Hi Reddit, I saw Seth Rogen's speech on /r/videos and thought some of you may enjoy an AMA with someone who works with Dementia patients.

I'm a Senior Care Assistant for people with all forms of Dementia. This means I am responsible for their care whilst they reside in a residential (/and nursing on occasion) setting. I run a team of carers, create care plans, administer medications, refer residents to professional teams when required and assist them to be as independent as possible with their day to day life.

AMA!

Edit: proof- http://imgur.com/3V588D9

Edit 2: popping out for coffee, keep the questions coming and I'll answer them when I get back...ASAP!

Edit 3: Right I'm back, may have got some chips too. Coffee and chips. I'm going to read through the questions and get on it!

Edit 4: I appreciate all of your questions/interest! Feel free to PM if you have any other questions and I'll try my best to reply but I'm going to call it a night. Thanks!

Comments: 482 • Responses: 37  • Date: 

cookies123488 karma

no question, just wanted to say thank you for taking on such a difficult but important job! It takes a very strong, patient and caring person to work with people suffering from dementia. My Nan was in a nursing home and suffered from dementia. Even though one of the family would go and visit her everyday it was so comforting knowing that she had a group of wonderful care assistants with her when we weren't there. Thank you!

etre-est-savoury35 karma

Thanks :)

araeos59 karma

Do your patients ever get visited by service animals? Is that something they enjoy, or do they end up afraid?

etre-est-savoury85 karma

The residents absolutely love visitors with animals... dogs in particular. We once had a visit from a zoo that brought a lizard or something... I didn't see, I was doing paperwork :(

johnnynoname1242 karma

as absurd as this question sounds I legitmately wonder about this:

anyway- are you totally used to the smell of shit by this time in your career?

etre-est-savoury38 karma

If I'm honest, I've kinda gone off poop nowadays.

SugarBells8 karma

[deleted]

johnnynoname129 karma

true but for him to have "run" the team means he has paid his dues and started from the bottom. During the the time he gained experience he probably built up a resistance to that particular odor, no?

etre-est-savoury21 karma

I still have to, and want to, work the floor with my team - it's not fair to not muck in; it gets really busy at times.

It's also important to assist with personal care at times because people with dementia often don't realize when they get skin conditions or remember injuries (say if they have knocked their leg on a door, un-witnessed)... as someone who is in charge of their care it's important to keep on top of these things!

riff106035 karma

Where are my underwear?

etre-est-savoury81 karma

on, hopefully?

cgbbcg28 karma

Hi there, thanks for doing this AMA!

My 77 year old grandmother on my moms side is beginning to develop dementia, or as far as we know just severe short term memory loss. This started last year around September. She'd forget about Christmas presents, blank on our names, etc. it's definitely no fun, but we're learning to accept it.

My question to you is: what, in general, should we expect in the coming years?

And also what is a good reaction to have to one of her incidents of forgetfulness? A lot of times I just play it off without telling her because honestly it's really starting to get to me. It's pretty rough seeing someone slowly slip away.

I guess what I really wanted to say is that I'm glad there are people like you out there. Thanks for all you do

etre-est-savoury32 karma

I know it's not overly helpful but it's difficult to say what to expect because dementia affects everyone differently and at different rates. I would say that (if diagnosed as dementia) it doesn't get better, so that is something to come to terms with.

The best thing to do, in my opinion, is to create as much normality as possible for her. Just a reminder may be enough.

m-lsaperstein26 karma

what made you want to enter this field? i feel like it would be a little soul-crushing to see suffering like that day after day.

etre-est-savoury67 karma

I did the job part time whilst at uni and it's something I have carried on since graduating. The first few months were terribly difficult but you really do get used to it (as bad as that sounds). Overall you tend to look at the positives rather than the negatives and try to make their lives as happy/pleasant as possible.

If I'm having an awful day I just like to think that someday I may need to be looked after the same so I man up some.

badfan20 karma

Hi, former CNA here who worked in late stage Dementia wards. I got into being a CNA as a precursor to starting nursing school to make sure that it was the sort of job I could do, and thank goodness I did because I realized quickly that it wasn't for me. I realized that these people, who were more vulnerable than they had ever been before needed someone with seemingly limitless patience and compassion, which I didn't have. I found myself starting to not care after a while and I took that as a massive red flag and resigned from the position as quickly as was reasonable (ie two weeks notice). Being that you are the senior member of the care staff I wanted to ask:

  • Do you find yourself ever growing apathetic (or even resentful) to your job and the people you care for? If so, how do you cope?

  • Have you worked with other people who might have been in a similar situation as me? Did they leave or find a way to stay on?

  • Is apathy towards the job the first steps leading towards abuse?

I want to make it clear that I NEVER gave anything but the best care of which I was capable (and in no way did I abuse anyone under my care), but the desire to provide that level of care dissolved until I no longer felt compassion for them, only a sense of responsibility.

etre-est-savoury5 karma

Thanks for the questions!

  • I don't resent my job at all... as I have previously stated in a response - if I have an awful or difficult day I just imagine being in their position and having to rely on someone else. It makes me appreciate how I would want to be treated. I also have a lot of hobbies outside of work!

  • It's not a job for everyone and unfortunately it's a job with a high turnover of staff. You get to a point where the right people stay though, so at the moment we have a strong and reliable work force.

  • I'm not really sure with regards to the abuse as it isn't something that I have experienced. I think it has so many factors depending on the situation and the person committing the abuse and it isn't limited to just apathy towards the job. The individual could be having problems at home, for example, and taking that out on the residents? Just one example... I'm sure there are many horrible reasons.

KatyCowbelter17 karma

[deleted]

etre-est-savoury64 karma

Funny haha, or funny odd?

The elderly can have a great sense of humor and have some brilliant stories. If I work on the upstairs floor, I usually get given sweets throughout my day from a lady who insists I have them. I hoard them and pop them back in her drawer at the end of the day.

Glenathon37 karma

She probably insists that you have them because her drawer seems that it spawns a never-ending supply. :) She's just trying to get rid of it so she can use the drawer for socks, but she can't get rid of this damn candy.

etre-est-savoury10 karma

I like this theory, I may ask her where she gets them all from

tiger_max11 karma

What do you think of euthanasia? If I know I am developing dementia, I really wish I could authorise, while my mind is still sound, someone to end my life when my mental capacity deteriorate to a certain objective, measurable criteria.

etre-est-savoury3 karma

It's a tough subject without bringing dementia into it. If you have capacity at that point then I guess it's up to you? However who is to say you'd want the same if you had dementia- Dementia patients can sometimes decline/refuse treatment which would often benefit their overall health, yet I'd argue that being of sound mind you'd have it no problem.

rmartinez939 karma

I am studying music education in college and we have been discussing the impact the mind on music. Have you ever used or considered using music therapy to help bring back certain memories of people with Dementia?

etre-est-savoury5 karma

I make music myself! So it's something I am interested in too. It seems that music is something that triggers memories for some dementia patients. We have a gentleman who cannot communicate or even hold a tea cup, yet when he hears the rolling stones... he lights up and has a good dance!

SugarBells9 karma

[deleted]

etre-est-savoury16 karma

Nope, my degree is completely unrelated to healthcare. I am hopefully going to do nursing in the near future as it is the natural progression at this point- although funding a second degree will take some thought!

I work in a residential environment (with the occasional nursing patient who is seen by visiting DNs). Anyone can administer prescribed medications legally in the UK and I have training for Dementia, assessing care, administration of prescribed medications, first aid and minor injury/dressing applications etc which is all overlooked by a DN team.

tisatnight8 karma

What's the most significant thing you've learned. What's the most significant thing you've learned.

etre-est-savoury17 karma

An utter realization of how I'm going to be one day... it's quite easy to ignore the thought of where we will be when we get to 70, 80, 90!

artsyfartsybabe8 karma

My sister cared for a woman in her 90s. She always asked about her family who had all passed. She basically had her heart broken every 3 hours because they would tell her when she asked. Is it better to be honest like that and see them upset or tell them the family is out of town(or something along those lines)? It killed me to see her so sad.

etre-est-savoury2 karma

It depends on the individual and how distressing it is to them. Some people just need reminding, others it is better to give little white lies to avoid distress

impablomations7 karma

I used to work in care too - forensic mental health. Loved the job, hated the abominably shitty wages.

I thought about going back into care, but with so many people looking for work the wages are even worse than before. Perfect example - care home along the road from me was advertising for a senior, 12hr shifts, sleep in 3 nights per week, needed nvq 3 and meds cert, etc - 15p above minimum wage! No shift bonus & sleep in payment was only £20!

Meanwhile the guy who owns the home drives round in a brand new range rover that he replaces every 2 years.

etre-est-savoury11 karma

This. I deleted my wage on the proof for a reason

_ShutThatBabyUp6 karma

what's the most common question your patients ask you?

etre-est-savoury4 karma

They usually tell me they haven't seen me for ages and that it's good to see me.

muffinseed5 karma

[deleted]

etre-est-savoury3 karma

I've worked with quite a few people who have served, mainly in the RAF due to where the home is situated... Visual stimuli can sometimes work a treat - maybe old pictures or badges etc? Having that visual can often stimulate more of a response than just talking to them alone.

haraldyo4 karma

I used to know somebody who had a family member at a home for people with dementia. Whenever they were going to leave the facility after their visit, they would say that they were going out to get something in the car, but then leave because the family member with dementia would just forget. How do you feel about this?

etre-est-savoury6 karma

If the person with dementia had a problem with this/it caused distress then it would be unacceptable but as a way to limit distress it is completely ok in my books to tell a little, tiny porky.

Sir-Toast3 karma

[deleted]

etre-est-savoury6 karma

The saddest experience to date is when a lady came to us following her husband passing the day before christmas. A letter arrived and she opened it. It read:

To my -----,

I was going to say lots but when I came to write this all I could think was that I love you,

Your ---- x

It was the saddest and most beautiful thing

swimbikerunrun3 karma

A close family member of mine is starting to get Dementia.. what can we do to help them?

Lychwood4 karma

Not OP, but a CNA with elderly care experience. I would suggest keeping close tabs on them, because dementia is unique to everyone. Sometimes it's a long time in developing, and sometimes it happens very suddenly. When you notice their independence becoming limited, you'll want someone there or available to care for them. This could be a family member if they have the time for it, an in-home caretaker, or a residentially oriented service. It's good to have someone on-hand to help them through their difficult patches while encouraging them to continue to be independent wherever possible.

I think the most important thing, though, is to continue to be an active presence in their lives. It can be emotionally and practically difficult at times. It's sad seeing someone you love change in this way. Some people respond to that by sticking them in a care facility and avoiding them to spare themselves those troubles. Just always remember that they are still a human being and still the person that you love. It's almost like...getting to know the toddler-version of the relative. They may be confused and troublesome at times but it's not their fault; they're doing the best they can.

etre-est-savoury3 karma

This is the perfect response!

Just be there for them and seek professional help/advice if things get too difficult for you/others. There is no shame in asking for help to care for loved ones and no one should feel guilty about it

jroses163 karma

How do you stay patient? My grandmother lives with us and has dementia. It is getting much worse. Even though we all know it is not her fault, some days it is very difficult to answer the same question multiple times and not get bothered by it.

etre-est-savoury3 karma

It's difficult but you just have to try your best. Thankfully I work in an environment where my colleagues are patient people but in times of agitation it's good for both parties to have some space.

Just try to imagine it from their point of view.

waynebradysworld3 karma

My Granny has dimentia. She is from Puerto Rico.

When she starts getting real delirious, we talk in a circle.

Mango smoothie from CPK triggers it every time!! She loooves mangos, and one sip will get her to bring up how wonnderful the Mangos are in puerto rico, if I like mangos, if I have tried mangos etc.

That conversation loops about every 30 seconds. Hilarious!!

etre-est-savoury3 karma

It's good to find things that stimulate positive memories. As you say, it can be something as simple as mango!

TheOutlier2 karma

Thanks for your work and AMA. It takes a bit of personal sacrifice to do what you do... even if it seem routine to you by now.

What signs do you look for in a patient to determine that she needs the level of care that you offer?

etre-est-savoury3 karma

We do monthly care plan reviews that are innnnncredibly detailed. They go into each element of care such as 'Food/fluid' which is then broken down into oral care, dehydration risks, waterlow, BMI, food dislikes/likes, weight recording, allergies... etc. then 'Skin integrity' which is broken down into risk of pressure damage, current skin condition... etc. We also do daily reports on each resident; basically a quick summary of things that happened during the day for them in regards to diet, eliminations, mobility etc. It's an insane amount of paperwork but you really do understand their needs. It also helps if you have a new member of staff start - they can pick up a care plan and grasp a good understanding of what that person's needs are.

We spend 12 hours a day with the residents and help them with every single element of their lives, so we know them and their habits/routines, abilities very well. If we notice any changes or concerns we can seek the relevant help/advice, adjust the care plans to fit their needs and make relevant changes to facilitate them.

jabib2 karma

What was the age of the oldest and youngest patient you had? My father was diagnosed at 56, he is just one month shy of 64, and is late stage now. Thank you for what you do

etre-est-savoury3 karma

I can't remember the exact age but 50s was the youngest. We have had ladies who were 100 but I haven't seen anyone older since I have been there.

tripositional_tripod2 karma

Hi, thanks for doing this ama. My grandmother was recently admitted to long-term care due to advanced Alzheimers. She gradually slipped further and further away and finally couldn't recognize my grandfather anymore. My question is kind of morbid: What is the usual end game for these types of patients? My dad said eventually they stop eating and drinking. Also, what are some good ideas for family members who want to help/contribute in some way? Going to see her and spending time with her seems kind of pointless since she doesn't remember who I am anymore. I read in another comment about pet therapy services. Are they helpful/enjoyable for the patients? Thanks for the time for your answers

etre-est-savoury3 karma

No worries!

The end game varies but from personal experience I do find that more often than not people tend to stop eating and then drinking and slowly slip away. It's not a pleasant process but apart from passing away in your sleep, what is?

Most of our residents love pets and dogs. They also seem to appreciate visitors no matter who they are - it gives them something to do other than watch TV.

sonofabutch2 karma

This might not be a question you can answer, but: I'm shocked by how much nursing homes charged per day, and equally shocked by how little most nursing home employees get paid.

Where does all the money go?

etre-est-savoury3 karma

To the people at the top, at head office. It's horrible to think about

gutter_rat_serenade2 karma

Ever convince one of them that they were a super hero in their younger years but lost all their powers when they got older?

etre-est-savoury3 karma

I hope this is how I feel if I ever get dementia. You have it on record - if I get dementia, convince me I used to be Batman

Redsoxlover2 karma

Have you ever worked a night shift? What's your scariest story?

etre-est-savoury3 karma

Loads, I started out on nights and sometimes have to cover them!

We had a guy try to break in to steal drugs one night. The home is in the middle of nowhere so it was a bit freaky. He bailed and went home empty handed.

fireflyfire2 karma

My grandma was diagnosed with Alzheimer's yesterday after about a year of forgetfulness. It is sad and we know it's only downhill from here.

I just wondered if you think there are any positives of having Alzheimer's?

etre-est-savoury3 karma

It's not a nice answer but no, not really.

People with dementia can and do have lots of fun and happy days though!

einaralex1 karma

[deleted]

etre-est-savoury17 karma

There was a lady who forgot her husband had passed away when she got up each morning and it tore her apart every single day. The whole 'Groundhog Day' thing is quite common with dementia but it really is sad.

Stthads7 karma

Did someone remind her every single day he was gone? I have an aunt that forgets her husband has died. We no longer confirm this because it would just tear her apart all over again.

etre-est-savoury7 karma

She settles better once it has been talked through with her, otherwise it would bother her all day long. Thankfully she settles once it has all been explained to her and how long ago it happened.

Sedentary-2 karma

ITT: Poop

etre-est-savoury5 karma

and wee, don't forget the wee.

Woden1Eye-9 karma

how gross exactly are old people?

etre-est-savoury4 karma

That's a big generalization - just like young people, there are some elderly who are gross and some who aren't