[rnsince83]

Recently I have noticed an increase in the number of advanced Alzheimer's patients in several areas: medicine, surgery, orthopedics, intermediate med/surg (tele), urology, etc. (seems like everywhere but OB!). The ones that are strong enough to get up and about are the scariest. In the past two weeks I've had two who were impulsive, highly agitated, paranoid, and combative (one had a stroke with a mild hemiplegia and the other had pneumonia, both were mobile and very strong). I was afraid for their safety as much as I was for my own (one bit a nurse at a nursing home). I guess this is an ongoing trend with the growing aged population. I realize they are in need of the medical care we can provide in the hospital setting, but getting slapped, punched, kicked, bitten, squeezed and pinched is way beyond what I signed on for. I am adding some Alzheimer's care to my CEU's, but would like to know if anyone else has had similar experiences.

[nursinghumor]

I've done my share of Long Term Care and Alzheimer's as well as Parkinson's patients can be very difficult to deal with.

From something as simple as AM care and ADLs, the nursing assistants, nurses and other residents can be put at a very real risk of assault.

Here are some resources you may find helpful:

Alzheimer's Association:"The Alzheimer's Association is your source for information, support and assistance on issues related to Alzheimer's disease.
The Alzheimer's Association National Headquarters, 919 N. Michigan Ave., Suite 1000, Chicago, IL 60611-1676
Call us at (800) 272-3900
http://www.alz.org/
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Alzheimer's Disease Education and Referral (ADEAR) Center:"The ADEAR Center is a service of the National Institute on Aging (NIA). The NIA is one of the National Institutes of Health under the U.S. Department of Health and Human Services."
http://www.alzheimers.org/

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Alzheimer's Society - about dementia...
The Alzheimer's Society is the leading UK care and research charity for people with dementia, their families and carers. This site is frequently updated with leading information appropriate to the Soc...
http://www.alzheimers.org.uk
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Alzheimer's Disease Research, American Health Assistance Foundation (AHAF):"Alzheimer's disease is a progressive, irreversible brain disorder with no known cause or cure. It attacks and slowly steals the minds of its victims. Symptoms of the disease include memory loss, confusion, impaired judgment, personality changes, disorientation, and loss of language skills. Always fatal, Alzheimer's disease is the most common form of irreversible dementia. Approximately 100,000 victims die and 360,000 new cases of Alzheimer's disease are diagnosed each year. It is estimated that by 2050, 14 million Americans will have this disease. America is not alone in dealing with this terrible affliction. In every nation where life expectancy has increased, so has the incidence of Alzheimer's disease. Alzheimer's disease is becoming tragically common. It is estimated that by 2020, 30 million people will be affected by this devastating disorder worldwide and by 2050, the number could increase to 45 million."
American Health Assistance Foundation
22512 Gateway Center Drive, Clarksburg, Maryland 20871
1-800-437-2423, (301) 948-3244, Fax: (301) 258-9454
ghandiboe@ahaf.org
http://www.ahaf.org/index.html

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Andrew Lopez, RN
http://www.4nursing.com

[smbrn]

I hate to admit this but I dislike nothing in nursing more than trying to deal with a combattive, agitated elderly patient be it from Alzheimer's or whatever else. They can be quite dangerous to staff; biting, kicking, spitting, digging their nails into you and breaking your skin. I find myself wondering what on earth is our healthcare system doing spending so much money forcing aggressive care on these people? If patients have to be restrained just to receive care that appears will have NO impact on their quality of life, what is the point? I certainly do not want to end up that way. I wish MD's had more training or inclination to bring in geriatric psychiatrists in these situations. They and psychiatric advanced practice RN's who specialize in geriatrics are really the only people I have seen who have the true ability to evaluate behaviors and make reasonable recommendations both in recognition of the needs of the patients and of those who interact with them. How many times have others gotten such ridiculous orders from PMD's as 0.5 mg of Haldol IV x1? Useless!

[nursinghumor]

It is certainly not a pleasant situation to deal with, giving direct care to a combative older patient. The fact is that we're about to be overrun with such patients as the babyboomers make their entrance into the healthcare system.

Once it becomes clear that their families either can't handle, or don't want to be bothered with providing care, they'll be placed in nursing homes.

They'll strain already scarce resources and make our lives that much more difficult. I'll admit I'm thankful that I only need to give meds and treatments to these patients usually. The nursing assistants that bathe, diaper and clothe them have a much harder time. It's not unusual for them to have to double up, or assign the largest physical bodies on hand to get the job done.

Andrew Lopez, RN
http://www.4nursing.com