, then water, then toilet, then food, and then please treat for assumed pain.” Again I cannot state how wonderful the article was, and I am going to try and incorporate it into my practice.
    Respectfully,
    Chris

  3. Mary Sinclair July 27, 2014 at 9:00 am

    The “help me” part opened my eyes & heart to know what my Pete is calling for. He is frightened and sometimes cold. So I put on a warm long sleeved shirt, an extra blanket, tell him everything is alright (do not have to call the police, the Dr. etc.) and I am right there to hold him (if in bed) or hold his hand. I give him a baby aspirin, ice chips to wet his mouth and a few sips of water. He is soon back to sleep. I know now that he is very frightened and in a panic so I also try to have him breathe deeply. Formally I would be very irritated that he would awaken me in the dark of the night! Mary in Colorado

  4. Stacy Slater July 26, 2014 at 7:03 am

    Just as I feel all humans should read “Tuesdays with Morrie”, we should all read these beautiful words. Thank you.

  5. Katie Mcclain July 23, 2014 at 4:51 pm

    Beautifully written and very touching for everyone who has been through this. I wish more people understood what people with dementia go through and how frightening it is for the people who have it.

  6. Marianna Crane July 23, 2014 at 11:25 am

    Now retired, I was actively practicing as a geriatric NP when my Mom was in hospice. Wish I learned of the Poster Therapy then for my Mom and my patients. Thanks for sharing.

  7. Wendy Nash July 23, 2014 at 8:42 am

    This story moved me to tears. Went through an almost identical situation with my Mom. As a nurse I spent hours trying to care for her, and make others see her as she used to be, not as she was now. She died a little over a year ago, but this story reminds me of all we went through together.

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