March 1, 2012

Your Advocacy Connection – Offering Comprehensive Care and Financial Advocacy

By Diana Spranger, R.N.
Administrator
Bettendorf Health Care

In the past six months, my role in the long-term care setting has changed dramatically. For nearly 30 years, I worked in the health- care industry as an Administrator, and then I retired. I now work part-time and find myself as a visitor there, as well at
independent living facilities. For many years, I have counseled family members and friends with regards to visiting with their
family and friends.

They often come to visit and find themselves without words for their loved one or friend. I would either meet them coming down the hall or they would find their way into my office just to vent their frustration about their inability to communicate. Sometimes the
resident they were visiting was verbal and sometimes not. It was obvious to me that they desperately wanted to visit with that person; they just simply did not know what to say or how to make them understand.

Some of the problems families/friends face are residents that are very hard of hearing, slightly or seriously confused, or who have been rendered non-verbal due to a stroke or some other serious physical condition. Often times, the resident is mourning the loss of their independence and are holding the family responsible for this loss; thus they exhibit great anger or total silence.

I would like to offer a few tips for some of these perplexing situations:

1) When you visit, have a plan. What will you talk about and how long do you intend to stay?
2) Make the visit as positive as you can.
3) If they wear a hearing aid, make sure it is in the correct ear, turned on, and that the batteries are good. (You should feel comfortable in asking for help from the staff with this).
4) If they wear glasses, make sure they have glasses on and that the lenses are clean. If they are blind, be sure they know with whom they are talking, if they are cognitively intact.
5) Always introduce yourself, even if this is close family/friend. It is important to tell them who you are, because they may not recognize your voice. They could be confused or unsure. When you communicate with someone, you always enjoy the visit more if you can see the person you are talking with and hear what they are saying.
6) Under most circumstances, I would suggest that you touch the person you are visiting; holding/touching a hand or arm or just placing a hand on their shoulder. The power of human touch is awesome. A touch can say volumes.
7) If the person is verbal, take a few moments to visit with them and find out where they are mentally that day. (Those that are suffering from Dementia/Alzheimer’s or other issues with short-term memory often have remarkable long-term memory still intact.
8) Select an appropriate place for your visit, a place with as little distraction as possible. Often times the person is easily distracted or fails to hear you, even with hearing aids, when the room is busy and congested with other people. Once you’ve gotten yourself and the person you are visiting with in a place to communicate, here are some topics that may help you spend quality time with your loved one:
a) Discuss ‘old times’, previous times in their lives that they may recall. You may be able to prompt this discussion with a simple question. ”Do you remember the grade school you attended as a child?”
b) Bring a picture album or pull out your purse/billfold if you happen to have pictures or a brag book.
c) If it’s possible to get the resident out of the usual place they spend much of their time, it’s a nice diversion for them. Weather permitting, with staff permission, take them outside or for a walk or ride in their wheelchair.
d) Take a pet, dog or cat, as long as you have prior permission from the facility.
e) Take a child with you. Usually a child will brighten up a person’s day, as long as the patient is not seriously ill.
f) A plant is always in order, unless otherwise indicated by the nursing staff.
g) If appropriate, take a book to read to them or pick up a bright colored magazine that is filled with bright colors. Point out items of interest. Let them identify objects that are familiar.
h) Maybe take their favorite treat or baked goods (in an airtight container) and use it as a talking point to discuss their favorite food/recipe. When did they last remember baking those cookies?
i) Take a DVD or book on tape to listen to, if that is their choice of entertainment and relaxation.
j) Take some birthday/anniversary cards that are appropriate for upcoming dates that they may want to remember with a card and assist them with addressing/stamping cards and preparing for mail.
k) There is nothing wrong with simple quiet time with a loved one in the appropriate setting.

There are many ways to change an awkward visit into something very meaningful for you and the resident. Give it just a moment of thought before you arrive and don’t fear saying the wrong thing. If the resident is difficult to communicate with, put some of those hindrances aside and simply visit as though this was a normal two-way conversation. If the family member/friend you are visiting is totally non-verbal, you need to always assume they hear and understand everything you are saying, whether you are speaking verbally or communicating to them by a simple touch.

I encourage you to try some of these simple suggestions and add a few of your own ideas. Make your visit a memorable occasion each time you visit, instead of a bad memory.

Diana Spranger is a registered nurse with nearly 30 years of long-term care experience. She works part-time for Goldercare Solutions and spends the remainder of her time involved with family and friends, as well as investing much of her time in community projects. She is an avid reader and has a passion to continue to learn new concepts and ideas daily.