When I first started into the nursing/caregiver field I was working in a nursing home getting training as a certified nurse aide. There were no speciality Alzheimers/memory care/locked units at that time. When you were old and no longer able to stay in your home you just went to the nursing home.
The Alzheimers diagnosis wasn’t used at that time either. You saw a lot of dementia and ‘hardening of the arteries’….. whatever its called then and now – it is a memory lose disease that begins with just not being able to remember until it steals away your ability to think clearly, to reason, to be who it has taken your whole life to become, to even be who you are! … you have no control and you cannot even understand that you have no control!
The medical training was when you had a patient/resident who said something inappropriate or not factual, you were to do ‘reality orientation’. Reality orientation meant that the 84 year old very proud respectable once a district court judge asked you where his wife was, you responded with “Judge, Susie is not here.” … and of course his next question would be… “Where is she, I’ve been looking for her?” And you were to say “Susie died.”
Before you could even get any further to perhaps state when she died, he would collapse into a weeping man tree… literally he would remind me of the smaller weeping cherry trees, decorative trees. His whole body would slump on over, long arms dangling at his side, and the sobs would begin to wrench his body as the winds of sorrow blew thru his soul with that heart wrenching news!
This would happen repeatedly thru the day. Day after day. The nurses spent time training and explaining that it is simple reality orientation.
What was so simple about that?! … not simple. At all. No wonder his family said he had aged so much since coming into ‘the home’. No wonder he was losing weight from not eating, and from the grief that was constantly assaulting his body!
I am not a rebel at heart. I choose to not indulge in ‘reality orientation’. IT just seemed more natural for me to redirect with a simple “Judge what interested you in the law, or do you see that beautiful bluejay?” And I listened patiently as the Charge nurses patiently explained to me time after time the importance of ‘reality orientation’.
Reality orientation was and is just plain mean! … and I do not mean to imply the nurses and doctors that truly thought this was the more practical approach were mean. I know that not to be true. They were just misguided.
Fast forward a few years and when I have graduated as an LPN geriatric care is now getting more attention and more in depth research. Still, no speciality units in the area where I was working but more articles and research being done into the field of dementia. You could still hear this in some facilities, but I can guarantee you it was nothing I shared with any of the aides working with me.
The basis of nursing is KINDNESS. Reality orientation does not usually lend itself to kindness.
It has been very rewarding for me to see the new developments in geriatric care, and especially the dementia and alzheimers. It is with the utmost pride that I have dedicated myself to working in Alzheimers Wards. Best of all is enjoying the beautiful homes that are available for our mothers, fathers and grandparents as they travel down that curvy, obstacle ridden roads of dementia and Alzheimers.
Best of all is that we now know it is not the confused person that needs to have a reality check – it is us! Each one of us that works with, or visits with a person now living in their reality of the Alzheimers mind.
I would say that most people would agree that I am generally a patient person, even maybe a slightly very patient individual. I don’t mind saying the same thing over and over. I don’t mind reminding YOU, the visitor, the individual with a Sound Mind that your loved one is unable to process and understand what seems so simple to you. They are not trying to drive you batty, they are not trying to anger you. They are simply scrambling thru all the tangles in their mind trying to find their way up to some clear headed thinking.
So when they tell you for the 100th time they don’t know why they are in a ‘home’ or why you the family member would do this to them. Please keep your answer simple and sweet. And then try to divert to something else. Do not continue with trying to reason until you become so heated that you are speaking loudly and the loved one begins to become rattled to the point of crying and yelling.
Redirect your conversation and continue circling around with kindless and love. Reassure them of your love as you talk softly and try to talk of more pleasant topics. Keep in mind – you are the one who holds all the ‘power’. You are still able to think, remember and reason.
YOU are the one in need of the reality check!
