Bribes

Tonight I was at work at my nursing home. I have a lot of residents with Alzheimers, and it can be very challenging to get all of them to bed on time. One woman in particular, went to the fire escape door furthest from her room right after supper. I noticed her trying to get out of the door, so I went to talk to her. I explained that it was a fire escape door and that she couldn't go out of it. She told me very calmly that "they" told her that she should wait by the door and they would take her home. No matter how much I reasoned with her, she said she was going to wait by the door. She wasn't having much success getting out of the door, so I left her alone.

The beauty (and tragedy) of someone with dementia is that their short term memory is so bad that you only have to wait a short period of time before re-approaching and starting the conversation from scratch. On my second try, I decided that maybe she really just wanted to go outside, so I tried to convince her that there was a much better way to get there. She didn't believe me.

My third try was talking about how she was probably tired, and "wouldn't you like to go to bed?" The answer was still no. I went to tell the nurses that I was still unsuccessful in getting her to bed. We all agreed that it would not be smart to force her to come down the hall against her will, since she could easily get out of control and start yelling and hitting. No need to do that when everyone else is in bed.

Then someone had the brilliant idea that I should offer her some food. This time my approach was totally different. I asked her how she was doing - fine.

"I was thinking that you've been down here a long time, and you might be getting hungry. We've got a bunch of snacks just down the hall that you might be interested in, like cookies, juice, bananas." (I knew that she loved bananas)

This time she said that yes, she had been getting a little hungry, and she was interested. She let me push her down to the snacks in her wheelchair. I gave her a banana, which she was very excited about, and then took her to her room where I got her bed and pajamas ready while she finished her snack. A few minutes later she was in bed and we said goodnight.

I am not quite a master at diverting attention in order to get someone taken care of, but it is probably one of the most useful tools in my job.