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OPINION

Nursing dementia better

  • 3 Comments

Making a positive contribution to the life of someone with advanced dementia is, in my opinion, one of the greatest challenges a nurse can have.

When faced with something you cannot cure, the only attainable goal is to put yourself in the patient’s shoes - be their eyes and ears, their voice to articulate what they feel, need and want, the champion of their dignity and the ray of sunshine in their life, making every day as vital as it was before they developed dementia.

Seeing beyond a person’s cognitive impairment takes empathy and compassion, and wherever possible - and certainly in the case of my own father - I believe that it is a partnership between families and care professionals. Nurses play a crucial role in tailoring their vast knowledge and experience to the needs of an individual - many of whom can only make a limited, and eventually non-existent, contribution to planning their care.

Fortunately, in my father’s nine years in care homes and hospitals, many nurses did just this. From a deputy manager who spotted dad’s rapport with a particular carer and assigned that man as his keyworker, to the night-shift nurses whose vigilance detected dad’s decline into numerous chest infections and summoned help - often challenging doctors who felt that someone with advanced vascular dementia was not a priority.

The bond many nurses formed with my father gave rise to huge levels of compassion: kind words, cheerful dispositions and gentle touch. This was never more evident than in the end-of-life care that he received, which exemplified how valued and respected he was.

Many nurses have told me how rewarding they find working with those living with dementia, and given that my father’s 19-years with this disease have taught me more than any other experience ever could, I understand why.

From a daughter’s point of view, you can ask nothing more of those caring for your parent than to show them the same love that you do. It is a huge credit to the nursing profession that I witnessed this on so many occasions during my father’s journey with dementia.

Beth Britton

  • 3 Comments

Readers' comments (3)

  • I try to extend the same love and compassion to my patients as I would to my own parents. My own father has dementia.

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  • Is the G4S debacle a sign of what is to come when the government farm out NHS health care to private companies?

    are there lessons here for the government to learn?

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  • tinkerbell

    having worked in dementia care for past 8 years, with severely cognitively impaired patient group with complex needs,high levels of aggression, i have still found it rewarding.

    Little things mean a lot. It is hard work physically and emotionally tiring/draining at times but when a patient tells me after spending some time with them 'you're a lovely little boy', or asks 'will you marry me' or says 'you've made my life complete' these terms of endearment remind me that however severely cognitively impaired they are we have made a 'connection' on a much deeper level. When i hear my colleagues getting the same compliments it more than compensates for the times when i am being chased down a corridor to avoid a punch or being told to 'eff off'.

    Patience and understanding of your client group should be first and foremost requirements for working with the elderly confused otherwise we are in the wrong job. It is not for those who take offence easily either.

    Not only will you make the patients miserable your life will be miserable too.

    When one of our staff is asked by a particular patient for the umpteenth time 'where's my purse, I know one of you's bastards have it?, colleague looks at me, I look her, she turns with a big smile on her face and says 'it's there beside you' it renews my faith in mankind that although we are all just a breath away from losing our patience we have chosen not to.

    I have seen one of our most impatient young HCW's blossom into a patient and tolerant nurse. I have had many a 'word' with her over the years. Now when i see her getting it right, she looks at me, i look at her and give her a smile and a nod. She smiles back at me and laughs to herself. I laugh too at the fact we have finally arrived on the same wavelength at last. Now she understands.

    Can patience be acquired? I think so, if it is combined with understanding. I've learned to become much more tolerant/patient towards the staff over many years.

    We have the odd one or two, make that 3 staff who are seemingly never going to get it. Having worked with them over many years i can only come to the conclusion that they are 'unteachable'. I would rather work short staffed than have them on my shift creating more conflict/stress with their impatient responses to the patients. What a downer it is to have all 3 on the same shift. No amount of discussion with them makes a difference and if it does only briefly as they cannot sustain it. All of them are middle aged women who think they know it all because as they repeatedly tell anyone who cares to listen 'I've been doing this job for years' to which i want to reply 'well why don't you leave and give us all a rest'.

    It's these staff who test my patience more than the patients. I have let out many a loud groan listening to them interact impatiently with a patient. They have the fattest personnel files in the cabinet. How can we get rid of these 'dinosaurs?'. It will be a relief to all of us when one of them eventually retires. They are so time consuming.

    They may tell me they've got 20 years experience but to me it seems like they have one years experience repeated 19 times.

    As one of our managers said to one of them once in a unit meeting when they were talking about 'how it use to be done' - 'evolve or die'.

    To all those caring, committed, passionate staff out there, working under huge pressure, tired, worn out but still managing to smile and be pleasant I salute it. We all know it's not easy but we are making a difference to at least one persons life on a daily basis.

    I read a slogan in a supermarket in america once which said 'you can't give kindness away, it always comes back'.

    Hopefully if and when our time comes for a smile and word of encouragement if we are hospitalised, for whatever reason, we will be amongst likeminded carers.



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