Posted 6-25-19 (6 months until Christmas!)
I have alluded to this before in previous posts, but, never to be averse to beating a dead horse, I feel like we should revisit the topic again. It seems commonplace in memory units for patients to need geriatric outpatient behavioral health hospital visits with those professionals who specialize in providing meds and other help that greatly reduces anxiety. Go figure…gradually losing your ability to communicate about and process the world around you causes extreme anxiety?!? I know I throw the term anxiety around like a rag doll these days as do most of you, describing everything from test anxiety to being anxious how my haircut will go. Perhaps we need to reconsider our overuse of this word in respect for those who truly have something “worth” being anxious.
So this 5-Diamond geriatric behavioral health hospital vacation from the everyday joyful reveling of daily living at a memory unit or at home with loved ones seems to follow a trend as far as I can see:
- The patient gets unruly, causing harm to either themselves or the staff or loved one in charge of his/her care (Especially common in bathing/toileting issues and/or eating issues -or-
- The patient is too much of a flight risk and escape in either common or imminent. The hospital is even more escape-proof.
- The need to somewhat “subdue” the patient, often caused by either under-staffing or untrained staffing (or both) is counteracted by the law against using any sort of restraint, whether chemical or physical.
- The subs/night crews struggle.
- Things come to a head and the care team is called in to approve this trip.
These trips seem pretty common in our memory unit. If you are a veteran of the dementia war trenches, you already know this, but, if not, allow this to be a head’s up. It happens…a lot. We recently had a Sweet 17 member who tries to stand up constantly and would fall a lot. She has had two trips to the hospital and she is doing much better now. These trips seem like a negative thing, given the stigma that in-patient mental healthcare facilities had in the 1980’s and earlier, but they are much more positive situations now than they used to be. Regulating medications seems to be a great equalizer, helping the patient become stable or sufficiently stable until the advanced stages of the disease when they, sadly, may not need as much help. Once the patient becomes more comfortable with their surroundings and their new reality, it seems as though the stable, structured environment is one they can thrive in. Until then, the personnel options for helping them in this tragic circumstance is you, the subs/semi-trained staff at a memory unit, or the unknown experts at the hospital.
The hardest part for me about mom taking her trip to the hospital is NOT knowing anybody there. Some new person would be feeding and bathing mom and she, like most dementia patients, absolutely hates change. Having some new dude (female or male depending on the gender of the patient) suddenly take over for the people we were comfortable with was a big shock for us and was a point of stress. But, they tend to be more specialized in training and, in our experience, did a good job. Their patient/staff ratio was more favorable for a good outcome as well. Add to this real anxiety the fact that they are locked down and have small visiting hours, unlike the 24/7/365 of the memory unit. Therefore, the stay is an emotional situation for all involved…but usually helps.
So let me bottom-line this for you quickly if you haven’t been down this path yet:
Behavioral health hospitals who specialize in geriatric needs are common and they typically do more good than harm, at least in my experience and in my study of others. You are still the captain of their care team and that does not change. Advocate for them, even more while they are visiting these facilities. Move them if necessary. Make the most of a challenging situation and hope/pray for the expected result.
Update: Mom had another typical day yesterday from all reports. I will see her tonight and will spend some more time with her throughout the week. I hate this disease and the necessity to visit hospitals to get things under control, but things are pretty dang stable now and she is happy and doing relatively well, all things considered. 🙁
Future topic teaser: Is Dementia a mental illness? Why or why not?