Anyone who works around the demented elderly population can attest to the fact that they sometimes say the darndest things.
Mr. Rider is a pseudonym for the slightly plump octogenarian nursing home resident who had some cognitive decline due to vascular dementia. Anyhow, I walked into his room with his breakfast tray one weekend morning about six years ago. I naturally assumed he would eat his food after I had gotten finished setting up the tray. After all, this guy was one who never missed any meals.
"I don't want to eat this morning," he earnestly tells me. "I'm trying to lose some weight."
I was taken aback by his response because Mr. Rider was not the type of man who ever worried about maintaining his figure. However, after a few more attempts to offer him the tray, he continued to refuse, so I respected his desire to 'trim down.'
Ms. Lucinda is a pseudonym for the petite septuagenarian nursing home resident who was afflicted with middle-stage Alzheimer's disease. Nursing staff had to be very careful with the manner in which they approached her because she would take a swing at any caregiver who made one wrong move. In addition to punching the person, she would give them a verbal lashing with vulgarities that were on the same level as a drunken sailor.
I had just given her a bolus g-tube feeding one night approximately four years ago. Before I left the room, she studied me from head to toe and declared, "You're getting too fat, girl!"
Her eyes suddenly shift to my round backside. She examines me for a few more seconds and nods her head in agreement before saying, "Yes, girl. You're getting fat! You need to stop pigging out!"
Anne is a pseudomyn for the frail nonagenarian nursing home resident whom I met in early 2006 at my very first nursing job. She had middle-stage Alzheimer's disease and other psychiatric issues. I was a brand new nurse back then, and had learned in nursing school to perform 'reality orientation' when dealing with disoriented patients.
She would ask me every 30 minutes, "How do I get to the fourteenth floor?"
My newbie response: "This building has no fourteenth floor. It only has one floor. You're in the right place."
Of course, she was never happy with my answer and would furiously roll around the building in her little wheelchair until she could locate anyone else who would direct her to the nonexistent elevator or the staircase that would lead to the fourteenth floor.
Nowadays I avoid reality orientation like the plague if the patient has middle-stage or end-stage dementia. Therapeutic fibbing seems to work well with these patients and causes them the least amount of emotional turmoil.