Revision [2516]
Last edited on 2012-05-02 21:28:27 by JenniferCastiglioneAdditions:
5/2/2012--Today at my internship I went around to the long-term care residents and had them answer a survey asking questions about staff and if they feel respected and if they are being treated well. Everyone answered postiively and was very pleased with staff. The only issue that was multiply reported was missing items and how nothing was done with them. I found this interesting, because I wonder where their items would go. It just shows that even within a facility things easily go missing. I also did some MDS 3.0 and care plans. It was a very simple day.
Revision [2508]
Edited on 2012-04-26 13:32:16 by JenniferCastiglioneAdditions:
While working at my internship, there was a variety of different cultures, socioeconomic statuses, and individuals with disabilities coming in. A lot differs from my culture when looking at these individuals, some individuals were coming from homes that were not in the best conditions, or they already had issues going on before coming to the hosptial. A lot of the people coming in have to later go on Medicaid or Medicare because they don't have the money to pay for all of the bills; it is simply too expensive. You can really see the stress that people go through, especially when they realize that their loved ones have to stay in long-term care placement instead of going home. The financial burden is quite large and it is a process to apply for medicare. Another woman who most definitely made an impact was something with obvious mental disabilites that have never been addressed, her family that came in smelled of urine, and she obviously was not coming from a positive atmosphere. This differs with me because I am not surrounded by any of that, so looking at the effects of a home that isn't really stable allows you to re-evaluate your life and where you come from.
Revision [2500]
Edited on 2012-04-18 12:36:25 by JenniferCastiglioneAdditions:
4/16/12 (9am-2pm)--Today there were seven new admittance at the hospital, so it was a very busy morning. I got six out of the seven done while I was there, so I was very happy about that. Today, the woman who stood out to me the most was a 63 year old woman who was there for multiple things. As I was giving her the mood interview and asking about her happiness and such, she explained that its just hard because of the injury, and then she shared with me that her husband passed away recently as of April 1st, 2012. This was shocking to me, because earlier when I asked her martitial status she simply said widowed and we kept going with the conversation. As we discussed how her husband passed away, she explained to me that she has strong faith and she knows that she will be okay. This just touched me a lot because if she never mentioned it, I would have never known that she was grieving the lost of her husband.
4/18/2012 (9am-2pm)--Today there were only three new admissions to do, so it was a very steady day. One woman, who was admitted a little big ago for short term care, continues to get worse with her agitation. She is not very aware of her surroundings, and yesterday apparently she was fine and pleasant, and then today she is saying many lies about the staff and being rude and hostile and sometimes aggressive. Its interesting to see how much someone's mental state can change. One man that I talked to today, he was perfectly fine at his hospital, walking 50 ft on his own and fairly independent. He fell and hit his head while at Degraff, and they did a CT scan and he is perfectly normal, but he is very flat and falls in and out of sleep and isn't responding well. He has something called Lewy Body Dementia, which is quite different than anything else I've seen. It was interesting because as I was asking him his basic information and doing the BIM's on him, he just stared, we made no eye contact. Then, he would repeatidly fall in and out of sleep. What I thought was quite amazing was even though this was so and he was barely responsive, he was still able to crack in a joke while we were talking, I liked that a lot.
4/18/2012 (9am-2pm)--Today there were only three new admissions to do, so it was a very steady day. One woman, who was admitted a little big ago for short term care, continues to get worse with her agitation. She is not very aware of her surroundings, and yesterday apparently she was fine and pleasant, and then today she is saying many lies about the staff and being rude and hostile and sometimes aggressive. Its interesting to see how much someone's mental state can change. One man that I talked to today, he was perfectly fine at his hospital, walking 50 ft on his own and fairly independent. He fell and hit his head while at Degraff, and they did a CT scan and he is perfectly normal, but he is very flat and falls in and out of sleep and isn't responding well. He has something called Lewy Body Dementia, which is quite different than anything else I've seen. It was interesting because as I was asking him his basic information and doing the BIM's on him, he just stared, we made no eye contact. Then, he would repeatidly fall in and out of sleep. What I thought was quite amazing was even though this was so and he was barely responsive, he was still able to crack in a joke while we were talking, I liked that a lot.
Revision [2486]
Edited on 2012-04-11 21:19:37 by JenniferCastiglioneAdditions:
4/11/12 (9am-2pm)-- At my internship one woman stood out to me the most, her name is Ellie. She is a 92 year old and is in because of a pelvic fracture, as I was asking her the basic questions about if she has been feeling down at all she stated that she just felt lonely, and she looked very sad. After all the questions were done we were just sitting on her bed talking; she is supposed to use the call bell whenever she needs something and she hasn't been using it so I recommended that she tried it because she needed to use the bathroom. I showed her which button to press, and then the nurse said what do you need, and you don't have to talk in the remote you just answer and they will hear you through the speaker on the wall. But, Ellie answered in the remote, and I looked at her and she looked at me and realized what she had done and laughed. Then we just looked at each other and we couldn't stop laughing, we were literally in tears laughing. It was just a nice moment to have with someone because she was sad just earlier, and that little moment really cheered her right up. Interacting with all the patients just allows you to learn so much about people and how little it takes to turn someones day around.
Revision [2483]
Edited on 2012-04-09 08:35:29 by JenniferCastiglioneAdditions:
4/4/12 (9 am-2pm)--A lot of people were very interesting today to be working with. The lady who stood out to me the most was a bipolar, anxiety, and depression. She was sent to the hospital and is back untill the end of April due to her IV's that she needs, she can not go home with them. She was interesting because she seemed as if she was in a manic phase of bipolar, she was very chatty, up and down, and when asking her if she has been feel down, depressed, or hopeless at all, she goes "well considering I almost died two times the other day I feel pretty crappy", but she said it in like a joking manner she didn't sound sad or mad, she had a light kick to it. I just found that very interesting.
Revision [2472]
Edited on 2012-04-02 16:45:28 by JenniferCastiglioneAdditions:
4/2/12 (9am-2pm)--Today a lot stood out to me, two people in particular. The first was a man named Marc, he is an alcoholic and was admitted on march 31st. I had to go in to talk to him today, there is obvious worries that he is going to go through withdrawal symptoms while being here, but he was a very kind man. When asking about his life, marital status, and how many children, you could see him start to tear up. When asking how many kids especially, he explained that he adopted three kids but they are all grown up now and he began to shed some tears. He was also legally separated; you really got the sense that his alcoholism had affects on his family which led to them moving on from him. He was an extremely kind man regardless though, and if you didn't know the background information you wouldn't have guessed that about him.
Another man is a long-term resident, his name was Philip. I went in to do a simple BIM'S test on him, which is done every three months, simply standard. Never in the seven months that I have been at Degraff have I been questioned as to why I was doing this, it is so pointless, etc. Philip continued to ask me why I was doing this and if this was so we could chose who we were going to throw in the nut house. I consistently confirmed it was done every three months to check on everyone, it was protocol. When I asked Philip what year it was he said, "I'm breathing, who cares what year it is", and this statement kind of set me aback. It is true though, he has his life and why should he care about anything else? It really showed me though what you need to do to deal with a difficult resident, and then put yourself in their shoes and think how would you react?
I also did numerous BIM's on other patients, care plans, and assessments. It was a very productive day.
Another man is a long-term resident, his name was Philip. I went in to do a simple BIM'S test on him, which is done every three months, simply standard. Never in the seven months that I have been at Degraff have I been questioned as to why I was doing this, it is so pointless, etc. Philip continued to ask me why I was doing this and if this was so we could chose who we were going to throw in the nut house. I consistently confirmed it was done every three months to check on everyone, it was protocol. When I asked Philip what year it was he said, "I'm breathing, who cares what year it is", and this statement kind of set me aback. It is true though, he has his life and why should he care about anything else? It really showed me though what you need to do to deal with a difficult resident, and then put yourself in their shoes and think how would you react?
I also did numerous BIM's on other patients, care plans, and assessments. It was a very productive day.
Revision [2458]
Edited on 2012-03-29 13:25:40 by JenniferCastiglioneAdditions:
How this relates to classes I've taken:
So far this semester, I have realized that my internship connects a lot with my Abnormal Psychology class from last semester. Some of these patients have schizophrenia (non-symptomatic), or other various disorders. It really brings everything that I learned in class to life because I am seeing the effects. One woman, who I discussed in my passages, had long-term effects from the psychotropic medications of Schizophrenia. I learned this in my Abnormal Class, and to actually see the effects in real life and how it can have such a large impact on you really opens your eyes. Also, I have seem Dementia and Alzheimer's, which I learned about last semester. When I was volunteering last semester, one man came in who has very quickly progressing in his Alzheimer's. In class we learned about how people with dementia or Alzheimer's will often have mood changes, they may possibly become very hostile. This one man who was at the home previously, sadly he passed, I was able to see the progression of the hostility that he took on. When he first came he was just an average individual in his behavior, but as time continued he got very hostile and would yell things at people. I really saw how his Alzheimer's progressed in a hostile manner.
Another subject that my internship has really connected with has been my Personality Psychology class. In class, we discussed cumulative continuity. This is when personality traits increase in rank-order consistency throughout the life span. Rank order consistency is when you are staying in relatively the same place, so if you are normally an outgoing person, you will stay relatively outgoing. We looked at a revised version of the bumulative continuity, and this showed that traits have curvilinear stability in adulthood such that they become more stable into midlife then decrease in later life. While working at Degraff, I have seen that this depends on the environment, which in class was confirmed that this is also true. At Degraff, there are many residents who lived in a closed community before they came here, they were lonely, kept to themselves, and didn't have many visitors. Now, they are lively and love going to all the activites. They are always out socializing with the other residents and really enjoying themselves. This topic just reminded me that depending the environment that the individual was in before coming to long-term care at Degraff, that may change their personality.
My Daily Logs:
So far this semester, I have realized that my internship connects a lot with my Abnormal Psychology class from last semester. Some of these patients have schizophrenia (non-symptomatic), or other various disorders. It really brings everything that I learned in class to life because I am seeing the effects. One woman, who I discussed in my passages, had long-term effects from the psychotropic medications of Schizophrenia. I learned this in my Abnormal Class, and to actually see the effects in real life and how it can have such a large impact on you really opens your eyes. Also, I have seem Dementia and Alzheimer's, which I learned about last semester. When I was volunteering last semester, one man came in who has very quickly progressing in his Alzheimer's. In class we learned about how people with dementia or Alzheimer's will often have mood changes, they may possibly become very hostile. This one man who was at the home previously, sadly he passed, I was able to see the progression of the hostility that he took on. When he first came he was just an average individual in his behavior, but as time continued he got very hostile and would yell things at people. I really saw how his Alzheimer's progressed in a hostile manner.
Another subject that my internship has really connected with has been my Personality Psychology class. In class, we discussed cumulative continuity. This is when personality traits increase in rank-order consistency throughout the life span. Rank order consistency is when you are staying in relatively the same place, so if you are normally an outgoing person, you will stay relatively outgoing. We looked at a revised version of the bumulative continuity, and this showed that traits have curvilinear stability in adulthood such that they become more stable into midlife then decrease in later life. While working at Degraff, I have seen that this depends on the environment, which in class was confirmed that this is also true. At Degraff, there are many residents who lived in a closed community before they came here, they were lonely, kept to themselves, and didn't have many visitors. Now, they are lively and love going to all the activites. They are always out socializing with the other residents and really enjoying themselves. This topic just reminded me that depending the environment that the individual was in before coming to long-term care at Degraff, that may change their personality.
My Daily Logs:
Deletions:
Revision [2456]
Edited on 2012-03-28 22:27:34 by JenniferCastiglioneAdditions:
3/28/12 (9am-2pm)-- At my internship the first thing that I did was hi good morning to Virginia, today she wasn't in a very chatty mood. Its always interesting because she doesn't remember me at first, then I say something to remind her who I am and she goes "ohhh yes!". I am waiting for the day that she remembers wait away in the morning. Also, on Monday I met a woman named Stella who I had to give a BIMS test to, and I told her that Wednesday I was going to see if she remembered my name. Later that day Monday she saw me and said my name, then this morning I asked her and she couldn't remember and was trying to think of the three words that I asked her for her BIMS test. I feel that some of the elderly are more confused in the mornings, thats what it seems like to me. After that I did a lot of MDS reports and discharge reports, I learned more about how to fill out the forms, information on the VNA, and what the hospital is responsible for. There was only one new patient today, she related to my abnormal psychology class because she had anxiety and when I went into her room today she told me she was having trouble breathing. She has congested heart failure, so she has oxygen and often has trouble catching her breath. I told the head nurse she was having trouble breathing, and they explained that she does have anxiety and her medicine will be kicking in shortly, so to go in and tell her to take deep breathes and her medicine hasn't kicked in yet. When I went in there I told her this, and she grabbed my hand and took some deep breathes and then thanked me. It makes you really see how something can make you a little paranoid, especially feeling like you cannot actually breathe.
Revision [2448]
Edited on 2012-03-26 12:40:37 by JenniferCastiglioneAdditions:
3/26/12 (9am-2pm)-- Today at my internship I started off my day by talking to Virginia and checking in with her. She was very nice but also very concerned about this new medicine that she has been taking, it is very nice though that she enjoys talking to me so much. Later I checked in with Lisa and got everything organized for the day. I had a few BIMS tests to do and one new admitted patient that I had to finish. Out of all the BIMS tests that I had to give, one lady stuck out to me the most. She was there for short-term rehab, and we were sitting down and chatting and we eventually started talking about Canisius. Her son went to Canisius and is now a psychiatrist in Florida. It was just pleasant talk, and as I was saying bye to her she thanked me. She thanked me for being happy and brightening up her day. I thought that was really nice, you don't realize how it must be sometimes to be stuck in a hospital for rehab and its refreshing to know that you helped someone out just a little bit.
Also, I checked back in with Virginia. She had me go to her and she showed me her family pictures; you can tell it makes her really happy to be able to talk about her family. She also explained the family dynamics and the things that are going on in her life. I enjoy checking in on Virginia whenever I am there, its nice to have someone to chat with and really learn about their life there. Also, today there was a new patient coming, but in order for this patient to have a room four room changes need to be done. You don't realize how much work is put into allowing someone new into the building and all the moving and organization that it takes to do this. To finish the day I did some care plans and MDS reports. It was a very successful day.
Also, I checked back in with Virginia. She had me go to her and she showed me her family pictures; you can tell it makes her really happy to be able to talk about her family. She also explained the family dynamics and the things that are going on in her life. I enjoy checking in on Virginia whenever I am there, its nice to have someone to chat with and really learn about their life there. Also, today there was a new patient coming, but in order for this patient to have a room four room changes need to be done. You don't realize how much work is put into allowing someone new into the building and all the moving and organization that it takes to do this. To finish the day I did some care plans and MDS reports. It was a very successful day.
Revision [2446]
Edited on 2012-03-25 14:51:43 by JenniferCastiglioneAdditions:
3/21/12 (9am-2pm)-- Today at my internship there were six new patients today at the hospital, it was a very busy day. One woman stood out to me the most today, she was there for a fall and I had to come in and just ask the normal questions and get the basic information. As I was talking to her you could tell she was not in a good mood and just complained about Degraff and how much she didn't like it. I will be interested to see if that changes at all on Monday, because a lot of times when people first come in they are so irritated, and once they are settled they are okay again. Also, something connected to my abnormal psychology class. While giving my BIMS test I had to ask this individual the year, and they stated that they really weren't sure. They told me the year 2005, and then asked me if they were right. In class we learned about this, if you should tell them the reality and confuse them more, or let them just think what they think, because those moments of confusion really aren't worth it. For some people, I really need to evaluate this because when I am asking the long-term patients sometimes I do have to say "you did great don't worry". For this patient, I told them the truth because I could tell that they could handle. This just presented something important to me.
Revision [2438]
Edited on 2012-03-07 18:27:49 by JenniferCastiglioneAdditions:
3/7/12 (9am-2pm)--Today there was only one new patient that I had to talk to, she was 66 and had a pelvic fracture. When it was really windy a few days ago, that wind physically blew her over and caused her to have her fracture. She had a very strong personality, and was very excited to get out of there and go back home to her normal life. Colleen and I also did more care plans and MDS today. Virginia, who I have mentioned earlier, is an example of someone who proves that long-term care really doesn't just have to do with old people laying in their beds doing nothing. In reality, there are a lot of activities always going on and people who come in and visit. Before Virginia came to Degraff she was living alone, and lived alone for a very long time. You can tell that she enjoys having all of these people around and doing the activities. It is nice to see that these activities do make a difference, and it is important for people to understand that these nursing homes actually do do things, it really doesn't consist of nothingness.
Today I also talked to a woman named Gloria, it was really a supportive visit just checking in with her to see how she is doing with the adjustment of becoming a long term patient. The whole time Gloria was telling me about everything going on, I was thinking about my Theories class. We were discussing her family and things that were bothering her, so person-centered therapy came to mind. I was trying to imagine going through that conversation without asking any questions, and at one point I attempted it, but found it very difficult to not ask Gloria any questions, especially because I really did want to know more.
Today I also talked to a woman named Gloria, it was really a supportive visit just checking in with her to see how she is doing with the adjustment of becoming a long term patient. The whole time Gloria was telling me about everything going on, I was thinking about my Theories class. We were discussing her family and things that were bothering her, so person-centered therapy came to mind. I was trying to imagine going through that conversation without asking any questions, and at one point I attempted it, but found it very difficult to not ask Gloria any questions, especially because I really did want to know more.
Revision [2433]
Edited on 2012-03-05 19:15:26 by JenniferCastiglioneAdditions:
So far this semester, I have realized that my internship connects a lot with my Abnormal Psychology class from last semester. Some of these patients have schizophrenia (non-symptomatic), or other various disorders. It really brings everything that I learned in class to life because I am seeing the effects. One woman, who I discussed in my passages, had long-term effects from the psychotropic medications of Schizophrenia. I learned this in my Abnormal Class, and to actually see the effects in real life and how it can have such a large impact on you really opens your eyes. Also, I have seem Dementia and Alzheimer's, which I learned about last semester. When I was volunteering last semester, one man came in who has very quickly progressing in his Alzheimer's. In class we learned about how people with dementia or Alzheimer's will often have mood changes, they may possibly become very hostile. This one man who was at the home previously, sadly he passed, I was able to see the progression of the hostility that he took on. When he first came he was just an average individual in his behavior, but as time continued he got very hostile and would yell things at people. I really saw how his Alzheimer's progressed in a hostile manner.
1/23/12 (9 am-2pm)-- Today was my first day back for the semester. I started off my day by doing some BIMS (Brief Interview for Mental Status) test on the residents. For these tests I have to check their mental status, how their memory is, and ask them basic questions on appetite and mood. The first woman that I did my test on was Theresa. A lot of times, I just ask all the questions I need to and people want to continue on, but on some occasions, some people really want to talk to you. Theresa, she wasn't completely there, but she was very friendly. As soon as introduced myself and informed her that I was going to be doing this test with her, she was very friendly and instantly commented "oh I look your hair!". Before I started the test we were joking around, and she was telling me that she loved me. Although she had no idea who I was until about one minute before that, it was still very cute. Although she wasn't completely there she was still outgoing and friendly and enjoyed my company.
1/23/12 (9 am-2pm)-- Today was my first day back for the semester. I started off my day by doing some BIMS (Brief Interview for Mental Status) test on the residents. For these tests I have to check their mental status, how their memory is, and ask them basic questions on appetite and mood. The first woman that I did my test on was Theresa. A lot of times, I just ask all the questions I need to and people want to continue on, but on some occasions, some people really want to talk to you. Theresa, she wasn't completely there, but she was very friendly. As soon as introduced myself and informed her that I was going to be doing this test with her, she was very friendly and instantly commented "oh I look your hair!". Before I started the test we were joking around, and she was telling me that she loved me. Although she had no idea who I was until about one minute before that, it was still very cute. Although she wasn't completely there she was still outgoing and friendly and enjoyed my company.
Deletions:
Revision [2432]
Edited on 2012-03-05 19:10:54 by JenniferCastiglioneAdditions:
3/5/12 (9am-2pm)--Today at my internship it was a very productive day. Colleen and I had four new patients to admit into the hospital today. She took one of the patients, and I did the other three. We also did care plans and a few MDS reports. I can tell that I am getting much better at doing these care plans and I've really started to understand what to put in for each patient. I also learned a lot about Medicare today and where the funding comes from. I learned about how nursing homes need to screen patients before they come in, and when they take people with Medicare they actually get less money. It almost seems like a point system, for example MS patients are very expensive, but you look better having more MS patients in the hospital. It was very complicated and there was a lot to it, but it really opened up my eyes onto the patients and all the different insurances. That is why, for the short-term rehab patients you want patients that are going to recover and be able to go home after. When patients are unable to recover, we are responsible for them and we cannot just send them home without the proper assistance. We need to either find them an assisted living facility or they technically become a "long term bed" at our facility. While doing my BIM's at the end of the day, one man stood out to me the most. I'm not sure if he had a stroke or not, but he was unable to talk. He mumbled a lot and had a lot of trouble answering my questions. It really showed me though that patience is key, and finding an alternative method is important. You could tell he wanted to talk to badly though, so it was hard to watch him struggle through. It really opens your eyes to the struggles people have to face, and how patience really is the best thing because you could tell that he enjoyed the fact that I waited for him to answer, and if he couldn't I would simply find an alternative way to understand him.
Virginia has been moved downstairs to the long-term floor now, she has been very sad lately so I visited her. She was very nice, we discussed her family members flower shop and you could tell she was very excited to be talking to someone. I think she just really wants to have more conversations because when she is in activities and around the other residents apparently she is much happier, its just when she is alone and realizes the big life change she is going through. We went to her room and she showed me pictures of some of the new babies in the family, and then I brought her out to activities. I promised her I would visit every time that I was in and I could tell she was very happy about that. I will be visiting her on Wednesday.
Virginia has been moved downstairs to the long-term floor now, she has been very sad lately so I visited her. She was very nice, we discussed her family members flower shop and you could tell she was very excited to be talking to someone. I think she just really wants to have more conversations because when she is in activities and around the other residents apparently she is much happier, its just when she is alone and realizes the big life change she is going through. We went to her room and she showed me pictures of some of the new babies in the family, and then I brought her out to activities. I promised her I would visit every time that I was in and I could tell she was very happy about that. I will be visiting her on Wednesday.
Revision [2426]
Edited on 2012-02-29 18:35:22 by JenniferCastiglioneAdditions:
2/29/12 (9am-2pm)-- Today one new patient was in, his name was Maurice. He was very interesting, he was born in New Brunswick and came over here in 1955. He only went to school until 5th grade and then he told me about how he would just work on the farm everyday. It was cool to hear his story, he had a very thick accent so sometimes it was hard, and I feel like he had trouble understanding me sometimes so there was some confusion. I also did some care plans and some MDS's today with Colleen. I had to finish up some BIM's that I didn't finish from Monday. One man, went to Canisius, so that was interesting. The other, named Joe, he was one of the first people that I saw how a BIMS was done on, around September, and I can see how he has declined. His BIM's were never amazing, but this time it was very difficult for him to respond and answer. At one point, he fell asleep so I had to wake him up to finish the questions. Another woman, Rose, who is normally very good with the BIMS but today she couldn't recall the year or month, and couldn't remember any of the three words was dissapointing. She is 90 years old, and probably one of the most friendly ladies at Degraff in my opinion. Since she normally does fine, I went back later to see if she would do better, but she still did just as poorly, which was dissapointing. Also, which was exciting, Virginia Smith who was mentioned earlier, she was able to join long term care at Degraff hospital. This was relieving to know because she really would have had trouble getting accepted into other facilities, so it was good to know she would be somewhere, and I told her I would definitely be seeing her.
Revision [2417]
Edited on 2012-02-27 18:47:32 by JenniferCastiglioneAdditions:
2/27/12 (9am-2pm)--There were two new patients today, Patricia and Bernice. Bernice was at the hospital just about two weeks ago so I literally just saw her. Patricia was a very nice woman, she told me all about her children and her grandchildren. As a kid she has tuburculousous and went through a lot of surgerys and back troubles. Everytime she had a child her doctors wanted to to tie her tubes because it was risky to have babies, but after the fifth she finally agreed. She chatted my ear off about her family for probably about twenty minutes, but I loved it. It is always refreshing when patients chat with you and share their life with you. Bernice was very sad, and scored high on her mood assessment, which isn't a good thing. She didn't state any reason for why she was so sad, most patients will say they have just been depressed and tired lately due to surgery and not being able to do much, which is completely understandable.
Also, we had a meeting with the Smith family today about Virginia. They are trying to find a nursing home for her, because she isn't going to be able to return to an independent status. She has a very bad tremor in her hands, which is making it too difficult to do things on her own. Especially because she had a hip replacement so she cannot bend down or anything like that, she has to hold a stick took to put on her shoes and such, but her hands shake too much so it is very hard for her to accomplish that. Her sister was there for the meeting and they are going to be applying for medicaid so they can enter into a nuring home. Viriginia was a very sweet woman, she was very sad though about having to give up her independence, but she stated several times she has to do it and knows she won't be okay on her own.
We also met with Mr. Becker today to discuss his sexual comments he has been making towards the staff, to no surprise he did not remember this event at all. When we first went up to him he asked to use the phone, and left his wife a ramboling voicemail asking where she was and that she got out of work at nine (9 pm, it was only about 11:30 am), and why wasn't she answering the phone. Then we took him aside and asked him if he remembers making these comments, and he goes of course not and then went on and began to tell us about his life. It was sad to see how he has been developing dementia, I feel like he tries really hard to hide it by telling stories and trying to seem alert and orientated.
Also, we had a meeting with the Smith family today about Virginia. They are trying to find a nursing home for her, because she isn't going to be able to return to an independent status. She has a very bad tremor in her hands, which is making it too difficult to do things on her own. Especially because she had a hip replacement so she cannot bend down or anything like that, she has to hold a stick took to put on her shoes and such, but her hands shake too much so it is very hard for her to accomplish that. Her sister was there for the meeting and they are going to be applying for medicaid so they can enter into a nuring home. Viriginia was a very sweet woman, she was very sad though about having to give up her independence, but she stated several times she has to do it and knows she won't be okay on her own.
We also met with Mr. Becker today to discuss his sexual comments he has been making towards the staff, to no surprise he did not remember this event at all. When we first went up to him he asked to use the phone, and left his wife a ramboling voicemail asking where she was and that she got out of work at nine (9 pm, it was only about 11:30 am), and why wasn't she answering the phone. Then we took him aside and asked him if he remembers making these comments, and he goes of course not and then went on and began to tell us about his life. It was sad to see how he has been developing dementia, I feel like he tries really hard to hide it by telling stories and trying to seem alert and orientated.
Revision [2413]
Edited on 2012-02-26 21:41:34 by JenniferCastiglioneAdditions:
2/24/12 (10am-4pm)-- Today at my internship I did something new, I looked at paperwork for people who are getting benefits from being a veteran or being married to a veteran. It is basically asking information about the patient, what they are there for, and all of the fine facts about them. I went through the charts to fill it out, but it was actually really difficult. A lot of the information you really had to search in the charts for, but it was good learning because I really looked at the fine details of the charts, more than I normally do. Also, there were some new patients that came in so I checked them in. One woman came in today to talk to Colleen about her sister that's in the hospital for rehab. Her sister is trying to return home to an independent status, but in reality she needs to enter a home. She asked Colleen to talk to her about different placements available so she really understands that she cannot go home on her own. I think that was interesting to me, because a lot of people obviously do not want to give up their original life of being independent, and they need some help to realize that they no longer can live on their own. Also, one of the men from upstairs said a sexually inappropriate comment to one of the nurses. He was perfectly fine, and then the other week he stood up from his chair to help someone, and fell and fractured his hip. After he woke up from his amnesia he has been very off, and it was obviously not normal for him to be sexually inappropriate. This reminded me of my abnormal class, because when we were talking about the elderly we discussed how as people develop dementia or Alzheimer they can become very hostile, or in general they change. On Monday we have to go in and discuss with him about what he said, but its likely he won't remember even saying it.
Revision [2406]
Edited on 2012-02-23 12:46:56 by JenniferCastiglioneAdditions:
2/22/12 (9am-2pm)-- Today at my internship I started off the day by doing some BIM's tests as usual, and then I was able to attend a discharge meeting. Normally these meetings take place every Tuesday but I was lucky and able to attend the meeting on Wednesday because it got changed. At this meeting OT, PT, Nutrition, Nursing, and Social Work is present. They all are caring for these short-term rehab patients, and they all assess them at this meeting and decide if they are ready to be discharged or not. It was very interesting to attend because you can see the development of the individual in all of the fields that they are going through, for example how many steps they are able to take and what services they will need at home. I was able to update the spread sheet before the meeting, which was just filling in the empty spaces that Colleen wrote in, and it was good to use Excell and really look at the process and the set up of this sheet. After the meeting, Colleen and I went upstairs and we were able to go to the patients rooms that were being discharged and give them the good news. I was able to do one on my own, and it was great to see how excited Ceil was when I told her that she was going home. It's like telling some people they just won the lottery, they are very excited to know that they finally made it. One woman, Mary Lou, I discussed her earlier, Colleen told her that she could go home today, and then I walked into the room shortly after and she was so excited and telling me all about how her son is going to get her and she can't wait to get home. It was nice to see the final touch of rehab and the happiness the patients had.
Revision [2401]
Edited on 2012-02-15 17:34:40 by JenniferCastiglioneAdditions:
2/15/12 (9am-2pm)-- Today at my internship I admitted two patients, they weren't like the average patient that I had to check in. One woman was in for cellulitis of the right foot, and the other woman was in for a left femur fracture. The one woman named Winnie stood out to me today. Her left lower leg was already amputated, and her right foot was possibly going to be amputated due to her cellulitis. Luckily, they might be able to save the foot. She is by no means independent, she fully relies on her husband and two daughters that she lives with. The other woman was 84, but looked much younger. The only thing that stood out about her was her skin color. She had a very grey color to her, which was odd. I only see grey color in patients who are near death and she was by no means near death. It was just very interesting and shocking to see that grey tone in someone completely alive with many years left to live. After this I completed both of their care plans with Lisa.
Revision [2400]
Edited on 2012-02-13 21:31:16 by JenniferCastiglioneAdditions:
I was given five BIMS tests to do, and there was one new patient that I had to fill out his paperwork and admit in to start off my morning. The BIMS tests went very well, I have done all of them before a few months ago. BIMS tests are done every three months on the long term patients, so I did their BIM's last time. It is interesting when you get to experience doing the test on them again. Some do better, worse, or the same. Many of the people that I had today spoke very softy, and one woman was aphasic. Her name was Louah, and it took me a while to catch her because she had many visitors. When asking Louah what year it was, it was extremely difficult to form the wording. She could say "12" but she could not say "2012". Everything else she got a perfect score on, and was able to recall all three of the words that she was asked earlier to remember. I also checked in a new patient named Bob today, he is 84 and in for a hip replacement. Him and I were discussing his stay and how he is doing, and how he is upset because he has to be dependent on people for the first time in hs life and it is very hard for him. He is 84 and this is his first hospitalization and surgery. It is interesting to see all the different people who come in, and you see how their backgrounds really affect them. To end my day, a woman has been declining in health and may possibly have cancer. She told one of the head nurses that she was thinking about end of life and was tired of all the tests. After the nurse talked to her and confirmed numerous times what she wanted to do, Lisa and the head nurse brought in a MOLST form for her. This form has a DNR section on there that she must sign, and then just stating that she does not want to be brought to the hospital, she will receive pain medication so she can die pain free, and does not want her heart started if it has stopped. The patient seemed good about this MOLST form and obviously wanted it, but it is still very difficult seeing someone who knows that the end of her life is approaching.
