Today marks day 45. While the ACE unit team finds themselves caring for patients with dementia on a daily basis, there are unique cases that require a team approach that requires patience, creativity, and resilience. While it would be easy to medicate the patient to a state of somnolence or place a safety attendant at the bedside, the team was focused on supporting the patient to the point of discharge. This has meant nearly constant 1:1 time with the patient. On any given shift, you can find all roles taking an active part in supporting the patient. As geriatric caregivers, we know that behind the dementia is a person who deserves the best care.
The devastating effects of dementia are very real in this patient; her frequent mood swings, combative moments and screaming out of nowhere when staff is standing next to her make it a challenge to meet the patient's needs. The team works diligently to ensure a safe environment for the patient and the other patients on the unit as a result. Staff have gotten to know the patient and provide reassurance that her family and dog are safe and being cared for.
A patient transporter took time on her break to bring clothes in for the patient and sit and visit. ACE unit volunteers have spent countless hours visiting. The staff sits with her during meals and support her in focusing on eating and order extras of what she likes: pudding, cake, etc. The unit secretary can be found playing cards, coloring or visiting with the patient at the desk.
The conversations adjust to what mood the patient is in; creating grocery lists, making greeting cards, folding laundry - the diversion tasks are countless. Staff have taken time to wheel her around the unit and lobby to get a change of scenery. The RNs and NTs take turns with the patient and due to her labile demeanor, they quickly step in to change caregivers when the patient decides she no longer wants someone around. Nurse techs have worked with the patient to maintain hygiene and assist the patient in changing into clothes from the donation closet at Blodgett. The team provides reorientation despite knowing it will be needed again in two minutes. The social work team has advocated tirelessly to seek safe discharge options for the patient.
Leadership from nursing, care management, the medical team, Priority Health, and the ethics team are working together to advocate for placement. Security has supported the team with ongoing rounding and quick responses when de-escalation is needed.
The compassion, excellence, and teamwork demonstrated over the last 45 days have been incredible to see. While the toll is wearing on the team, they continue to work together to meet the needs of this patient. They get frustrated at times, but rally and demonstrate resiliency as a strong team because truly the care of this patient would not happen without all hands on-deck.