When you look at your patient in the bed, who do you see? A frail little abuela rolling the sheets between her thumb and forefinger, wearing a green gown that has rice stuck to the collar? Pictures around the room tell a story of younger, more lively days. She may not be able to tell you today’s date or who the current president is, but she could sing along every word to Sunday morning’s hymns.
In the acute care setting, you may take care of Abuela one day, and return to see that she’s been discharged the next. But for some nurses, working in a long-term care facility affords the opportunity to get to know these patients on a deeper level. I spoke to Dawn G., LPN, about what this meant in her role as the charge nurse and night supervisor of a memory care unit. She shared with me the ins and outs of this unique nursing specialty, and five things she’ll never forget after working in memory care.
1. Safety is the top priority
In a long-term care facility for dementia patients, one of the biggest safety risks is a resident wandering away from the property. One of Dawn’s primary responsibilities as the charge nurse was to make sure each of her 60 patients was accounted for under her watch. During the day, families sign out their loved ones and take them for outings. It was Dawn’s responsibility to make sure they made a safe return. At night, this locked unit utilized alarms that would alert staff if a resident attempted to leave. Falls are another big risk for these patients, and it’s up to staff to work together to prevent patient falls at all cost.
2. Maintaining a relationship with families is crucial
Dawn made it her mission to get to know families of her residents and keep an open line of communication. When patients’ families walked by, she’d go out of her way to start conversations and make sure any of their concerns were addressed. “It’s so simple,” said Dawn, “to talk to families and be proactive about their concerns rather than avoiding them.” Building trust helped ensure that families were comfortable leaving their loved ones in her care. In memory care, preventing both staff and patient turnover is huge because familiar faces help residents gain a sense of security.
3. It’s a multifaceted role
As the only nurse in-house overnight, Dawn acted as the charge nurse and supervisor who the entire staff reported to. In the event of an emergency, it was up to Dawn to escalate issues to the director of nursing or the on-call doctor. When the unit was short-staffed, she absorbed the role of medication pass technician or caregiver—she did it all.
4. New skills slip away and old habits never change
Dawn got to know her patients’ patterns and routines, and was able to anticipate behaviors like sundowning. Here are a few themes she noticed among her dementia patients:
Bilingual patients often lose their second language and return to solely speaking their native tongue.
Music is one of the last memories to fade.
A patient may wait for the train every night at 8:00, even if it left the station decades ago.
5. It’s easier to get to know patients than you’d think
Getting to know dementia patients comes with time and repetition. “Want to know about their life? Just ask,” says Dawn. Even if it meant having the same conversations over and over, Dawn chatted with her residents to find out their favorite things. Whether it be a cozy nightgown or a sugar cookie, she always found a way to make her patients feel at home.
When I asked Dawn if there’s a patient that left a lasting impression on her, she told me about a woman who always made her feel seen. Though Dawn did her best not to let the stress from her job show, this woman could always sense if she was having a bad day. She was thoughtful, kind, and always made a point to thank Dawn for taking care of her. And despite her dementia, she always called Dawn by name.
To learn more about how you can support our aging population and join the fight against Alzheimer’s and dementia, visit the Alzheimer’s Association website.
By Alexa Davidson, MSN, RN
Alexa is a freelance health writer and registered nurse with over a decade of experience in pediatric and neonatal intensive care. As a travel nurse, she worked her way from the Atlantic to Pacific, taking care of some of the most inspiring sick kids in the country. When Alexa is not busy putting pen to paper, she can be found recreating dishes from her favorite restaurants at her home in Charleston, SC.