Happy Fathers Day!

Many times when I have interviewed a geriatric client they have reminded me of my father or grandfather. I know my father and grandfather would be pleased to know they are remembered everyday. If you have parents still alive cherish the time you have with them because they will not always be with you. My father and grandfather were taken from me within six weeks of one another in 1984. That was one of the darkest years I ever experienced. I try to remember things they shared with me. My grandfather said more than once "You can't put a young head on old shoulders" and my Dad always said "Live within your means". Enjoy this Father's day and celebrate the special people in your life.

Always a Nurse

An interesting occurrence happened this evening about 5 pm a car stopped in front of our driveway and the passenger door opened. An elderly lady leaned her head over and proceeded to be sick. When I realized what was happening I picked up a towel damped it and took the towel out to her. I asked if she was having any chest pain and she replied no, she was just sick to her stomach. She said she had eaten some ice cream and thought that is what had made her sick. The driver appeared to be middle aged, maybe her daughter. After the lady seemed to be back in control she took the towel, wiped her face and thanked me for my kindness. I felt concerned for her. The contents on the drive appeared to have more than just ice cream and I was concerned she had gotten a hold of some contaminated tomatoes. However I didn't think to ask her if she had eaten any tomatoes. I hope she will be ok.

Incompatible Medications

This week in reviewing resident charts discovered a problem with elevated INR results due to coumadin for three of the residents we were reviewing. Modern pharmaceuticals are phenomenal however they also bring risks. To keep a resident safe it is everyone’s responsibility to be vigilant to the potential untoward effects. The residents INRs were above therapeutic ranges measuring from 2.3 up to 9. In researching possible causes learned that simivastatin can increase results of an INR. Two of the three clients were taking simivastatin. When developing a care plan there should be directions for teaching the resident what signs to watch for and report to the nurse, directions should include indications for which caregivers should be alert and when the resident should be seen by the doctor or sent to the hospital.

Memory loss

Geriatric nursing can be so delightful and full of surprises. Each senior is different and has a story to tell. I had a pleasant elderly lady call me this week. If fact she has called me at least three times. She never remembers my name or that she has called me. She was concerned about the government being charged for protective undergarments when her insurance is paying for the supplies. I explained that this type of issue is handled by the Medicaid Fraud Unit and often takes an extended amount of time to complete an investigation. She continued on with her story and listed people she has talked to, she couldn't remember their names but knew they worked in the government. I continued to visit with her and asked her how I could help her. She wanted to know when she would be receiving a report about what was found out. I replied I was sorry, but that I do not work at the Medicaid Fraud Unit so do not know that information. I asked her if she was getting the supplies she needed and she said yes. I asked her if anyone was mistreating her she said oh no, of course not, she was just wondering about what had been done about the government being charged for the protective undergarments. We visited a little more. I thanked her for calling and said if I could be of assistance please call back. She thanked my for my time and for listening. I suppose I will get another call next month and my friend and I will visit again.

Vulnerable Adult?

Who is defined as a vulnerable adult?An adult who:

*is 60 years or older who cannot take care of him or herself and/or

* has a developmental disability and/or* has a legal guardian and/or

* lives in a facility (adult family home, boarding home, nursing home, or soldier's home) and/or

* receives services from a licensed health, hospice or home care agency and/or

* receives personal care or health services from an individual who is paid for providing the service.

What is abuse?Abuse is an action (that is not an accident) that injures, intimidates, punishes or unreasonably confines a vulnerable adult. Abuse can be physical, mental, sexual, or coercive. Types of abuse include abandonment, neglect, self-neglect, and financial exploitation. Some professions are automatically mandated reporters such as nurses, teachers, psychologists, and employees of any adult family home, boarding home or nursing home. I'm sure there are others that I have missed.

Light verses Sunlight@

read an interesting article this week titled "Brighter lighting Improves Symptoms in Patients with Dementia". The study is published in the June 11 issue of the Journal of the American Medical Association. Researchers were studying the effects of light and melatonin in elderly patients. Light exposure was manipulated by installation of large number of ceiling-mounted fixtures with glass diffusers in the common living rooms of group-care facilities increasing the residents exposure to brighter light. The results of the study showed that light therapy attenuated cognitive deficits and reduced symptoms of depression. In combination with bright light, melatonin also improved sleep efficiency, reduced nocturnal restlessness, and reduced the average duration of brief nocturnal awakenings.
In assessing a patient's environment I try to determine if there is adequate light. I've interpreted this to be is there enough light in which to read. After reading this article perhaps adequate light should be redefined.

Share Experience

Geriatrics can be so delightful. Some of the clients I have the privilege to interview are so engaging, witty and surprising. I spent an hour today with a young lady of 87 years that was so charming I was sad to leave. One of her opening statements was so profound "I grew old too fast and smart too late". We shared thoughts about children, the bible, sad state of affairs of the country and her worry that she will outlive her money and have to accept state assistance. She said she was a writer and had stories she would like to write before she dies. I hope she gets that chance.