In modern economically developed countries (thank you Geography GCSE) the increasing number of those reaching old age means more people with degenerative diseases. Recently, I've dealt with one of the worst ones to properly deal with and care for: Alzheimer's. Such patients are incoherent, frequently aggressive and permanently confused when they reach an advanced stage.
The back story behind this particular patient was a family that refused to accept his confused state and meant instead of getting adequate care and housing, he had lived on his own, ended up asleep outside on the street and now was on my ward. As we will all in life (unless orphaned or being shitty, shitty people) have to deal with parents, relatives and/or friends (or even ourselves) who will develop the same and similar diseases here are some tips for the inexperienced when dealing with such confused persons.
Don't step inside the killing zone.
As confused people (or patients as I will call them) are often by nature unsure of what is going on and either angry at this or scared, they can get pissed off. And when this happens they get aggressive. My patient frequently challenged me to fisticuffs but due to his age wasn't too speedy. This meant a quick step back and I was out of harm's way, free to calm the old boy down. Another nursing assistant didn't heed my warning and got five grey knuckles to the face for his lack of battlefield knowledge.
You don't have Alzheimer’s, so don't be a pussy
However sometimes (quite often) restraint and forcibly moving the patient is required if they are putting themselves, others (or most importantly YOU) in harm's way in whatever way. Being younger, fitter and free of Alzheimer’s gives you a considerable advantage. Whether they are in aggression mode or not, you can quickly step up on them, grab them by the arms, pin them to their sides and walk them to wherever they need be before they can even start laying the smack down on your candy ass. Screaming, shouting and threats of ass-kickings don't mean much from them at this point as they can't punch you now. With two people it's even easier to put them in a chair. You have probably scared the shit out of them and they may hate you, but rule 6 means this doesn't matter.
When seated watch for cheap shots
One problem with sitting them down forcibly does mean your groin is now exposed to kicks that even old patients are able to carry out. Same guy who got punched found this out when same patient delivered a nice right foot to his sensitive spot despite my warning. Oh well, he'll learn.
Lie, cheat and manipulate
Being confused and bearing in mind you're acting in their interest, you can use any and all arts of persuasion and manipulation to get patients to follow you believing they are heading for whatever goal they are looking for. Usually its a door to a way out or sometimes if they believe they are at home when really in hospital (this has happened) another room in the house may be what they envisage in their head.
"You ain't the boss of me!"
In general confused patients not being open to honest requests or normal behaviour will take any suggestion as attacks on their independence. For example asking them to go to sleep when it's 2am and every other patient is pissed off at them for being a loudass can elicit a response such as 'I decide when I go to bed, I'm an adult you fucking, piece of shit" and other tasteful phrases. This is why it's better to use suggestion and manipulation to achieve your ends, being an honest person doesn't work here. Also lacking the idea of social convention a patient just walked up to me asking when she was getting picked up to go home. At 3am. Go to bed woman.
If you've seen Memento, most patients are like that
This is crucial, you can lie repeatedly, have as many arguments as you like and they will never hold a grudge because they won't remember. The downside is that they won't remember what they should do which is where the problem originates. And don’t be a dick and molest them or something, that’s messed up (obvious but well... it can happen).
Get them proper help
No shame in admitting you can’t look after them, just make sure they’re in a proper nursing home to care for them so you aren’t driving to insanity and more importantly so they don’t end up in hospital and drive ME insane.
