You know it's going to be a long day when...
...your first patient greets you with "Get out of my house!".
It's amazing how the body becomes less tolerant to infection as one gets older. A perfectly well elderly person can become completely loony with a simple chest infection or urinary tract infection. They won't be able to walk steadily, they'll suddenly become incredibly confused or incontinent. Sometimes, they can even become violent.
I have a staff nurse sitting in the corner quietly applying ice to a huge swelling on her forearm - our elderly lady clamped onto her with her toothless gums for about 5 minutes becfore we could pull her off.
Sometimes their personality changes so much that they can't recognise their own family members (which can be more distressing to the family than to the patient).
It's all temporary, however. Once the underlying infection is treated, the patient returns to normal, and it's amazing how quickly they recover after that.
Meanwhile, the elderly ill patients are highly distressed - people seem to be invading their home, stabbing them with needles, asking them questions. They scream and scream to get the strangers to leave, but instead the strangers come and yell in their ear, telling them to relax. How can they relax when thieves are in the house, hurting them?
Their bed has grown bars and become a jail; they cannot seem to escape from it to get to the toilet (where has the toilet gone, anyway?); they wet their beds with great embarassment. Someone comes along and pushes their bed from one end of the room to another, into a cold room where they have pictures taken of their nakedness. The walls of their house have taken on garishly bright colours, and appear to be moving, sliding back and forth on rails.
It's no wonder elderly patients become violent. It's self-defence.
It's amazing how the body becomes less tolerant to infection as one gets older. A perfectly well elderly person can become completely loony with a simple chest infection or urinary tract infection. They won't be able to walk steadily, they'll suddenly become incredibly confused or incontinent. Sometimes, they can even become violent.
I have a staff nurse sitting in the corner quietly applying ice to a huge swelling on her forearm - our elderly lady clamped onto her with her toothless gums for about 5 minutes becfore we could pull her off.
Sometimes their personality changes so much that they can't recognise their own family members (which can be more distressing to the family than to the patient).
It's all temporary, however. Once the underlying infection is treated, the patient returns to normal, and it's amazing how quickly they recover after that.
Meanwhile, the elderly ill patients are highly distressed - people seem to be invading their home, stabbing them with needles, asking them questions. They scream and scream to get the strangers to leave, but instead the strangers come and yell in their ear, telling them to relax. How can they relax when thieves are in the house, hurting them?
Their bed has grown bars and become a jail; they cannot seem to escape from it to get to the toilet (where has the toilet gone, anyway?); they wet their beds with great embarassment. Someone comes along and pushes their bed from one end of the room to another, into a cold room where they have pictures taken of their nakedness. The walls of their house have taken on garishly bright colours, and appear to be moving, sliding back and forth on rails.
It's no wonder elderly patients become violent. It's self-defence.
Labels: Clinical observations
posted by tscd at 9:27 pm
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