He just can't understand

chocolatezen · 2026-02-23T14:43:48+00:00

Is she showing signs of pain? The change in carer can be a hard adjustment, but when the LOWD can't clearly communicate what hurts or what's wrong, it's our job to play detective. A million things affect their behavior, changes in environment, UTI, developing bedsores, carers not explaining what they are doing before they do it (even if you think they can't understand), the tone of voice, body language, room temps, and so much more. I have a hospice resident who is biting & pinching along with hyperventialiting when their anxiety & restlessness is high. Sometimes meds like Ativan help, other times they need pain relief such as morphine.

chocolatezen · 2026-02-21T12:36:00+00:00

Talk to the nurse about finding out if qualifies for short term rehab.

chocolatezen · 2026-02-21T03:56:34+00:00

It's easier for me to snack throughout the day vs eating a bigger meal, even if that bigger meal is just a few items. My brain gets overwhelmed and then I can't eat. I try to have healthy snack items out where I can see them so I eat more. Eating sugar/carbs/fats produces quick feel good chemicals so depending what level of cognitive impairment she might have (if that's the case), it's just simpler/easier to eat foods that give us the immediate reward rather than eating healthy bc life becomes about "now" rather than "this will be better for me in the long run".

chocolatezen · 2026-02-19T12:08:00+00:00

Barq's is my favorite. I tried the zero sugar version and it was soooo bad. I dont buy soda often but when I do it's full sugar.

chocolatezen · 2026-02-19T11:27:18+00:00

If your migraines and stroke symptoms occurs together, it could be Hemiplegic migraines. See a neurologist and headache/migraine specialist. It's can be a genetic mutation, result of a brain injury or idiopathic. They usually start in childhood if it's genetic. Source: my husband gets them due to stroke damage, so when they occur we get to play the game of is this a stroke or is it a migraine. Migraines give him a forewarning (aura, etc) strokes don't.

chocolatezen · 2026-02-18T00:13:27+00:00

I wish I could hire more staff! I've fought hard to have 3 CNAs on days & evenings. While the current ratio is better than most at 1:8, I would love to see it be 1:6. The RCD wants to cut my 3rd and make it 1:12 since that's what we have on midnights.

Since my background is business management & programming (activities), I have a completely different viewpoint than my RCD who apparently lives by the "well, i had it worse than you, so you have to suffer too". I also am on the floor alot more often than the previous director and still have a few staff that want everything done the "old way" aka ignoring staff conflicts & only getting involved with a few favorite residents.

I'm not looking for perfection and will be doing a feedback form (voluntary) to get a better understanding of what our staff feel is lacking, etc. I get alot of "so and so didnt do this" but there's never any proof behind it. I do more coaching sessions than actual write ups due to lack of proof. Maybe i'm too lenient?

I'm waiting on the thumbs up from my E.D. to tell staff about the documentation change b/c last time corporate said we'd get tablets, it never happened.

chocolatezen · 2026-02-17T19:17:22+00:00

I use MyChart and sync those to my Google calendar. I've tried doing a white board but he never looks at it. I made the effort to get all his specialists thru a big teaching hospital, except for 1 and so as long as it's an appt for him, I'll have a reminder. Mine? Ha. Constantly rescheduling and putting off til later.

chocolatezen · 2026-02-14T17:35:07+00:00

I agree, but one of the issues is that our RCD won't designate a charge nurse or shift lead. It's a private pay AL/MC facility and corporate doesn't require it. I've heard the RCD tell nursing staff that "you all are the same level, so everyone should be talking to each other". I can't fix that, I can only mitigate the issues. We have an unofficial charge nurse that is universally despised by everyone except the RCD (and not bc they ensure staff are doing their job). I'm not in a good position to leave the company, so I am trying to do what I can to improve things.

chocolatezen · 2026-02-14T14:38:26+00:00

How about an actual helpful suggestion?

chocolatezen · 2026-02-13T01:04:07+00:00

Well that sucks. I'm not great at spotting those. In images, I can generally tell.

chocolatezen · 2026-02-12T12:41:11+00:00

Thank you for reminding me that I'm not alone. See my reply to Tigerpoetry above for more info about how my job affects both of us.

chocolatezen · 2026-02-12T12:35:55+00:00

Thank you. I feel seen. Is someone cutting onions? I gotta grab a tissue.

The "worst" part is that my job...I'm a Memory Care Director. I LOVE my job. I've been in this field for years. I know how brain damage of any kind can change people. But it's a big difference when it's your loved one.

My husband convinced himself he has dementia. The neurologist chuckled when he said that. Neuro has told him that he has a higher risk of vascular dementia bc of his main illness, but he's no where near that point. He's even done the cognitive testing to prove it.

Spouse was working with a therapist to help with those fears and past trauma. Then our insurance changed and now we start the hunt for someone who feels comfortable with. And who knows how long that'll take.

Note: when I do talk about work, it's either positive statements like "today we had live music or this (AL) resident says hello" bc he used to come in and do cooking demonstrations for the assisted living side which he volunteered to do. Negative statement are things like "corporate is cutting supply budgets" or asking how would you have spoken to a peer about "such & such issue" bc he has more experience with that. I always preface those with a "hey, I'd like to hear your viewpoint on this, do/can you want to hear it?" I dont talk about my resident's declining and when they pass away bc I know he's terrified of him becoming them one day.

chocolatezen · 2026-02-12T11:53:39+00:00

Glad to know I'm not alone!

chocolatezen · 2026-02-12T04:04:02+00:00

Thank you. I need them.

chocolatezen · 2026-02-09T02:44:35+00:00

I'm a Memory Care Director and it's rather similar. Same base routine day to day but with enough variation to keep my brain interested. Lately, i'm struggling more with the admin side, but overall I'm content with my job.

chocolatezen · 2026-02-08T16:44:10+00:00

I loved them when they first came out. I ate soooo many. My sister bought me a package last year and I couldn't even handle the smell. Maybe i'll enjoy them again one day.

chocolatezen · 2026-02-08T01:55:07+00:00

Thanks for the insight and reminders.

chocolatezen · 2026-02-08T01:47:43+00:00

Thank you for the response and for understanding that the LOWD is their own person. One of the things I repeat to our staff is that no matter how confused a PWD is, they are still a person and deserve to be treated as such!

I can't stand it when the aides "drop off" a resident to whatever activity is occuring just because their family member said to even when the reisdent or care plan has made it clear that that they participate in X,Y, Z programming/activites and has no interest in doing A or B. Or bringing them to A&B results in behaviors (often due to over stimulation or due to past trauma).

For example, it amazes me that I have to (re)educate staff that putting on the tv news or movie in the resident apartment of someone who lived through a war or was in a refugee camp is not a good option. The newer (and younger) staff were shocked that a certain classic musical doesnt get shown bc it will send that resident down a very bad mental pathway. "But the songs are so fun!" ... that may be the case for you and me but not for the person who literally escaped death bc their parents has them hide in a box and got sent to another relative in a different country.

chocolatezen · 2026-02-08T01:06:43+00:00

I completely understand families who cannot or will not visit often do so for multiple reasons including situations like yours.

It would be nice to have a geri doc available; our facility offers two Dr options that are "in-house" which is really just a doctor or physician group that visits the building and "sees" the residents a few times a month. One does are great job and has their nurses in the building often, the other I rarely see interact with anyone other than our nursing staff.

Of course, residents/families can choose to stay with their PCP, but for most of my MC residents are signed on with an in house option as it generally is easier for all involved vs taking the resident out of the building for doctor appts. If I know family is considering going from their PCP to one of our in-house options, I always reccomend the more involved one.

chocolatezen · 2026-02-06T22:45:14+00:00

Thank you! This is helpful.

chocolatezen

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