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 […]

2016-11-21T13:04:15-05:00July 23rd, 2014|Nursing, Patients|7 Comments

Downsizing with Dementia

fence 2 Photo by Shawn Henning, via flickr.

By Amy M. Collins, editor

I’ve blogged before about my grandmother and her dementia, which has long since been staking a claim on her memory. A few years ago I wrote a post called “No Country for Old Women.” In it I tried to describe the feeling of helplessness that my family felt when a series of providers had failed to diagnose the cause of sudden delirium superimposed on dementia . . . a frustrating game of hot potato had ensued, with each physician passing her around to the next. It ended when a nurse finally diagnosed her with an impaction.

A similar sinking feeling strikes me as her dementia advances, and again, there seems to be no place for her to go. At her independent living center, we know she’s just barely scraping by. If it weren’t for the nurse we hired to keep an eye on her each day, her difficulty living there would be much more obvious.

Our nurse faithfully calls to let us know when my grandmother has forgotten to shower; when she’s been seen in the same clothes a few days running; when she won’t stop cleaning the break room, the distant memory of her long-standing career as a housewife stubbornly clinging to her; when she’s been found wandering the corridors at night. I think we’ve kept her there so long because everyone there loves her, she’s allowed to have […]

2016-11-21T13:07:59-05:00March 29th, 2013|Nursing|5 Comments

Top 10 New AJN Posts of 2012

British Nurse and Baby, via Flickr/jdlasica British Nurse and Baby, via Flickr/jdlasica

By Jacob Molyneux, AJN senior editor/blog editor

Maybe, who knows, some social media content isn’t really quite as ephemeral as we usually believe. Some of our posts seem to keep finding readers, like 2009’s “New Nurses Face Reality Shock in Hospitals–So What Else Is New?” They’re still relevant and timely, addressing as they do some of the more perennial topics in nursing.

Our 20 most-read posts for the year include several others that aren’t “new” this year: “Parting Thoughts: 10 Lessons Learned from Florence Nightingale’s Life”; “Confused About the Charge Nurse Role? You’re Not Alone”; “‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses”; “Is the Florence Nightingale Pledge in Need of a Makeover?”; “Do Male Nurses Face Reverse Sexism?”; “Fecal Impaction and Dementia: Knowing What to Look for Could Save Lives”; “Are Nursing Strikes Ethical? New Research Raises the Stakes”; and “One Take on the Top 10 Issues Facing Nursing.”

The upstarts. Putting aside posts that have shown a certain longevity, here are the top 10 new posts of 2012, according to our readers, in case you missed them along the way. Are they our best posts of 2012? We will leave that to you. Thanks to everyone who wrote, read, and commented on this blog over the past year.

1.

A Crucial Distinction: Missing Incidents vs. Wandering in People With Dementia

At every stage of dementia, people with the condition are at risk for both missing incidents, in which they are unattended and unable to navigate a safe return to their caregiver, and “wandering,” a term often used to describe repetitive locomotion with patterns such as lapping or pacing. By understanding the differences between these two phenomena, nurses can teach caregivers how to anticipate and prevent missing incidents, which are not necessarily related to wandering. The authors differentiate missing incidents from wandering, describe personal characteristics that may influence the outcomes in missing incidents, and suggest strategies for preventing and responding to missing incidents.

When someone’s behavior is consistently outside the norm, our tendency is to stop paying close attention to observable differences in that behavior. This may be particularly true when we are responsible for the care and safety of a person with dementia. As described by the overview above, one of the CE articles in the December issue of AJN, “Missing Incidents in Community-Dwelling People with Dementia,” focuses on a crucial distinction between two types of behavior in people with dementia, one that is expected and manageable and even at time beneficial (for exercise, self-calming, etc.), and one that can be far more dangerous. Here’s a useful table that spells out some of the key differences to keep in mind between missing incidents and wandering. But for a more detailed look at the topic, please click the link above and read the entire article.—Jacob Molyneux, senior editor

The Cruel Irony of Alzheimer’s Disease

By Amy M. Collins, associate editor

As I watch my grandmother navigate the murky waters of her Alzheimer’s disease, it continues to surprise me that parts of her brain work at warp speed, while other parts seem to be completely defunct. For example, although she can’t remember what she’s done from one minute to the next, she can make up a lie to compensate for the memory loss in less than 30 seconds.

“Where did you get that new necklace, Grandma?” I recently asked at a family party. “Oh I bought it at the place where I work, you know, I type at a school,” she said, with certainty. Or when asked where she got a new sweater, she told my mother she went to the store. “How did you get there?” my mother asked. “I drove,” she said. “But you don’t have a car.” “Oh, well then I must have walked.”

She no longer remembers my name unless prodded, but she does remember that she has a cat in her room at the independent living center, and worries about it constantly. “I have to get back to take care of my cat,” she says when she visits us, becoming increasingly stressed the longer she’s away. Yet it’s hard for her to […]

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