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Things That Go Bump In the Night

Years ago, I went to a seminar where the speaker, a nurse, talked about a lesson she had learned from one of the residents at the long-term care facility where she was working.  This gentleman was similar to many of the folks we encounter in this setting; he was on the call light every few minutes.  He needed a blanket, he wanted something to drink, and he had a pain.  It was never the same thing, and after 2-3 hours of this she was understandably a bit annoyed.

Finally, our nurse had an idea.  The next time this man rang his light, she went to his room and calmly reassured him that she was just down the hall, and if anything happened she would come right away.  Then, every time she went down the hall, for one reason or another, she would take a few seconds to peek in his door and wave, or say a soothing word, if he was awake.  And the number of times this gentleman rang his call light decreased significantly.

Researchers have shown, over and over, that brain scans done on persons with dementia are markedly similar to those done on children.  As the dementia symptoms progress, the brain function resembles younger and younger children.  And I repeatedly find that lessons I’ve learned from my years of working with young children help me to better understand my current patients.

Many young children go through a phase when they seem to need reassurance that their parents are nearby, and that they are safe from any real or imagined dangers that might come their way.  These are the little ones who cry out in the night, wanting a drink of water, or who totter into their parents’ bedroom.  Sometimes this is in response to a dream, or an unexplained household noise.  Often, all they really need is a hug and a promise that Mom and Dad are in the next room, ready to pounce on any monsters that might crawl out from under the bed.

I’ve recently begun to think about what all this could mean for our care of persons with dementia.  As cognitive function declines, it’s possible to lose the concept of object permanence, just as assuredly as it is to lose the ability to feed oneself.  And, just as a person can forget how to use a call light, or even that he has one, it’s possible for him to forget what water sounds like as it gurgles through the pipes under the floor.  Or, being hard of hearing, he may hear voices from down the hall and not understand that it’s the television or two caregivers discussing another resident.  Or he may see a photograph on the wall and think its some stranger looking through the window.  (Not an uncommon occurrence for those with dementia, even during the daylight hours.)

So, what do we do to help these people?  Could we use the example of strategies used with our children? Perhaps, I honestly don’t know at this point.  It’s definitely an area that I’ll be researching, and I’ll be trying out a few things with some of my patients.  And I’ll be sure to post my findings here, as well as listening to any words that others might have to say.

My first experiment began yesterday.  At the facility where I currently work, we have a resident who calls out frequently (sometimes it seems like it’s every ten or fifteen minutes).  Sometimes she says she has to use the bathroom, at other times she just wants someone to be with her.  This has happened day and night, and seems to be getting worse rather than better.

So, I located a very realistic baby doll that I’ve used in my therapy with other residents, and brought it to this woman.  She was instantly enchanted by it, and was very happy to “help” me by watching it for a while.  She bounced it on her lap and told it what a pretty boy he was.  And, for a time at least, she was quiet.  I left the doll with her over the weekend, to see how it might affect her behavior.  And I’ll definitely be looking in on her tomorrow, when I go to work, to see if she is still finding comfort from a new-found friend.

Keep your fingers crossed that I’ve found a way to make a very unhappy woman at least a little more at ease with her lot in life.  I know I’ll be doing the same.

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