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Putting this out there to see if anyone is remotely interested.. I work in a high end retirement/dementia/palliative care facility. We have a huge campus that strives to provide all the activities and care an old person could want, it’s privately owned and classy as hell. I primarily work in dementia/end of life housing and do everything from helping in day to day tasks, personal cares, feeding and dispensing medications. My location: A maximum of 12 occupants we currently have a few empty rooms. Cost: $900 usd a week (covers everything). Male and female residents in various stages of dementia. I have previously worked in other facilities, much less “classy” than this one. Handy tip: Avoid getting old at any cost.
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Mar 29, 2023 00:41
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As in this is located within the States? Why is it so cheap, considering the amenities?
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Mar 29, 2023 16:03
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External to the states.
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Mar 30, 2023 01:57
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How would you approach your own end of life care? Is it true that people with dementia often have a period of lucidity just before death? How do you handle escape artists? How much do your patients/clients gently caress?
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Mar 30, 2023 04:38
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Decoy Badger posted:How would you approach your own end of life care? There’s a running “joke” amount staff that we will use steroids when we get weak, and if we are going the same way our residents are we would get jacked out of our heads on cocaine and die doing something awesome but stupid. It’s hyperbole obviously but seriously, gently caress that dementia poo poo. It’s legitimately horrifying. Decoy Badger posted:Is it true that people with dementia often have a period of lucidity just before death? I’ve seen residents come out of their advanced dementia and return to lucidity (or something near to it) for a period of time, sometimes it lasts for hours, sometimes literally minutes. I was with one woman who would occasionally “come around” and spend a couple of minutes pleading with me to be sedated so her family didn’t have to see her like this before becoming demented again. Decoy Badger posted:How do you handle escape artists? My facility is completely enclosed and all the exit doors require swipe card access, every now and then one of the mobile residents will wander out to the gardens but they can’t get further out that that, we have constant checks on the roomers to make sure they don’t hurt themselves. Decoy Badger posted:How much do your patients/clients gently caress? Thankfully they are well pasted that, I’m not cleaning that up!
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Mar 30, 2023 13:40
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Extra row of tits posted:I was with one woman who would occasionally “come around” and spend a couple of minutes pleading with me to be sedated so her family didn’t have to see her like this before becoming demented again. That is horrifying. Is there a lot of haldol being prescribed? Any common injuries among the staff?
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Apr 2, 2023 16:39
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Just quetiapine and some risperidone. No injuries in this ward beyond the occasionally pulled muscle.
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Apr 2, 2023 20:34
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Extra row of tits posted:I was with one woman who would occasionally “come around” and spend a couple of minutes pleading with me to be sedated so her family didn’t have to see her like this before becoming demented again. This is horrifying. Holy poo poo I could not handle this. Is there any way to actually do this? Is there some way to set it up such that 'the system' euthanizes me if I end up with dementia?
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Apr 10, 2023 18:53
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Dang I could not handle that. How does it work when there’s a morning check in and someone has passed away? Is it have a nurse check vitals, contact the family, then the coroner to pick them up? Do you ever have a patient who is not appropriate for the facility? When my grandma was in end of life hospice they oddly had someone check themself in who kept ordering food and driving places with their own car, and eventually got told to leave as they were old but not dying and might have misunderstood the purpose of the place.
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Apr 11, 2023 03:33
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Canine Blues Arooo posted:This is horrifying. Holy poo poo I could not handle this. Not that I am aware of, that patient was an exception, she’s literally the only one I’ve come across that was aware of her situation. Hyrax Attack! posted:Dang I could not handle that. How does it work when there’s a morning check in and someone has passed away? Is it have a nurse check vitals, contact the family, then the coroner to pick them up? During night shifts I do hourly checks to make sure everyone is ok, we have sensors that beep if someone gets out of bed so if someone did pass away they would be found pretty quickly, if a resident has obviously reached the end of life stage they can be moved to a hospital wing and kept comfortable there. We do have people in for an type of assessment to see if they are ready to move in with us permanently but no one really comes in “inappropriately”. Humorous story: One of my residents that I care for daily ALWAYS points out I’m going grey. She tends to remember me, if not by name she recalls she’s seen me before in the mornings, but for some reason my hair always seems to come across as a surprise. Every day it’s “You know, you’re getting very grey” or “You’re so grey” of “I’ve seen yo before, why are you so grey” or my personal favourite “”Did you get enough sleep, you look terrible”.
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Apr 12, 2023 01:48
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Canine Blues Arooo posted:This is horrifying. Holy poo poo I could not handle this. Google is failing me at the moment, but I read an article several years ago about a doctor who was diagnosed with dementia relatively early and decided she didn't want to live out her days like that. She signed a statement asking for euthanasia once she hit one or more indicators that her dementia had progressed to a point where she would no longer want to live - while she was still rational enough to make the decision.
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Apr 14, 2023 05:52
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I don't know if you're still checking this thread, but have you ever listened to Everywhere At The End Of Time by The Caretaker? Going through that album series was an ordeal that has both made me fascinated with and deeply paranoid of dementia. Some caregivers have listened to it and said it's a pretty accurate depiction of the progression of Alzheimer's.
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Jul 15, 2023 02:17
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Decoy Badger posted:Is it true that people with dementia often have a period of lucidity just before death? I’m by no means a professional on the matter, but i watched my grandfather pass last year after suffering from advanced dementia for many years. A few hours before he died he asked for my grandmother by name; he hadn’t remembered her with any specificity for at least a few years prior to that.
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Jul 21, 2023 03:52
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two fish posted:I don't know if you're still checking this thread, but have you ever listened to Everywhere At The End Of Time by The Caretaker? Going through that album series was an ordeal that has both made me fascinated with and deeply paranoid of dementia. Some caregivers have listened to it and said it's a pretty accurate depiction of the progression of Alzheimer's. No, I haven’t heard of that one. I can understand the paranoia though. We have two new patients, one that consistently destroys his room in the middle of the night and another that has zero memory and re-asks the same question over and over. She’s killing me.
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Jul 21, 2023 15:15
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Bouillon Rube posted:I’m by no means a professional on the matter, but i watched my grandfather pass last year after suffering from advanced dementia for many years. A few hours before he died he asked for my grandmother by name; he hadn’t remembered her with any specificity for at least a few years prior to that. I noticed one of my more talkative patients seemed to become much more lucid in her last 3/4 days of life. It was very strange in that she was no longer complaining about imaginary ills and was aware she was dying.
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Jul 21, 2023 15:17
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Extra row of tits posted:No, I haven’t heard of that one. I can understand the paranoia though. https://youtube.com/watch?v=wJWksPWDKOc It's brutal. Absolutely worth a listen if you can spare the time for it, also fine to do it in chunks because it's separated into six albums, each one representing a separate stage of Alzheimer's. It consists of samples of ballroom music, sans vocals, that progressively get more distorted across the series as attempts are made to recall the music, and these attempts start to fail. All of this is incredibly well done and treats the subject matter respectfully without romanticizing it.
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Jul 21, 2023 16:00
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Extra row of tits posted:I noticed one of my more talkative patients seemed to become much more lucid in her last 3/4 days of life. It was very strange in that she was no longer complaining about imaginary ills and was aware she was dying. I've long been curious about terminal lucidity, but I've never experienced it in person. How does it manifest? Does the patient just suddenly start and then stop talking, or is there a gradual lead into it and a fade away from it? Is the patient able to recall things from their dementia phase? Do they know they even experienced it, or do they just "wake up" on their death bed without any context of why they're there?
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Jul 21, 2023 16:16
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My patient was well known for getting out of bed dozens of times a night with complaints about how she couldn’t breath - while holding a perfectly normal conversation and breathing, how she was in pain - the location constantly changed and no nurse could find anything wrong with her, how she couldn’t walk and would stagger back to her room at 3km an hours groaning and limping.. after walking out of her room and over to me perfectly fine. She would also constantly say she was dying and attention seeking. She was also a world class “horrible old person” verbally and sometimes physically abusive, lashed out, hated everyone. When she reached end of life she was having pain, difficulty breathing and needed assistance to even move in bed at all. She never complained about it, and when any of us went into her room to visit she was grateful we were there, thanked us for coming in and although she still said she was dying (now correctly), she was at peace with it and understood what was going on.
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Jul 21, 2023 16:53
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When it comes to being able to consent to things like treatment, how does it work with a dementia patient? If they start screaming that they don't want a pill, and the pill is necessary for their well-being, is the refusal respected or are they forced to take it?
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Jul 21, 2023 17:34
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Shooting Blanks posted:Google is failing me at the moment, but I read an article several years ago about a doctor who was diagnosed with dementia relatively early and decided she didn't want to live out her days like that. She signed a statement asking for euthanasia once she hit one or more indicators that her dementia had progressed to a point where she would no longer want to live - while she was still rational enough to make the decision. Not the same, but an essay from a decade ago about how doctors choose to die more generally: https://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/ I've talked to a doctor about this, and even in Washington state--which has a relatively loose death with dignity law--requires that in order to receive lethal medication, you have to have a condition that is likely to kill you within six months. So, Alzheimers and dementia don't qualify, at least not at any point where you'd be lucid enough to make the request competently.
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Jul 21, 2023 18:00
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two fish posted:When it comes to being able to consent to things like treatment, how does it work with a dementia patient? If they start screaming that they don't want a pill, and the pill is necessary for their well-being, is the refusal respected or are they forced to take it? I’ve never seen a patient refuse medication, they can always (so far) be convinced to take meds with yogurt or in a drink. I can’t say for sure as I haven’t encountered this situation in my current workplace, but it previous places my patients were under a law order and refusing to take meds would result in removal of privileges, or in extreme cases restraint and an injection. However, these patients were psychotic forensic patients ie; had committed crimes. They were on permanent lock down in a secure ward.
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Jul 21, 2023 18:51
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Do advanced dementia patients still have preferences in food? Are they able to remember what their favorite foods were? What do they even eat at that point, and how do they eat?
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Jul 21, 2023 20:08
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They do, one of my ladies is allergic to fish and is always able to identify it when eating. Another patient is extremely disconnected from reality, doesn’t speak, full cares and feeding, but will reject tomatoes when offered. His wife says he’s always hated them. We have a mix of diets ranging from fully independent eats everything through to food that is basically goo and patients that need to be fed. The fish allergy lady always makes me laugh as even if she eats very little of her dinner she will scoot back to the table when reminded there is desert coming, The food is all prepared onsite by a chef and is pretty classy, expressly when compared to public hospitals.
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Jul 21, 2023 20:18
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What happens to patients who run out of money for a good facility, lack friends and family to pay for them, and they're at an advanced stage of Alzheimer's? Do they get transferred elsewhere or does the facility eat the cost?
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Jul 21, 2023 21:04
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I’m assuming they would have to move out, it hasn’t happened so far as they are all loaded
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Jul 22, 2023 07:02
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Do you have patients who refuse to be bathed or have their fingernails clipped, or even have their room cleaned? That's my father basically  and the staff at his home sometimes manage to persuade him but more often they don't. And when we complain about his condition they say, well there's only so much we can do, we don't have the policy or the means to physically force patients into anything.
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Jul 28, 2023 23:58
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Doctor Malaver posted:Do you have patients who refuse to be bathed or have their fingernails clipped, or even have their room cleaned? That's my father basically Luckily no, the worst we have is one guy who would rather just stay in bed but begrudgingly allows us to shower him. Two of my patients appear to be on the way out at the moment. Different ends of the scale they are, one is the angry screamer the other a lovely old lady who is my best work friend.
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Jul 29, 2023 10:37
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How many STDs are there floating around? How often do you walk in/hear them loving?
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Jul 31, 2023 04:00
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Tell me you didn’t read the thread without saying I didn’t read the thread.
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Jul 31, 2023 07:42
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What do patients with advanced dementia do on a daily basis? Do they wander aimlessly, constantly forgetting what they wanted to do, or do they stay immobile and stare into space? How much do they sleep? Do they ever seem to dream while they sleep?
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Jul 31, 2023 19:49
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two fish posted:What do patients with advanced dementia do on a daily basis? Do they wander aimlessly, constantly forgetting what they wanted to do, or do they stay immobile and stare into space? We have diversional therapy which is designed to keep them engaged and active, also we have visitors from musical groups and the local library. You do need to steer them into activities though as they would be quite happy to watch tv (any tv) all day between meals. Overall they sleep well, I’m sure the drugs help, but we do have one or two that get up fairly regularly or scream all night. We had one resident that would push her call button over and over and over and over all night, often you would not even get out of her room and she would be pushing it again. Once I found her asleep with the button in her hand still reflectively pushing the button! I often suggested the button in her room be removed as it was never an actual emergency and on occasion we were missing rare calls from other residents because we had tuned out the constant repetitive tone.
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Aug 1, 2023 04:47
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