Patience, Violence & Other Stories of Change

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We deal with the temperature and the underlying infection, and leave the lady to sleep, with a promise that I will return in two hours to check on her. Dealing with the situation takes ages. It gets to 6am when all the morning jobs start.

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By the time I remember, three hours have passed. Something is very wrong with me. She was septic — people die of sepsis — nurses are supposed to recognise this. I call the team.

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They are at a crash call one floor below. The nursing team is in handover — the worst time to get sick.

Late Stage and End-of-Life Care

I shut my eyes and I see the look in hers, silently begging for someone, me, to help her. A colleague told me the lady was taken to intensive care.

I am not. I call a friend who has never worked in healthcare, who is not a girl in her early 20s who just watched somebody the same age as their mother fight for their life and tried to fight with her. I need to be able to handle the confused, the aggressive and the very unwell. I failed to do my job that night and a women nearly died.

Patience - Wikipedia

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The writer writes under a pseudonym. Have realistic and attainable goals. Often, caregivers try to make everything all right and strive for unrealistic goals, though end up exhausted and frustrated.

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Perhaps your goal is to be sure that your patient is clean, comfortable and well fed. However, accepting that success may be only 80 percent will allow you to enjoy time you might have otherwise spent fretting about not reaching these goals. Although difficult, try being comfortable with a less than perfectly groomed spouse or perfectly organized home. Control vascular risk factors. While there is no current treatment to change the effects of VaD, preventing risk for additional vascular damage , particularly stroke, can be an effective way to lower someone's risk of worsening dementia.

This can be done by encouraging exercise, abstaining from smoking, drinking alcohol in moderation and possibly changing diet to reduce salts and saturated fats. It is also important that people with VaD have their blood pressure checked and their blood fat levels measured at least once a year.

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In addition, some risk factors for stroke, such as high blood pressure, heart disease, diabetes and high cholesterol can be controlled with drugs. Don't hesitate to discuss these options with your doctor. If vascular risk factors are not attended to properly, recurring strokes and worsening dementia symptoms may occur.

Continue reading. Anticipate misinterpretation by your patient. A person with VaD may no longer be able to accurately interpret verbal or non-verbal cues, which can cause anxiety and frustration in both you and your patient. Try to be clear and concise in your communications—repeating things as needed using the same words or message. Reduce extraneous noise and distractions when trying to communicate. Do not use confusing pronouns, such as he, she or it, but rather names and specific titles. Remember that all behavior has a purpose.

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Many experts believe that some of the behavioral symptoms that people with VaD exhibit, such as shouting or striking out, are meaningful. Although the person does not generally intend to disrupt things or to hurt someone, they do intend to be noticed and perhaps communicate a need that is not being met. In addition, it is important to remember that while these behaviors are meaningful, they are not intentional and the person is not doing this "on purpose," but more likely trying to convey a message that they can longer explain in words.

Treatment Issues

Slowing down, trying to see the world through their eyes and trying to respond to the "feeling" behind the behavior, rather than the behavior itself, may prevent an emotional crisis. Enjoy the good times. Many people with VaD remain physically fit and retain their ability to be comfortable and involved in social situations quite late in the disease. Therefore, continue to socialize, travel, be physically active and participate in activities that are enjoyable to both you and your patient.

Often, familiar activities will continue to be enjoyable for a person with VaD and should be encouraged. However, trying to learn new tasks or starting new hobbies may be frustrating or overwhelming. Reminisce about the past and encourage discussions about people and places that are familiar and evoke pleasant feelings for both you and your patient. Memories from the distant past are not usually affected and watching family videos, looking at photographs or reviewing travels from the past can allow you and your patient to continue to share experiences and feelings.

  1. I despair at the public's perception of nurses as selfless or sexed up.
  2. Most accurate article on BPD we have read—kudos!.
  3. The Patient Experience Library.

Allow your patient to share the history they remember with family members, grandchildren and friends. This is fun for everyone and helps your patient feel connected to their loved ones. Be flexible. Remember that VaD is a progressive disease. Your patient's symptoms and needs will change over time. If strategies such as notes or reminders are no longer working, don't use them.