Author Archive
Posted on June 13, 2013 - by Nurse Virginia
A USELESS LIFE IS AN EARLY DEATH, ALWAYS MAKE THE CONFUSED ELDER FEEL NEEDED
A very small child will glow when they have been of service to their parent. A smile and sincere thank you can go so far while costing you nothing. It only takes a moment to smile and say “Thank you for keeping me company” when the person can no longer contribute physically.
While the confused elder is still able to do small activities or chores, make those opportunities happen. Many times in a nursing home, while making cookies together, the staff will have one batch of the batter made ahead of time. Then while the elders are putting together their cookie dough, the staff made cookies are already baking. The smell of the baking cookies fills the room while the elders are taking turns breaking eggs, adding the ingredients and stirring the bowl.
It really doesn’t matter if the elder’s cookie dough is done right, or even gets baked. It is the activity of being together, talking about the cookies and most of all feeling of service in participating. Words of appreciation, “Boy you are really doing a good job there stirring the dough Marge,” “Thanks for helping put the dough on the pans for me, George,” are all about how they made you feel.
Maya Angelou is quoted as saying, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
Include the elder in whatever chore you are doing. If you are folding towels from the drier and all the elder can do is hold a warm towel that still can include them in the task and make them feel involved. Holding that warm towel and hearing those warm words, “Thanks for keeping me company Mom,” can make the elder feel useful.
Words are cheap, yet words can hurt, harm, belittle or build, encourage, make a person glow. Words can make a person feel useful, needed, necessary or in the way, a bother, an annoyance, a problem. A caregiver especially, needs to choose their words carefully to make their elder bloom.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on June 6, 2013 - by Nurse Virginia
ELDERLY WITH MEMORY LOSS NEED CAREGIVER WITH SENSE OF HUMOR
No one could remember what they ordered and the waitress was getting impatient
They were five for lunch, four elderly ladies with significant memory loss and their caregiver. The caregiver read the menu and ordering went just fine. Chicken salad, BLT sandwich with fries a cheeseburger, all the usual lunch at the diner orders. The problem came when the waitress returned with the order and said “Who ordered the BLT with fries,” and no one remembered.
At first there was an awkward moment while the group was feeling some pressure from the waitress to claim their meals. Then the caregiver started to giggle and pretty soon all the ladies were giggling and then laughing out loud. A moment that could have been difficult, hurtful and embarrassing was not only averted, but turned into a comfortable bonding moment for the group. Even the ladies who did not realize what the “joke” was, could join in the laughter of the group at the table.
The significant person in this scenario was the thoughtful and aware caregiver. The giggle was the cue to the ladies that, we aren’t going to take this too seriously. The giggle said to the ladies “No harm done, if this is the worst thing that happens today, what a great day.” And all the ladies were looking to the caregiver for many cues that day in the diner. Cues can come in the form of smiling while you engage in pleasant table conversation. Cues can be related to dining and the right utensils to use and where to put your napkin. But the cue the elder with memory loss needs the most, is how to react when something goes wrong.
Laughter is said to be a great “self-care tool” for caregivers
The role of caregiver is so difficult that a caregiver with a great sense of humor will be less stressed by the little things. Laughter can fight off the effects of stress and create a more positive attitude towards life. As an unknown author once said:
“To understand a man you should walk a mile in his shoes. If what he says still bothers you that’s ok because you’ll be a mile away from him and you’ll have his shoes.”
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 29, 2013 - by Nurse Virginia
WHEN THE CONFUSED ELDER MAKES BAD CHOICES
Don never talked about dogs; no one would have known that he had this great unfulfilled passion for dogs. Yet, now that he is in his 70’s he not only talks exclusively about dogs, he has sent for papers to prove he is a “breeder.” Don having acquired a female and male dog has decided he will strike it rich by selling puppies.
Even if the elderly are confused and making mistakes it’s still their lives. To a point at least, they have the right to maintain their own lives.
(Book excerpt)
Family caregivers often ask, “What do we do when Dad resists our efforts to help him, to talk about his health or his medication? Even though Mom withholds information, should I pry or push?” How much do I assert myself?”
When it’s not life threatening – back down.
As a general rule, if it’s not a serious or life-threatening situation, the person has a right to make choices, even if those choices may be unwise or even foolish.
In talking to a variety of people, most of them suggest that the caregiver present a case and express concern. If the parent still insists on ignoring it, they advise, “Back down. It’s out of your hands.”
When it is serious, and you may have to intervene – use the last resort.
When the problem becomes serious, caregivers may have to intervene. In those instances, they need to assert themselves and even take over if necessary.
Here’s one hint a caregiver passed on. If the person refuses, say, “Then do this for me.” In a few instances, we had to use this ourselves. We knew Edith was grateful that we had taken her into our home. The one last argument that always worked-we made it one of last resort-was to say: “If you won’t do it for yourself, then do it for me, I’ll worry a lot less, and it will make less work for me.”
It may help to remind ourselves: We who care have responsibility for our loved ones. Responsibility may mean intervention, even if the loved one resists our help.
(Excerpts from: Cecil Murphey’s My Parents, My Children – Spiritual Help for Caregivers)
So what about Don and his dogs? Is anyone in danger? No. Is everyone tired of hearing about those dogs? Yes. Don however now has the pleasure of having four puppies along with his first two dogs. Trouble seems to be approaching as Don refuses all offers to buy his puppies. No amount of money seems to be enough for one of these fine dogs, at least to Don. Soon Don will have six dogs in his care, certainly on the road to being a dog hoarder. Then the neighbors might have something to say.
Virginia Garberding, RN
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 27, 2013 - by Nurse Virginia
MEMORIAL DAY – A FAMILY DAY TO REMEMBER – MOM WHO WAS A ROSIE, AND UNCLES WHO WERE SILENT HEROS
What I remember most was that they (my family’s military men) never talked about it, the war, “their war.” My great-uncle Ray had served in WWII, I wish I knew today where he served and what he saw. But he never spoke of it, not to me not to anyone to my knowledge. My Great-grandmother, grandmother or mother would certainly have repeated what he said, but nothing.
Uncle Harvey also served, and came back in one piece. There was that dent in the metal cover of the bible he carried next to his heart, that he never explained. But he, like Uncle Ray, had nothing to say, yet in every other way he was the consummate talker.
When Uncle Harvey returned he became a car salesman and was known to always drive the latest Buick, convertible of course. He was a good looking, cigar smoking, and fun loving talker. But not about that, his war. I wonder if he just wanted to forget it and get his life back. Uncle Harvey went on to marry the widow of a friend, a fellow warrior with a very small daughter, and raised her as his own.
Mom worked in a factory during those years; she was a Rosie the riveter. Mom passed away in March at the age of 90, as the last one in this family who contributed to that war effort.
Uncle Harvey’s picture in his uniform is on the cover of my book. My mother is sitting in front of the piano her parents had given her, it is early 1943 and her brother is away in the war. And so, his picture is on the piano and there is a star in their front window.
Everyone knew these uncles had served but they never claimed a bigger share of the American dream. They never held forth in political conversation as though their opinion was any more valuable than anyone else’s, because they had served. They never got those uniforms out again, never marched in parades and most of all never talked about it.
Like so many others just like them, all they wanted was just to fit in and pick up their lives where they had left them. Those lives they had thought about when they were so many miles away doing what their country had asked them to do.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 15, 2013 - by Nurse Virginia
LISTENING – CAN BE A GREAT GIFT FOR THE ELDER WITH ALZHEIMER’S DISEASE
Everyone wants people to show interest and pay attention when they speak. A person with Alzheimer’s disease is no different; they want the respect that was given to them and their conversation before they developed Alzheimer’s. Yet, persons with Alzheimer’s disease many times will be unaware that their speech has changed and may even be non-sensical. Showing that person the courtesy of paying attention is a great gift that anyone can give to the confused elder.
Four Ways to Show your Interest:
1. Show that you are listening by leaning forward toward the elder, possibly nodding slowly to indicate you understand and maybe even agree with what the elder is saying. When the listener nods too fast it indicates impatience, nodding slowly indicates that what the elder is saying is interesting maybe even too interesting to miss.
2. Showing patience by letting the elder finish, not butting in just to make the conversation stop sooner than the elder intends.
3. Ignoring the phone ringing, the TV, someone else interrupting – ignoring all distractions while just paying attention to the elder makes the elder feel very important.
4. Making little positive sounds like “uh huh”, “I see,” can make the person feel like you really understand them and encourages them to continue to share.
We all know what the “bored” listener looks like. He might frequently check his watch while you are talking, or yawn to show his boredom with you. Instead of sitting forward in his chair he might slouch or appear to be ready to fall asleep.
The elder with Alzheimer’s disease even in the late stage of the disease will continue to be able to read body language and knows when he has been insulted.
Virginia Garberding RN
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 9, 2013 - by Nurse Virginia
NATIONAL NURSES WEEK – FIVE TRAITS THAT MAKE A NURSE OR ANYONE ELSE GREAT
I just read an article called the 5 things that make a good nurse. In reading the list I realized these 5 things would be good traits in anyone, especially anyone caring for an elder.
5 – Traits that make a great caregiver:
1. Compassion – the ability to really see you’re elder and take action. Whether it is providing pain relief because you know the elder so well that you know when they are agitated they are in pain. Or the caregiver who realizes the elder is upset because they just can’t make any sense out of the environment or their situation, and the caregiver provides a comforting presence. The caregiver that realizes this isn’t what that elder wanted for themselves or expected in their life.
2. Empathy – The Oxford Dictionary defines sympathy as sorrow at someone else’s misfortune – however empathy is the ability to share and understand another’s feelings. I remember a day many years ago when I needed to “call-in” to work. Something I rarely did, but it was worth it for the words my Director of Nursing said to me that day that have stayed with me. When I explained that my arthritic knee was acting up to the point that I quite literally couldn’t stand, she said, “My knee hurts for yours.” That was empathy. Instead of saying “I’m so sorry you hurt, she said “I hurt for you.”
3. Selflessness – putting someone else and their concerns above your own. The private caregiver who just can’t go home on time because her elder isn’t doing well today. The caregiver who misses meals and hardly dashes away for a bathroom break.
4. Self-aware – knowing your strengths and weaknesses is important in a caregiver. No one is great at everything, knowing when you need to call for help doesn’t indicate weakness it shows self-awareness. Knowing when you need to step back and take a break is strength.
5. Thirst for knowledge – new ways to care for the elderly are discovered every day. Becoming part of a support group and attending educational opportunities to learn about new approaches for different disease processes, promotes better care. Sharing with other caregivers also rejuvenates the caregiver. A person who is always seeking new information is never a dull person.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 8, 2013 - by Nurse Virginia
CULTURE CHANGE, PERSON-CENTERED CARE IN HEALTHCARE, LOOK TO THE RESTORATIVE NURSE
Healthcare is moving in a more holistic system of care. The definition of “holistic” is: to treat the whole person rather than just the symptoms of the person’s disease. In the field of nursing care, the restorative nurse and restorative care would qualify as “holistic nursing.”
Restorative nursing uses routine activities of everyday life: eating, bathing, dressing, walking, getting in and out of a chair, brushing your hair, brushing your teeth, even turning and repositioning yourself in bed to improve the individual’s physical function, promote independence, improve safety and self-esteem. Helping the elder continue at their highest level of independence increases the elder’s self-esteem.
Just as in the area of holistic healthcare, restorative care is a philosophy. A philosophy of individualized care, rooted in getting to know the person for whom you are caring. There is no such thing as one size fits all about restorative care. No ridged rules to follow, the individual you are caring for determines the care based on their needs.
The restorative nurse is the last one to look for an answer in a medication; this is the nurse who is a detective looking for a reason based on the environment, and the individual’s abilities. Restorative nursing stressing abilities, not disabilities, and that is always the focus of restorative nursing. The restorative nurse is the true problem solver; changing the environment when needed to make it more user friendly, building balance and strength as indicated while supporting sensory systems.
Restorative nursing had its beginnings in the 1940”s and remains a belief system of care. A belief that every individual wants to be known by their caregiver, wants to be as independent as possible as long as possible despite their diagnosis, and maybe most of all wants a relationship with those that care for them.
With the current culture change movement in healthcare, as well as the changes in regulatory systems and reimbursement for services, restorative nursing will become an even more important area of nursing. This restorative nurse thinks that is a good thing.
Virginia Garberding RN
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 2, 2013 - by Nurse Virginia
NURSING HOMES – THE FUTURE OF SENIOR CARE
(PART IV)
Is it a spa, a cruise ship or a nursing community? The focus of the future in senior living will be on wellness programs, living green, cyber learning labs, themed restaurants, green environments, senior living design, wellness and healing gardens, therapy pools, and aquatic centers. Having life long learning will be very important in nursing facilities in the future.
The future may not be a nursing home, but perhaps a “smart home.” A home that has all the latest in technology, connecting the elder with their caregiver through wireless means. Tele-health technology, geriatric assessment through technology, and non-medical services to promote quality of life are all possibilities right now. There are beds that document how often you get up during the night, can take your weight, and body temperature. How about a toilet that will test your urine, as well as measure the amount of your output. Technology used to create safe environments, automatic light sensors when you get out of bed at night to show you the way to the bathroom.
New terms to know will be aging in place, which means staying in your home and having services and technology come to you. Aging in place could mean going outside your home to adult day care as well as bringing services into the home.
Green spaces, are long-term care settings which have small group residences instead of large institutions. A green space may have 6 to 10 residents instead of 100 to 200 residents. It would be a small home setting, self contained and organized around normal living routines and a sense of community. An activity director in this setting would now be called your life care coach.
Of all the choices, it seems that aging in place will continue to be the first choice of many.
Virginia Garberding RN
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 1, 2013 - by Nurse Virginia
NURSING HOME – TODAYS NURSING COMMUNITY MORE OF A REHAB FACILITY THAN LAST STOP FOR ELDER
(PART III)
The usual move into a Nursing Home is often looked at, as the last home for that elder. But that is not always the case. When the elder has been living at home and now moves into the Nursing Home they gain many services.
Myrtle brought Bill into the Nursing Home in a wheelchair because he had had several nasty falls. Bill had also recently lost quite a bit of weight. He had a diagnosis of Alzheimer’s disease and was now in the mid-stage of the disease. After Bill started falling at home he just seemed to go down hill.
The Nursing Home has many resources available.
On admission the nurse did a full assessment of Bill’s condition and the Therapy department completed an assessment as well. The dietitian followed his meal intake and provided supplements. Bill started working with physical and occupational therapies twice a day to build strength and increase balance.
The elder will have a personal diet developed for them while in the Nursing Home. The nursing assessment will include a total body assessment looking at the skin for any thing unusual. The Nursing Home may even have a wound nurse on staff trained in healing the most stubborn wounds with the latest treatments.
Whether it is a psychological problem which is identified by the social worker’s assessment or a foot problem noted by the nurse, help is not far away. Nursing homes have access to physicians from dentist to podiatrist.
Bill goes home.
Much to her surprise after only two months Myrtle received a call from the Nursing Home saying Bill could go home in three days.
When Bill left he walked out next to Myrtle, his balance problems resolved at least for now. His appetite was back and they said they would be stopping at his favorite hamburger place on the way home.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on April 26, 2013 - by Nurse Virginia
NURSING HOME CARE – A LITTLE DIFFERENT WAY OF LOOKING AT IT
(PART II)
Jail or Nursing Home? – Food for thought.
Let’s put the seniors in jail, and the criminals in a nursing home.
This way the seniors would have access to showers, hobbies, walks, and they would receive unlimited free prescriptions, dental, medical treatment, wheelchairs etc. and they would receive money instead of paying it out.
They would have constant video monitoring, so they could be helped instantly, if they fell, or needed assistance.
Bedding would be washed twice a week, and all clothing would be ironed and returned to them.
A guard would check on them every 20 minutes, and bring their meals and snacks to their cells. They would have family visits in a suite built for that purpose.
They would have access to a library, weight room, spiritual counseling, pool and education.
Simple clothing, shoes, slippers, P.J.’s and legal aid would be free, on request.
Private, secure rooms for all, with an outdoor exercise yard, with gardens.
Each senior could have a P.C., a T.V., a radio and daily phone calls.
There would be a board of directors to hear complaints and the guards would have a code of conduct that would be strictly adhered to.
Back In the nursing home “criminals” would get cold food, be left all alone, and unsupervised.
Lights off at 8pm, and showers once a week.
Live in a tiny room, and pay $5,000 per month or more, from their savings and have no hope of ever getting out.
Justice for all.
Virginia Garberding R.N.
Author: Please Get To Know Me – Aging with Dignity and Relevance
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