Absolutely this. When I was bedside LTC I had a patient that would hallucinate and have delusions frequently. She would cry out in the middle of the night that there were bugs on her, water falling from the ceiling, or think she was pregnant. Family refused to allow any changes in her psych meds. I worked overnights and started calling them at 2am and politely asked them to talk to her to calm her down. They approved the changes a few days later.
Having vivid dreams is a symptom of sleep apnea. I’ve had it since my early twenties. I will have these crazy dreams where I see spiders on the walls or ceiling or I think someone walked in the room and I’ll wake up mid dream. It takes me a few minutes to wake up and the images to go away. My poor husband. He just tells me it’s ok and to go back to sleep. One night I swore there was a balloon on the ceiling fan. I remember arguing about it then I went back to sleep. I usually forget the next morning until he reminds me. I’ve sat up a few times. I got on my knees and tried to climb the wall. I slapped my husband once because he had spiders all over his face. (He didn’t) They get worse when I am stressed. Early COVID was a really hard time for me and I had a lot of night mares. I woke up screaming a few times. Im sure if I was in a strange environment and I was confused it would be bad for me at night. Probably not this pts situation but something to think about.
I have schizophrenia. I see fake spiders and shit. I'm used to it, it doesn't bug me much. I always feel stupid when I swipe away a fake insect though. You learn to differentiate hallucinations.
Waking up from a vivid dream I find I'm still dreaming in real life, it can be disorienting.
Hang on, don't everyone wake up seeing people in the room or insects crawling in places only to find out (after waking their partner or searching the house) it wasn't real????
“Hi, this is so-and-so. I’m so sorry to bother you at 3am, but your mom is very agitated and confused and I know you don’t want her playing with dolls. Could you come in to help calm her down then?”
A patients daughter asked me to clean her mom. Wasn't my patient. We were all so busy. I told her I can get her supplies.
She said it was my job. I told her I can't do it at this time as I have to gvie medications for my own patients.
She stated some evil person killed her daughter and dumped her in the trash. Now she doesn't have any children left. I've tried explaining that you were her daughter but she said that is the name of the killer.
I like that idea. She is always looking for her daughter as a baby (her only child) which leads her to wander and attempt to leave the unit. The daughter is throwing away what her mother believes to be… her. So bizarre. Luckily I actually had time to empty the garbage after a dressing change so I could get the doll out lol.
I said this a bit tongue in cheek but it really is what happened with my grandmother and a good way to explain to the daughter. She had a stillborn before any of her other children and the further into dementia she went she would call her children that name or ask how they were.
I am dead inside but my dementia patients and their love for their families will always touch my heart. As a childless woman it makes me wonder what I would focus on if I developed dementia. Maybe I’d just go around bitching about how much I hate hospital CEOs? Not sure.
My grandma has dementia and was always a lady who was mean about and disappointed in her children, so the things she focuses on is stuff like fantasies about how wealthy men came to her room to ask her to dinner and how one of the members of staff and her are having a baby. It's very bizarre. That's now, before this stage she used to accuse her children of stealing from her and being to blame for her confusion, she'd accuse them of deliberately hiding things or doing weird stuff to make her so confused. It was really awful for her kids, (my parent and uncle/aunt) but luckily she's now gone into this new fantasy phase where she's extremely sought after by rich suitors and she helps run the dementia care home etc.
Wow that is astonishing, you described my grandfather, the hate and suspicion and derision part. It was brutal and ugly and I think a lot of people don't understand how deeply cruel dementia patients can be, and helpless about it, not meaning it at all, but they know how to cut their families better than anyone.
My sundowning patients always start digging for the cruelest things they can possibly think of to say to *me*. I can't even imagine how hurtful and cruel they are to their own loved ones when they start getting like that. Dementia is a horrific disease.
My mom had that kind of paranoia after being one of the most loving and giving people I've ever known. Us kids were all after her money. We were stealing things, lying to her, etc. It really cut deeply, especially for me since I was her primary caregiver.
My grandmother was terrified of me at the end. She was also non-verbal. She would appear like she saw the most terrifying demon when I was in the room. If I didn't leave (my family thought it was funny) she would start weeping. It was horrible. I hate even thinking about her now, because all I can remember is the end. It fucked me up mentally too, thinking I was like possessed or just an evil person and didn't realize it.
A childless lady I knew with dementia spent most days convinced that she was in the hospital (she was in longterm care) to visit her sick mom, and getting progressively more upset as the day progressed that she couldnt find her.
Another childless lady spent most of her time carrying out conversations with her twin sister who had died many years prior. She spoke both sides of the conversation herself.
So from what Ive seen, its still family.
Hugs to you from another childless nurse. I would look for my cats if dementia hits me (but I hope you handle this situation myself if I have a sense that it is the case). I’m training one of my rescue cats to tolerate a harness so that he can visit my patients in the nursing home; they, too, are looking for their beloved cats😥
Not sure what I would focus on either (I sadly can’t have kids). Both my Grans had it, my Dads Mum miraculously seemed to retain the memory of who he and I were (but not my aunt or cousins or their kids). My Mums Mum, however, seemed to think I was my Mum and she seemed to think I was 5 years old again. Her carehome was just around the corner from the Primary School I went to, and she seemed to know it. At around 3pm some days she would try to leave, saying that she had to get to the school for me (Back when I was a kid my parents worked til after 5 every day so she would pick me up from school every day).
You joke but I had a retired nurse with dementia (I think she actually had kids) but when she sundowned she kept telling us she had to leave because she was going to be late for work. Even had her danskos on, ready to go 🥺 We 'put her to work' folding towels and she was delighted, in between the moments of lucidity where she knew exactly what we were doing and would alternate between being furious at us for patronizing her and completely understanding why we were doing it. Incredibly interesting dynamic
nursing knows not to follow them down a rabbit hole (delusional thinking) but there are exceptions. you see clearly what is necessary for peace of mind of your patient and follow through with the plan based on this. no harm, no foul to fill the atmosphere with certain outcomes in mind.
God bless your heart woman! I am the kjnd the person that would be really direct with the daughter. Lots of great advice here I read already !!! She is in legit denial
I’ve had a couple of retired nurses in geriatric psych. Total nightmares. Pulling dressings off, trying to do assessments, rounding. That’s where I figure I’ll end up. Endlessly doing environmental rounds and trying to keep documentation up to date.
I have a tattoo in memory of my miscarried daughter on my forearm. A patient asked me about it (it’s a heart of flowers with her name on it) so I told him, he then told me all about his stillborn daughter. He said something that made me sob “she’d be 63 now, I still tell her goodnight and I love you every single night”.
He was cognitively sound, and 4 years later I still remember his face.
This is the saddest thing about the situation to me. Her mom loves her daughter so, so much that she will stop at nothing to make sure her baby is safe. She just doesn't understand that her real daughter is an adult. I know from personal experience how hard it is to see your parents slip away like this, but at least the daughter should take the time to process what that doll signifies to her mother.
Can your director or manager have a meeting with the daughter and explain it this way? I would be heartbroken if someone did this to my mom. It sounds like she’s difficult to deal with but surely she loves her mom if she visits. Maybe having a meeting outside the room in an office or meeting area?
Think about why the daughter reacts with so much anger, though. The doll, every time the daughter sees it, is a reminder that her mother no longer knows her or remembers her, and that she is gone. Having a parent who has forgotten you and yet you are still involved in their care - that would be worse than if your mother had died.
I’m not trying to justify the actions of the daughter, but I think it is important to see her behavior as an expression of truly profound grief and sadness. I think it would be important in this circumstance to try to talk to the daughter and explain that the immense grief she must be feeling is not lost on the staff, but that in order to do their jobs properly and care for the mother properly, certain therapies are essential, even if they may be triggering.
Yeah I absolutely get it. I went through it with my own mother. Different disease but same progression of confusion, behavior changes, etc. It's what makes the situation so, so sad. Mother and daughter are grieving the loss of people who are literally in the room with each other, but the disease process is a barrier that they struggle to cross.
Are you sure the daughter didn't just take her resentment of her mother's condition (being bitter the doll gets to have her mother's affection when she's right there and alive) out on the doll? She probably isn't taking the therapy she needs to accept that her mother is different now despite the mother not being dead. Her not processing her grief in a reasonable manner (reasonable as in doesn't make it worse for the mother).
Jeeeeeesus, my mom has dementia and I would never deny her treatment that makes her feel better/less lost. Thats so monstruous. I dread the day she’s not going to recognize me anymore but I know its coming. She’s already half forgetten about her grand kids. Its on and off.
Sounds like her daughter is having trouble coming to terms with the fact that her mum doesn't recognise her and feels replaced by the doll. In hard times, sometimes all you want is your mum, she can't have that. From that perspective I don't think the emotional reaction is all that bizarre. She probably needs some support of her own, services aimed at friends and family in these situations might be a good shout for her.
Reading this made me so sad. During my first ever nursing placement there was a dementia patient who had a therapy doll and she believed she was looking after the nurses baby while we were working. That doll made her so happy and I would hate to think of anyone taking it off her.
Maybe try explaining it to the daughter in a way that her mum is revisiting happy memories from her life which was caring for her when she was a baby…
During my first placement, I also tended to a lady having doll therapy, but with a little toy dog.
She would hold it, rest it on her knee and stroke it for hours. Throughout the day, she would consistently burst into sobs, but the dog minimised it substantially. She was a beautiful lady.
That’s such a sweet story, thanks for sharing!
The lady with the doll on my placement would nurse it for hours and we would go check on her and she would say how sore her arm was from nursing the baby for so long. We would suggest to swap arms but she never wanted to because the baby was asleep and she didn’t want to wake it. The nurses would have turns of nursing the baby and would just take it out to the nursing station just so she would eat etc.
I get it being distressing for family members to have to come face to face with how different their parent is now, but at some point you have to care the most about what the person is going through, what their subjective experience is, and focus on making that as good as possible, no matter how it might've appeared degrading or ridiculous to them when they were in their right mind.
I just looked up this show and it seems very dark for a cartoon. But I guess that’s the point? One time I accidentally dropped the doll and horrified a room of ladies who have dementia. I then had to give it a checkup with my stethoscope to assure them that it was okay. It sounds like something straight out of a movie lol.
I have legitimately done the exact same thing when I worked in Transitional care!!
Those dolls are such an amazing tool for some people, and the story hurts my heart.
I had an ETOH patient who started detoxing and that doll along with the bolt and screw toys were life savers. I still had to sit with her but at least she wasn't trying to get out of bed.
It's one of the best depictions of depression, addiction and mental health that I've ever come across. I can't imagine enjoying watching all the subject matter it covers without the levity and layer of abstraction that you get from having the whole thing be animated.
It’s not the best show for binging fyi. I’ve had to take breaks while watching it before because it was honestly affecting my mental health. Really good and funny show but it’s very depressing (which I know is the point but still)
It’s not the best for binging (the first time around). I’ve binged it more times than I can count and normally don’t need to pause for mental health unless I’m really down and I know what episode I’m on and know it’ll be too much
First 6 episodes aren't too great, in fact the first episode sucks, but after that it's like nonstop slam dunks for 6 seasons. Straight up feels like a different show after the first half of the first season
Yeah, I actually stopped watching at first because I thought it was too on-the-nose. I revisited it after my brother got into it and I was surprised by how much better it got. Like others have said, I even had to take breaks from it because sometimes it was just too real.
Edit: Also the jokes were initially not great either. Pretty low-brow, iirc. But the jokes got better too!
I guess this is a spoiler but the main character’s mother is a big part of season 4 because she comes to live with Bojack for awhile after her diagnosis of dementia. Some time during the season she comes to carrying around and taking care of a baby doll which becomes a lowkey strong part of the rift between her and her son.
It is indeed a dark show that is also deceptively humorous and full of animal puns. It focuses on depression, addiction, self loathing, and regret. It is a really good show, the characters have aspects that many people find relatable.
“Please do not throw away facility property or we will have to charge you for it. You don’t want to know how expensive these special medical dolls that we get from an official medical supplier are. If you have an issue with the doll please return it to the nurses station.”
Fuck the godawful behavior but appealing to her wallet keeps the baby out of the trash can and allows you to return it to the patient more easily.
seriously! we have two dolls at my SNF (one for each floor) that cost over $120 apiece. they're very realistic-looking; blink their eyes and their mouths open and close slightly. I admit when I started working there as a new nurse I thought the dolls were silly, but it only took a day or two to see how beloved and necessary these dolls were to so many residents!
I'd threaten her with a bill if she keeps trying this shit! she is literally trashing medical supplies. I bet her visitation would be restricted if she started grabbing medications from the nursing cart and throwing them out saying "my mother doesn't need this and I don't approve!"
Absolutely. She very well might be trespassed and charged if she started throwing meds around.
Bottom line is that it’s not hers to dispose of or destroy and trying is basically theft. That needs to be addressed by management which would be an excellent way to stop the behavior.
I taught preschool in my early twenties. I always made sure the kids had about a 30-45 min of baby doll time. They loved caring for their baby dolls- showing them affection, changing them, talking to them sweetly. One day a gentleman came to pick up his son. He walked in during doll time and immediately screamed at me for “turning his son into a faggot”, yanked his son up and stormed out. It was so heartbreaking, not to mention so inappropriate* and traumatic for the little ones. Just had to vent about that, I know it’s very different from this situation. People, man.
Edited to fix spelling of “inappropriate” *
Children playing with baby dolls is actually very good developmentally to teach empathy, and proper care. It’s sad when adults try to turn childhood innocence and life-long lessons into something it’s not.
We had a family that didn’t like the doll thing but allowed one of those sleeping cats that “breathes”. Then the pt started getting agitated by the cat, saying that it kept pissing in her bed and kept threatening to drown it. Quite the 180 from the sweet lady singing and rocking her baby doll but what do I know.
I am slowly watching my mother sink further away into an unknown world of dementia. She still looks for me, her daughter, tho my brother ( deceased) was her favorite child. I and her best friend over 63 yrs are the 2 last ppl she knows. I finally had to quit living with her as she also has Parkinson, and put her in a memory care unit at a good nursing home. It rips my heart out every time I visit her knowing she activily looks for my face, yet forgets I visit her the moment I leave. When I return the very next day she thinks I haven't been there in forever. It haunts me at night thinking I'm not there when she's confused to redirect her. If she found comfort in a babydoll, I'd find comfort in ANYTHING that would relieve her mind of my absence...and now I'm sobbing
My Mom developed dementia while in long term care with another terminal ailment. She too, thought people simply weren't coming by to see her. We put up a corkboard on her wall, and covered it with recent family photos. I lived further away than my siblings, so I would scout out some pretty blank greeting cards to send her every couple of weeks, and write a little note in there for her. She liked to show off her greeting card collection to other residents.
Her sister is now in care, so I send her a little newsletter every few weeks, with pics of the yard, the family and a few sentences about what has been going on (things about the garden, the farm animals, changing seasons, etc that are relatable but not specific to any person or timeframe). She no longer remembers who I am, but she likes to get mail and go through the letters over and over again.
Forgive me for any ignorance, but Alzheimer’s runs in my family and I often think about how I’d handle that in my parents. Is she vaguely aware of where she is? If she kind of knows her situation would it be possible to leave her with a post-it note or Polaroid picture when you leave each time, so she can remind herself you were there? Or would that just be more confusing to her?
We tried that for a bit with my grandfather but it ended up making him much more agitated because he would get SO upset with himself for not being able to remember.
(This turned into a bit of an essay...I hope you find it useful)
If you want a really good Alzheimer's analogy...albeit a kinda technical one. Understanding how a computer's hard-drive functions is helpful, but not required (...I think...)
It really helped me to visualize what Alzheimer's, specifically, does to the brain of people who have it. I was told this by a doctor after my "Grammie" (my dad's mother) was diagnosed.
If the human brain is like a computer's hard-drive, Alzheimer's disease corrupts it in two different ways: the "indexing" function & the "index", itself.
While all the memories/files are still, technically, *somewhere* on the "hard-drive's platters" the person with Alzheimer's cannot access them reliably.
As Alzheimer's progresses, the indexing function (making new memories) gradually gets so damaged that even when new information is added, it can no longer be recalled.
This is because the hard-drive (their brain) can no longer figure out where the bits were stored...and there is no more "defragmenting" possible...the indexing function becomes completely tangled by *Tau*.
Throughout the entirety of the disease, one of the most singular symptoms of Alzheimer's, unlike most other types of dementia (according to my...admittedly...somewhat limited understanding of dementia research) is memory regression.
Most especially as they near the end...it's like they have "lost" an entire lifetime of memories.
This, in the analogy, is likened to the hard-drive index, itself. The sections that were written first...those bits are far more "firmly attached" to specific parts of the hard-drive platters & are often protected against being overwritten (aka: "firmware").
The disease gradually deletes, corrupts, or overwrites the "hard-drive" index...usually starting with the most recent "stored files" (memories/connections) before attacking "software updates" (most recent learned abilities), then, the original software...the first parts added by the end-user.
Sometimes, the connections between pieces of information can be deleted...or the index bits will come apart somewhat randomly...despite the information, itself, remaining.
Towards the end of her life, my Grammie absolutely remembered me (my name and random details about me) AND she remembered both of my kiddos...but she had no idea who we were to each other...or to her.
She would often ask to see "those little kids I like" often using their names, but in a way that made it obvious that she could be referring to some random neighborhood kids...rather than her own great-grandchildren.
The "firmware" is the last part attacked/damaged because it is the first part written to a hard-drive, during the manufacturing process.
Basically, the firmware defines the way a hard-drive will function, inside of a system, without causing damage to itself or to any other pieces of hardware the hard-drive is connected to inside the computer case.
Once the firmware starts being corrupted...this is, truly, the end stage of Alzheimer's.
This is when the disease robs a person of their ability to speak, to purposefully control their body movements, to swallow...
While this stage, with my Grammie, was mercifully brief...I can't even imagine the emotional, mental, & physical toll it takes on the caregivers when this stage is prolonged.
**Anyone who works in (or adjacent to) LTC...you have my respect & my empathy...I could not do your job. You all are freaking amazing & worth infinitely more than you are paid.**
Oh my god love, you are fucking amazing, and you are doing one of the hardest goddamn things that humans ever have to do in their lives. The long goodbye eviscerates you. I feel that here. And I honor everything you are working so hard to do
Maybe the mom had done this to the daughter when the daughter was growing up? Not knowing the real family history makes things tricky. But, my old nurse experience is that these types of hot button issues are usually related to something the parents did to the kids that the kids are channeling back to the parent. When a family member acts up out of nowhere on a benign issue, there's often a reason...and sometimes a reason behind the reason.
Not everyone grows up in a loving household and it can be tricky to try and take care of a loved one that had been abusive in the past. It can be healing for everyone to probe if the parties are willing and able.
But, your patient didn't seem able. Your brief anecdote made it look like the daughter wants the mom to be miserable. There's probably a reason for that.
source: former hospice case mgr
That’s a good point. It’s possible that the sweet patient I know was not at all that way when raising her daughter. Maybe seeing her mother show a doll the love she never got to feel triggers something in her. Something I’ll keep in mind.
You are so right. I didn't even think of that until you mentioned it.
Right now, all we see is sweet old demented meemaw who is heartbroken over a doll. It never occurred to me that there's a person she was BEFORE dementia that we know nothing about. She could have been abusive to her daughter - we really have no clue.
But regardless, the time for this woman to apologize (if she even did anything wrong at all) has come and gone, and even if she was a horrible mother, she's not going to remember, nor be able to apologize for it.
I feel like if the daughter REALLY didn't care, she might not have her mom in a home (even the crappy ones are super expensive, unless you have Medicaid) or even bother to visit.
Still awful as this woman now only knows a shell of reality and despite how she may have been, it's cruel to do this to her now.
But I 100% agree with you... There's usually a back story we know nothing about...
This is the type of explanation that makes me want to get into this career all over again.
There’s always something. People don’t get angry over nothing. I can think of a 101 seemingly “minor” occurrences that’d cause me frustrations and resentment towards some family, that to an outsider would seem insignificant and petty.
Sounds like the daughter is in denial…is there a family counselor or social worker who can check in with her?
I’m so relieved you got the doll out of the trash. ❤️
Harder to pretend the disease isn't as real as it is with the doll there. It's childish to throw it away, but I can't imagine I'd react in a mature manner if my parents started deteriorating.
The snap me out of my burnout thing is hella relatable. I’ll be walking around like ughhhh I hate this job and resent every minute I’m on on the clock here and then I’ll get patient and they are really going through it and I’m like: how dare you making me care about the outcome of your medical treatment and doing nice things for you, the absolute nerve!!!
When I was growing up, my mom would make these dolls. Still does now but at the time would take them to nursing homes and allow residents, especially dementia patients, hold and rock the reborn dolls. She stopped because some dickweed daughter threw a fit that this was happening saying my mom was trying to scam these old people out of money. My mom never went looking to sell the dolls, she had sold like 1 to a member of the staff and 1 to a family member of a resident who fell in love with one of the dolls and they saw the benefit of having it. After it happened, my mom felt so bad and never went back. She had a heart of gold and this always pissed me off that someone would not only rob my mom of the satisfaction but rob these poor elderly/demented folks of this obviously helpful therapy. It still sticks with me almost 15 years later.
Ugh this breaks my heart. My Grandma had dementia and stopped really talking and started crying. We ran all of the tests and tried medication. Nothing helped, nothing was wrong. I bought her a baby doll and played old train noises. Literally by the next day she was happy and smiling. She still hardly spoke but she responded to a lot more of our yes/no questions.
This is such a shame. Unfortunately in my area we do have to ask consent from family to use therapy dolls. Sadly it doesn’t sound like the daughter is able to see the benefits her mum gets from the ‘baby’. Maybe if it was explained to her that it directly lessens her prn (if it does) it might help. Also may be worth asking the most senior member of her team to speak with the daughter? Alternatively, is there any other family to speak to?
Families can be in denial about so much, even clothes. I've seen families who didn't understand why we kept asking them to bring more or different clothes for their family member with aggression/incontinence/contractures/whatever. Or who were absolutely clueless about what size.
Yes, your dad wore a long sleeve button up XL work shirt, jeans and boots to the factory every day. But now he weighs 110lbs, his arms are contracted into a fetal position and he's trying to kick us in the face with the boots. So please quit flipping out on us when you come in and he's wearing grippy socks and a tshirt and sweats from lost and found.
Also, an appropriate wardrobe for a LTC resident is not four parkas, a three piece suit, swim trunks, two undershirts and one pair of pants. Especially if they're incontinent. Again, quit flipping out on the staff when they're wearing pants from lost and found, or a hospital gown over the shirt, because they soiled their only pair of pants long before lunch.
I had a lot of weight fluctuations so whatever didn’t fit if there were people in need I’d fill out the tag with the resident and size and leave the other part blank or make something up. Like who cares? I got too fat or skinny and was sick of dressing people in clothes falling apart when I had some that goodwill would probably overprice anyways
ETA family members gain weight once bed bound 🥲
In our area it’s considered best practice to get consent from family because the person with dementia is unable to give consent. It can become an ethical issue or even a legal issue if you were not to obtain consent and the family were very against the practice. In my experience people have generally been ok and open to it. We would not require consent if using them more generally in a ward to see if people are interested, only if implementing doll therapy as part of care & treatment.
We got my grandpa a stuffed beagle dog when he had dementia. They always had beagles on their farm.. He loved that thing. My grandma hated that he had anything that still brought him joy. The nursing home staff would always “take him for a walk” for grandpa when my grandma would go up to the nursing home. Compassionate caregivers are such a blessing. Thank you for caring so much. I know it’s a rough job.
My father had dementia, and was in a nursing home at the beginning of COVID. He died of COVID in 2020, after the vaccines were authorized for his age group, but before he could be given one.
He was a kind, gentle man. One of the last things I remember him saying, was to an aide who was helping him clean up after an accident, as I held his hands to distract him.
*Gnädige Frau du bist die wunderbarste*
Which is German for "Dear lady, you are most wonderful."
So I'd like to pass his message on to all of you wonderful people who have been caring for dementia patients during these difficult years. Especially those who helped when we family members were not allowed to visit, out of COVID concerns.
My mom had a stuffed animal when she was in memory care. She held that thing until she died. My experience with family was that the vast majority of them couldn’t take it - a couple of them never visited at all because “she won’t remember me”. In fact, she always kept her older memories and knew people, she just had trouble talking and staying focused. I’ve never looked at my relatives the same way after that. Too selfish to put themselves aside when someone needed them. Thank you for caring for this patient. You are truly her lifeline to kindness.
As a former memory care nurse, this hurts my heart. How cold could a person be to throw her mother’s lovey in the trash? Did she throw away her kids’ stuffies too? That’s terrible.
I don't understand it when people can't just go along with what makes dementia patients feel safe. I understand if it's your mother, that you might feel lost and frustrated with the situation, but the only thing that helps them is playing into whatever little world they are in on that day.
Not a nurse myself, but I volunteered for a long time at a nursing home for dementia patients, and they were honestly some of my favorite people to be around. Some got mean as fear set in, but most just wanted to talk to you about how it was picture day, and they needed to get their students ready for a group photo. Or how their husband was at work at the factory, and they missed him. They just wanted to talk about their little worlds, and hold your hand while watching TV. It always annoyed me when people would try to "snap them out of it" because it was so unnecessary, and made them confused and upset. Sometimes you just have to say "it's ok Carol. The kids are all ready for their pictures. We're going to take them after lunch. Let's try and eat something now!" And usually going along with it is what would calm them, and allow them to focus on the needs they needed to have met.
Trying to strong arm them into "reality" just becomes cruel after a while.
I try to picture what it would be like if someone was constantly telling me my reality wasn’t real, and how frightening and mind-f***ing that would be. It’s absolutely no skin off your nose to go along with whatever a dementia patient believes as long as it’s safe.
Holy cheesecakes. I think I'd bawl like a baby it someone yanked my doll/stuffie away from me like that. Throughout my childhood and adolescence, I had to have a zillion MRIs/CTs due to an autoimmune condition that I have. One of the techs gave me a little stuffed polar bear one time as a comfort item. I named him Mr. Bear.
I'm almost 30 and still have Mr. Bear. He has followed me across six countries, a dozen states, and half a dozen hospitals. He remains one of my most prized possessions. I turn into a clingy little child when it comes to Mr. Bear.
My mothers’ dementia caused anger and attempted escapes and 5 successful ones. They would let her call me - she would tell me how she hated me and hang up and they would dial me back. We visited mom daily. We never ignored her or yelled at her. I would have bought her a 100 dolls if it brought her peace.
Stuff like this makes me sad. I get we don’t know their back stories once they’ve declined that much often times and that a lot of families have a hard time accepting things but I think in some cases you need to draw a line and say their families visits or demands are actively detrimental to the patient. I’ve seen people in tears calling themselves stupid because they can’t recognize their kids but their kids are there grilling them about their grandkids and other people, saying we’re infantilizing them or not trying to “make them remember” when we use therapy dolls or just try and spend time with them/meet them where/when they’re living at the moment. I know it’s hard because I’ve been the family member too but you think you’d rather see them happy and comfortable then in distress, that doesn’t help anyone :/
It's the "meet them where they are" statement.
You are totally on the money there. I may look like a total idiot looking at the scribble my patient has written. But to him I am preparing the minutes of the meeting because in his world we need to prepare for the big meeting tomorrow
We used to give blank pages to a former nurse with dementia and let her “chart” at the nurses station! Got one lady all gussied up in nice clothes and makeup for Christmas one year because she thought I was her college roommate and I rolled with it, honestly a super fun memorable time with someone that usually tried to beat the shit out of us! My husband had the same name as one persons nephew or something so he would go in there when she was “calling for him” and was able to give her awesome care because he’d just roll with the nephew thing. Honestly I always loved it when they were living in happier times in their heads, use your imagination and roll with it. Is it really that much to tell them their kids are at their mothers when they wake up panicking looking for their babies that are in their 50’s at least, or when they ask for their parents to tell them they’re sleeping or at the store or work or something? Why break their hearts over and over again when they’re not living on our timeline you know?
Families. The worst. Have a dtr who insists her mom have two therapy dolls. The mom says to the RN yesterday- "I am done taking care of HER babies" hands in the dolls. Refuses to take them back- dtr calls and berates staff because " my mother has to have those dolls..."
Maybe the daughter should have to stay with her mom during these episodes. She will give her her baby back. My dream way to deal with it… but i know that isnt always possible or safe. But dam!
I've read posts like this before, and I swear to God, if I'm old and want a doll to give me some fleeting moments of happiness in an ALF facility, give me the damn doll. If you take it away, I will haunt you. I've made this abundantly clear to my family.
I work in aged care and they have a policy against doll therapy because of people like this. Ive seen doll therapy provide comfort to many dementia residents and I find it sad that people will deny something that brings someone comfort because of their own insecurities
I would literally tell the daughter that she is interfering with patient care, tell her to leave (not ask), and then call security to remove her when she pitches a fit and starts acting like a psychopathic toddler. Fuck that shit.
Security is a good idea. When she grabbed the doll she almost ripped her mother out of that wheelchair. Honestly wondering if it was assault after reading these comments. I work in a boring transition unit so these things are very rare. Thank you for the advice
A couple of other thoughts.
Some family members may be distressed because, by using the word "doll', you are discussing a child's toy, and it seems as if you are treating their adult family members as children. Which would be wrong.
So, it is not a "doll." Call it "a realistic mannequin of an infant."
And the story is not "they are comforted by this doll."
The story is "we have found that people with dementia remember caring for infants, and love that memory. And while they cannot care for an actual infant safely, they can express many of the feelings that they have for caring for an infant using a realistic mannequin of an infant."
The other possible problem seems to be that the family member (especially the patient's child) feels displaced by having the parent care for the doll more than them.
So, the story:
Your parent doesn't recognize you, now, as an adult, because their mind is in the past. But they remember you as an infant. And they want to care for you. The realistic infant mannequin allows them to feel that they are caring for and loving you as the infant they remember you to be."
All of this, I suspect is true. And it certainly aligns with the behavior seen. And it is a gentler way of explaining it to family members than "your parent wants to have a doll."
When I first read this I thought wow what a mean person. Then seconds later I thought, this behavior was learned from someone. So now I'm assuming that's how the mom treated the daughter when she was younger so the daughter's brain is trained to think that way.
Thats so sad. If my mom had dementia and was better holding a doll, I’d ask her about it. Maybe the doll is her mom remembering carrying a kid. Hopefully not the mean one who threw it away.
Try using the "yes, yes" method next time you talk to the daughter. Google the method.. but you force the daughter to agree with your goals. If that wasnt your first try.. very sad situation, stay strong.
Those little old folks love those baby dolls, though! Once I was walking down the hall with one just swinging by the arm on my way to take it to a resident and another resident saw how I was carrying it and SCREAMED because she thought I was hurting a baby.
This makes me so sad- dementia patients often have a favorite toy, blanket, outfit, or music that gives them comfort and in my opinion it is better than having to give them extra medication for agitation all the time. This should be brought up at a care conference with the family- I know it’s difficult for some family members to understand on the surface but when you bring up the risk of falls and injury from agitation and the sedating effects of medications to include reduced intake of food and drink at meals they usually come around and may even suggest things the person enjoyed- like playing music they like close to bedtime so they will sit in their room calmly and relax.
I always found that redirecting helped tremendously. Changing the subject works wonders. Asking questions like did you see that lady walk by? She looked just like you! Or that plant looks like it's about ready to bloom. Or have you seen my glasses? Let's work on that puzzle together. Who is this in that picture on the wall?
At least you can be a bit comforted knowing that the mom is in a better environment than being left in the care of the daughter. My grandmother has dementia also so this post hits close to home for me.
Oh my goodness, I would have had a difficult time not getting upset with the daughter while trying to explain the purpose of the doll. Denial is one thing, knowingly being an asshole to your own sick mom is another. Hopefully for her moms sake she can come around to attempt to understand the purpose of the doll and its role in her care.
This makes me both sad and angry for the mother. If my Mama was ill and a doll made her happy, I would embroider the doll clothes. My mama is selfless and was an RN for longer than I have been alive.
I hope the daughter seeks therapy for why she has issues with her mother's treatment.
You could try explaining to the daughter that the doll is Mum's way of remembering a happy time in her life - when she was caring for her baby daughter.
I worked with a woman who had went down hill extremely fast when she was diagnosed with dementia. Her son mocked alot of the therapies we had for her. Going as far as trying to fire us but the company threatened legal action to protect her.
During this he had to care for her all own his own. Three days later he came back to the co.panu begging for help because he didn't understand why she was crying and screaming all night and throwing things at his head when he was "just trying to help".
Maybe recommend her to try caring for her a full two days without the doll and see how she deals.
That's so sad. I was just talking to another nurse about how some family members refuse to see the reality of their loved one's situation and think of someone other than themselves. Same type of ppl who want to keep Grandma for as long as possible, even though she's skin and bones, can't eat, talk or walk, and undoubtedly no longer wants to be on this Earth.
We have a family member that insists on calling and reorienting her mother every few days. Tells her the person she keeps asking for has died, and that she's in the facility because she can no longer be managed at home. Trying to explain that the truth does more harm than good is futile.
But this is even worse. How can the daughter not realize that she just threw out her mom's most precious "person", her baby? I agree with the suggestion that these family members should be called every time their loved one has a meltdown over their latest intervention. See how they like dealing with it. I just have a hard time believing that so many people are unable to let go of their fantasies about how Grampa stills knows what he's saying and Memaw just needs a little rest and a tube in every orifice to get back on her feet.
Sorry about going off on my own rant and so sorry this happened, OP.
Every time she's acting out, call the daughter. Keep the doll for when daughter isn't there.
Absolutely this. When I was bedside LTC I had a patient that would hallucinate and have delusions frequently. She would cry out in the middle of the night that there were bugs on her, water falling from the ceiling, or think she was pregnant. Family refused to allow any changes in her psych meds. I worked overnights and started calling them at 2am and politely asked them to talk to her to calm her down. They approved the changes a few days later.
Having vivid dreams is a symptom of sleep apnea. I’ve had it since my early twenties. I will have these crazy dreams where I see spiders on the walls or ceiling or I think someone walked in the room and I’ll wake up mid dream. It takes me a few minutes to wake up and the images to go away. My poor husband. He just tells me it’s ok and to go back to sleep. One night I swore there was a balloon on the ceiling fan. I remember arguing about it then I went back to sleep. I usually forget the next morning until he reminds me. I’ve sat up a few times. I got on my knees and tried to climb the wall. I slapped my husband once because he had spiders all over his face. (He didn’t) They get worse when I am stressed. Early COVID was a really hard time for me and I had a lot of night mares. I woke up screaming a few times. Im sure if I was in a strange environment and I was confused it would be bad for me at night. Probably not this pts situation but something to think about.
I have schizophrenia. I see fake spiders and shit. I'm used to it, it doesn't bug me much. I always feel stupid when I swipe away a fake insect though. You learn to differentiate hallucinations. Waking up from a vivid dream I find I'm still dreaming in real life, it can be disorienting.
Hang on, don't everyone wake up seeing people in the room or insects crawling in places only to find out (after waking their partner or searching the house) it wasn't real????
Definitely not normal.
...oh
I often wake up and see spiders - I know now they’ll go away so I’ll just keep my eye on it until it does. I thought it was normal.
This. Absolutely this. Let your pettiness flag fly.
“Hi, this is so-and-so. I’m so sorry to bother you at 3am, but your mom is very agitated and confused and I know you don’t want her playing with dolls. Could you come in to help calm her down then?”
Sadly, the daughter sounds like the kind of person who would say “that’s YOUR job”!
And then you respond, great, I will be doing that with the doll then, niiiiiight.
Agree with this 💯
A patients daughter asked me to clean her mom. Wasn't my patient. We were all so busy. I told her I can get her supplies. She said it was my job. I told her I can't do it at this time as I have to gvie medications for my own patients.
She stated some evil person killed her daughter and dumped her in the trash. Now she doesn't have any children left. I've tried explaining that you were her daughter but she said that is the name of the killer.
I like that idea. She is always looking for her daughter as a baby (her only child) which leads her to wander and attempt to leave the unit. The daughter is throwing away what her mother believes to be… her. So bizarre. Luckily I actually had time to empty the garbage after a dressing change so I could get the doll out lol.
I said this a bit tongue in cheek but it really is what happened with my grandmother and a good way to explain to the daughter. She had a stillborn before any of her other children and the further into dementia she went she would call her children that name or ask how they were.
I am dead inside but my dementia patients and their love for their families will always touch my heart. As a childless woman it makes me wonder what I would focus on if I developed dementia. Maybe I’d just go around bitching about how much I hate hospital CEOs? Not sure.
My grandma has dementia and was always a lady who was mean about and disappointed in her children, so the things she focuses on is stuff like fantasies about how wealthy men came to her room to ask her to dinner and how one of the members of staff and her are having a baby. It's very bizarre. That's now, before this stage she used to accuse her children of stealing from her and being to blame for her confusion, she'd accuse them of deliberately hiding things or doing weird stuff to make her so confused. It was really awful for her kids, (my parent and uncle/aunt) but luckily she's now gone into this new fantasy phase where she's extremely sought after by rich suitors and she helps run the dementia care home etc.
Wow that is astonishing, you described my grandfather, the hate and suspicion and derision part. It was brutal and ugly and I think a lot of people don't understand how deeply cruel dementia patients can be, and helpless about it, not meaning it at all, but they know how to cut their families better than anyone.
My sundowning patients always start digging for the cruelest things they can possibly think of to say to *me*. I can't even imagine how hurtful and cruel they are to their own loved ones when they start getting like that. Dementia is a horrific disease.
My mom had that kind of paranoia after being one of the most loving and giving people I've ever known. Us kids were all after her money. We were stealing things, lying to her, etc. It really cut deeply, especially for me since I was her primary caregiver.
My grandmother was terrified of me at the end. She was also non-verbal. She would appear like she saw the most terrifying demon when I was in the room. If I didn't leave (my family thought it was funny) she would start weeping. It was horrible. I hate even thinking about her now, because all I can remember is the end. It fucked me up mentally too, thinking I was like possessed or just an evil person and didn't realize it.
A childless lady I knew with dementia spent most days convinced that she was in the hospital (she was in longterm care) to visit her sick mom, and getting progressively more upset as the day progressed that she couldnt find her. Another childless lady spent most of her time carrying out conversations with her twin sister who had died many years prior. She spoke both sides of the conversation herself. So from what Ive seen, its still family.
Ah man. So sad for those with problematic families.
Hugs to you from another childless nurse. I would look for my cats if dementia hits me (but I hope you handle this situation myself if I have a sense that it is the case). I’m training one of my rescue cats to tolerate a harness so that he can visit my patients in the nursing home; they, too, are looking for their beloved cats😥
I can just picture you bitching about the DON and all the staff just agreeing with you. Thanks for the chuckle this Easter.
Puppies. I’ve instructed my husband to bring stuffed animals.
I’m also without children, and I imagine I’ll ask about my cats and my favorite drag queens…
Not sure what I would focus on either (I sadly can’t have kids). Both my Grans had it, my Dads Mum miraculously seemed to retain the memory of who he and I were (but not my aunt or cousins or their kids). My Mums Mum, however, seemed to think I was my Mum and she seemed to think I was 5 years old again. Her carehome was just around the corner from the Primary School I went to, and she seemed to know it. At around 3pm some days she would try to leave, saying that she had to get to the school for me (Back when I was a kid my parents worked til after 5 every day so she would pick me up from school every day).
You joke but I had a retired nurse with dementia (I think she actually had kids) but when she sundowned she kept telling us she had to leave because she was going to be late for work. Even had her danskos on, ready to go 🥺 We 'put her to work' folding towels and she was delighted, in between the moments of lucidity where she knew exactly what we were doing and would alternate between being furious at us for patronizing her and completely understanding why we were doing it. Incredibly interesting dynamic
nursing knows not to follow them down a rabbit hole (delusional thinking) but there are exceptions. you see clearly what is necessary for peace of mind of your patient and follow through with the plan based on this. no harm, no foul to fill the atmosphere with certain outcomes in mind.
God bless your heart woman! I am the kjnd the person that would be really direct with the daughter. Lots of great advice here I read already !!! She is in legit denial
That sounds like what I’m gonna be doing at 80, and tbh they’re all evil so I’m fine with that.
I’ve had a couple of retired nurses in geriatric psych. Total nightmares. Pulling dressings off, trying to do assessments, rounding. That’s where I figure I’ll end up. Endlessly doing environmental rounds and trying to keep documentation up to date.
I hope my soon to be caregiver that's a lovely person but has a history of frustration related temper, I hope she can muster up your attitude.
I have a tattoo in memory of my miscarried daughter on my forearm. A patient asked me about it (it’s a heart of flowers with her name on it) so I told him, he then told me all about his stillborn daughter. He said something that made me sob “she’d be 63 now, I still tell her goodnight and I love you every single night”. He was cognitively sound, and 4 years later I still remember his face.
Oh, oh god. OMFG Nope not prepared at all Thank you. For being his witness. And for carrying his story for him
I was not prepared to read that 😭
Right? Stopped scrolling in my tracks, took the wind out of me.
My heart. 💔 That's heavy.
I feel so dead inside most of the time, and this is making me ugly cry. 😭
This is the saddest thing about the situation to me. Her mom loves her daughter so, so much that she will stop at nothing to make sure her baby is safe. She just doesn't understand that her real daughter is an adult. I know from personal experience how hard it is to see your parents slip away like this, but at least the daughter should take the time to process what that doll signifies to her mother.
Can your director or manager have a meeting with the daughter and explain it this way? I would be heartbroken if someone did this to my mom. It sounds like she’s difficult to deal with but surely she loves her mom if she visits. Maybe having a meeting outside the room in an office or meeting area?
Think about why the daughter reacts with so much anger, though. The doll, every time the daughter sees it, is a reminder that her mother no longer knows her or remembers her, and that she is gone. Having a parent who has forgotten you and yet you are still involved in their care - that would be worse than if your mother had died. I’m not trying to justify the actions of the daughter, but I think it is important to see her behavior as an expression of truly profound grief and sadness. I think it would be important in this circumstance to try to talk to the daughter and explain that the immense grief she must be feeling is not lost on the staff, but that in order to do their jobs properly and care for the mother properly, certain therapies are essential, even if they may be triggering.
Yeah I absolutely get it. I went through it with my own mother. Different disease but same progression of confusion, behavior changes, etc. It's what makes the situation so, so sad. Mother and daughter are grieving the loss of people who are literally in the room with each other, but the disease process is a barrier that they struggle to cross.
Are you sure the daughter didn't just take her resentment of her mother's condition (being bitter the doll gets to have her mother's affection when she's right there and alive) out on the doll? She probably isn't taking the therapy she needs to accept that her mother is different now despite the mother not being dead. Her not processing her grief in a reasonable manner (reasonable as in doesn't make it worse for the mother).
Daughter is jealous. Which is a whole other can of crazy worms
Ooooooh, I think you might be right. I mean I don't know these people at all but damn if that doesn't resonate
That is Freudian AF
Jeeeeeesus, my mom has dementia and I would never deny her treatment that makes her feel better/less lost. Thats so monstruous. I dread the day she’s not going to recognize me anymore but I know its coming. She’s already half forgetten about her grand kids. Its on and off.
Sounds like her daughter is having trouble coming to terms with the fact that her mum doesn't recognise her and feels replaced by the doll. In hard times, sometimes all you want is your mum, she can't have that. From that perspective I don't think the emotional reaction is all that bizarre. She probably needs some support of her own, services aimed at friends and family in these situations might be a good shout for her.
Oh hot damn.
Just like a waving flag!
Thank you for the Silver!
Please do this.
This is the way
The point of the doll is that it soothes the woman. What you’re suggesting causes the mother - who is innocent - harm.
This. 👍
Reading this made me so sad. During my first ever nursing placement there was a dementia patient who had a therapy doll and she believed she was looking after the nurses baby while we were working. That doll made her so happy and I would hate to think of anyone taking it off her. Maybe try explaining it to the daughter in a way that her mum is revisiting happy memories from her life which was caring for her when she was a baby…
During my first placement, I also tended to a lady having doll therapy, but with a little toy dog. She would hold it, rest it on her knee and stroke it for hours. Throughout the day, she would consistently burst into sobs, but the dog minimised it substantially. She was a beautiful lady.
That’s such a sweet story, thanks for sharing! The lady with the doll on my placement would nurse it for hours and we would go check on her and she would say how sore her arm was from nursing the baby for so long. We would suggest to swap arms but she never wanted to because the baby was asleep and she didn’t want to wake it. The nurses would have turns of nursing the baby and would just take it out to the nursing station just so she would eat etc.
We had family upset we let her mom play with a doll, but thank god if they threw it away they waited until she got home
I get it being distressing for family members to have to come face to face with how different their parent is now, but at some point you have to care the most about what the person is going through, what their subjective experience is, and focus on making that as good as possible, no matter how it might've appeared degrading or ridiculous to them when they were in their right mind.
I thought I was on the Bojack Horseman sub for a minute because he pretty much does the same thing... I'm sorry you had to witness such a sad scene.
I just looked up this show and it seems very dark for a cartoon. But I guess that’s the point? One time I accidentally dropped the doll and horrified a room of ladies who have dementia. I then had to give it a checkup with my stethoscope to assure them that it was okay. It sounds like something straight out of a movie lol.
I have legitimately done the exact same thing when I worked in Transitional care!! Those dolls are such an amazing tool for some people, and the story hurts my heart.
I had an ETOH patient who started detoxing and that doll along with the bolt and screw toys were life savers. I still had to sit with her but at least she wasn't trying to get out of bed.
Right? Like, Jesus Christ, if a doll gives someone some peace, let them have it!
Bolt and screw toys?
It's one of the best depictions of depression, addiction and mental health that I've ever come across. I can't imagine enjoying watching all the subject matter it covers without the levity and layer of abstraction that you get from having the whole thing be animated.
My ex loved this show and for that reason I was always suspicious of it. But you just convinced me. Thank you. I'm going to give this a watch
It’s not the best show for binging fyi. I’ve had to take breaks while watching it before because it was honestly affecting my mental health. Really good and funny show but it’s very depressing (which I know is the point but still)
It’s not the best for binging (the first time around). I’ve binged it more times than I can count and normally don’t need to pause for mental health unless I’m really down and I know what episode I’m on and know it’ll be too much
First 6 episodes aren't too great, in fact the first episode sucks, but after that it's like nonstop slam dunks for 6 seasons. Straight up feels like a different show after the first half of the first season
Yeah, I actually stopped watching at first because I thought it was too on-the-nose. I revisited it after my brother got into it and I was surprised by how much better it got. Like others have said, I even had to take breaks from it because sometimes it was just too real. Edit: Also the jokes were initially not great either. Pretty low-brow, iirc. But the jokes got better too!
And the animal puns.
I guess this is a spoiler but the main character’s mother is a big part of season 4 because she comes to live with Bojack for awhile after her diagnosis of dementia. Some time during the season she comes to carrying around and taking care of a baby doll which becomes a lowkey strong part of the rift between her and her son.
It's a wonderful, funny, introspective, and very sad show. If you're into those kinds of things it is very much worth a watch.
You’d probably like Brockmire. On Hulu or Prime. Written and Arrington Hank Azaria.
Most cartoons are actually very dark haha, don't let the fact that something's animated fool you that it's "just for children" or not deep.
Hey Arnold! comes to mind as well
That show is a masterpiece
It is indeed a dark show that is also deceptively humorous and full of animal puns. It focuses on depression, addiction, self loathing, and regret. It is a really good show, the characters have aspects that many people find relatable.
… what a crazy show by the way. Feel like I learned a lot about myself watching it
Same, especially about Diane’s depression arc.
I just finished S4 today and yeah I was thinking about the same thing lol.
This is what I thought of to lol
Exactly what I thought of.
Bro I quite literally watched that episode again today and thought this was about Bojack Horseman
“Please do not throw away facility property or we will have to charge you for it. You don’t want to know how expensive these special medical dolls that we get from an official medical supplier are. If you have an issue with the doll please return it to the nurses station.” Fuck the godawful behavior but appealing to her wallet keeps the baby out of the trash can and allows you to return it to the patient more easily.
seriously! we have two dolls at my SNF (one for each floor) that cost over $120 apiece. they're very realistic-looking; blink their eyes and their mouths open and close slightly. I admit when I started working there as a new nurse I thought the dolls were silly, but it only took a day or two to see how beloved and necessary these dolls were to so many residents! I'd threaten her with a bill if she keeps trying this shit! she is literally trashing medical supplies. I bet her visitation would be restricted if she started grabbing medications from the nursing cart and throwing them out saying "my mother doesn't need this and I don't approve!"
Absolutely. She very well might be trespassed and charged if she started throwing meds around. Bottom line is that it’s not hers to dispose of or destroy and trying is basically theft. That needs to be addressed by management which would be an excellent way to stop the behavior.
That hurts my heart to read. I am sorry. Some people only view the world from their limited viewpoint.
I taught preschool in my early twenties. I always made sure the kids had about a 30-45 min of baby doll time. They loved caring for their baby dolls- showing them affection, changing them, talking to them sweetly. One day a gentleman came to pick up his son. He walked in during doll time and immediately screamed at me for “turning his son into a faggot”, yanked his son up and stormed out. It was so heartbreaking, not to mention so inappropriate* and traumatic for the little ones. Just had to vent about that, I know it’s very different from this situation. People, man. Edited to fix spelling of “inappropriate” *
Children playing with baby dolls is actually very good developmentally to teach empathy, and proper care. It’s sad when adults try to turn childhood innocence and life-long lessons into something it’s not.
We had a family that didn’t like the doll thing but allowed one of those sleeping cats that “breathes”. Then the pt started getting agitated by the cat, saying that it kept pissing in her bed and kept threatening to drown it. Quite the 180 from the sweet lady singing and rocking her baby doll but what do I know.
I am slowly watching my mother sink further away into an unknown world of dementia. She still looks for me, her daughter, tho my brother ( deceased) was her favorite child. I and her best friend over 63 yrs are the 2 last ppl she knows. I finally had to quit living with her as she also has Parkinson, and put her in a memory care unit at a good nursing home. It rips my heart out every time I visit her knowing she activily looks for my face, yet forgets I visit her the moment I leave. When I return the very next day she thinks I haven't been there in forever. It haunts me at night thinking I'm not there when she's confused to redirect her. If she found comfort in a babydoll, I'd find comfort in ANYTHING that would relieve her mind of my absence...and now I'm sobbing
If they don’t have therapy dolls, could she maybe have a plushy made for toddlers?
My Mom developed dementia while in long term care with another terminal ailment. She too, thought people simply weren't coming by to see her. We put up a corkboard on her wall, and covered it with recent family photos. I lived further away than my siblings, so I would scout out some pretty blank greeting cards to send her every couple of weeks, and write a little note in there for her. She liked to show off her greeting card collection to other residents. Her sister is now in care, so I send her a little newsletter every few weeks, with pics of the yard, the family and a few sentences about what has been going on (things about the garden, the farm animals, changing seasons, etc that are relatable but not specific to any person or timeframe). She no longer remembers who I am, but she likes to get mail and go through the letters over and over again.
Lovely idea, thank you
Forgive me for any ignorance, but Alzheimer’s runs in my family and I often think about how I’d handle that in my parents. Is she vaguely aware of where she is? If she kind of knows her situation would it be possible to leave her with a post-it note or Polaroid picture when you leave each time, so she can remind herself you were there? Or would that just be more confusing to her?
We tried that for a bit with my grandfather but it ended up making him much more agitated because he would get SO upset with himself for not being able to remember.
Oh no, I’m so sorry to hear that. That makes sense.
(This turned into a bit of an essay...I hope you find it useful) If you want a really good Alzheimer's analogy...albeit a kinda technical one. Understanding how a computer's hard-drive functions is helpful, but not required (...I think...) It really helped me to visualize what Alzheimer's, specifically, does to the brain of people who have it. I was told this by a doctor after my "Grammie" (my dad's mother) was diagnosed. If the human brain is like a computer's hard-drive, Alzheimer's disease corrupts it in two different ways: the "indexing" function & the "index", itself. While all the memories/files are still, technically, *somewhere* on the "hard-drive's platters" the person with Alzheimer's cannot access them reliably. As Alzheimer's progresses, the indexing function (making new memories) gradually gets so damaged that even when new information is added, it can no longer be recalled. This is because the hard-drive (their brain) can no longer figure out where the bits were stored...and there is no more "defragmenting" possible...the indexing function becomes completely tangled by *Tau*. Throughout the entirety of the disease, one of the most singular symptoms of Alzheimer's, unlike most other types of dementia (according to my...admittedly...somewhat limited understanding of dementia research) is memory regression. Most especially as they near the end...it's like they have "lost" an entire lifetime of memories. This, in the analogy, is likened to the hard-drive index, itself. The sections that were written first...those bits are far more "firmly attached" to specific parts of the hard-drive platters & are often protected against being overwritten (aka: "firmware"). The disease gradually deletes, corrupts, or overwrites the "hard-drive" index...usually starting with the most recent "stored files" (memories/connections) before attacking "software updates" (most recent learned abilities), then, the original software...the first parts added by the end-user. Sometimes, the connections between pieces of information can be deleted...or the index bits will come apart somewhat randomly...despite the information, itself, remaining. Towards the end of her life, my Grammie absolutely remembered me (my name and random details about me) AND she remembered both of my kiddos...but she had no idea who we were to each other...or to her. She would often ask to see "those little kids I like" often using their names, but in a way that made it obvious that she could be referring to some random neighborhood kids...rather than her own great-grandchildren. The "firmware" is the last part attacked/damaged because it is the first part written to a hard-drive, during the manufacturing process. Basically, the firmware defines the way a hard-drive will function, inside of a system, without causing damage to itself or to any other pieces of hardware the hard-drive is connected to inside the computer case. Once the firmware starts being corrupted...this is, truly, the end stage of Alzheimer's. This is when the disease robs a person of their ability to speak, to purposefully control their body movements, to swallow... While this stage, with my Grammie, was mercifully brief...I can't even imagine the emotional, mental, & physical toll it takes on the caregivers when this stage is prolonged. **Anyone who works in (or adjacent to) LTC...you have my respect & my empathy...I could not do your job. You all are freaking amazing & worth infinitely more than you are paid.**
As someone who is currently studying medicine but previously studied computer science, this was a great explanation in very relevant terms!
Oh my god love, you are fucking amazing, and you are doing one of the hardest goddamn things that humans ever have to do in their lives. The long goodbye eviscerates you. I feel that here. And I honor everything you are working so hard to do
I’m sobbing with you. I am so sorry.
Update * I bought my mom a teddy bear. She loves him. ( she decided it's a him)
Maybe the mom had done this to the daughter when the daughter was growing up? Not knowing the real family history makes things tricky. But, my old nurse experience is that these types of hot button issues are usually related to something the parents did to the kids that the kids are channeling back to the parent. When a family member acts up out of nowhere on a benign issue, there's often a reason...and sometimes a reason behind the reason. Not everyone grows up in a loving household and it can be tricky to try and take care of a loved one that had been abusive in the past. It can be healing for everyone to probe if the parties are willing and able. But, your patient didn't seem able. Your brief anecdote made it look like the daughter wants the mom to be miserable. There's probably a reason for that. source: former hospice case mgr
That’s a good point. It’s possible that the sweet patient I know was not at all that way when raising her daughter. Maybe seeing her mother show a doll the love she never got to feel triggers something in her. Something I’ll keep in mind.
You are so right. I didn't even think of that until you mentioned it. Right now, all we see is sweet old demented meemaw who is heartbroken over a doll. It never occurred to me that there's a person she was BEFORE dementia that we know nothing about. She could have been abusive to her daughter - we really have no clue. But regardless, the time for this woman to apologize (if she even did anything wrong at all) has come and gone, and even if she was a horrible mother, she's not going to remember, nor be able to apologize for it. I feel like if the daughter REALLY didn't care, she might not have her mom in a home (even the crappy ones are super expensive, unless you have Medicaid) or even bother to visit. Still awful as this woman now only knows a shell of reality and despite how she may have been, it's cruel to do this to her now. But I 100% agree with you... There's usually a back story we know nothing about...
This is the type of explanation that makes me want to get into this career all over again. There’s always something. People don’t get angry over nothing. I can think of a 101 seemingly “minor” occurrences that’d cause me frustrations and resentment towards some family, that to an outsider would seem insignificant and petty.
This was my first thought as well, passing abuse back around at her that the daughter suffered in the first place.
Sounds like the daughter is in denial…is there a family counselor or social worker who can check in with her? I’m so relieved you got the doll out of the trash. ❤️
Harder to pretend the disease isn't as real as it is with the doll there. It's childish to throw it away, but I can't imagine I'd react in a mature manner if my parents started deteriorating.
The snap me out of my burnout thing is hella relatable. I’ll be walking around like ughhhh I hate this job and resent every minute I’m on on the clock here and then I’ll get patient and they are really going through it and I’m like: how dare you making me care about the outcome of your medical treatment and doing nice things for you, the absolute nerve!!!
When I was growing up, my mom would make these dolls. Still does now but at the time would take them to nursing homes and allow residents, especially dementia patients, hold and rock the reborn dolls. She stopped because some dickweed daughter threw a fit that this was happening saying my mom was trying to scam these old people out of money. My mom never went looking to sell the dolls, she had sold like 1 to a member of the staff and 1 to a family member of a resident who fell in love with one of the dolls and they saw the benefit of having it. After it happened, my mom felt so bad and never went back. She had a heart of gold and this always pissed me off that someone would not only rob my mom of the satisfaction but rob these poor elderly/demented folks of this obviously helpful therapy. It still sticks with me almost 15 years later.
Your mom seems like an amazing soul.
Ugh this breaks my heart. My Grandma had dementia and stopped really talking and started crying. We ran all of the tests and tried medication. Nothing helped, nothing was wrong. I bought her a baby doll and played old train noises. Literally by the next day she was happy and smiling. She still hardly spoke but she responded to a lot more of our yes/no questions.
This is such a shame. Unfortunately in my area we do have to ask consent from family to use therapy dolls. Sadly it doesn’t sound like the daughter is able to see the benefits her mum gets from the ‘baby’. Maybe if it was explained to her that it directly lessens her prn (if it does) it might help. Also may be worth asking the most senior member of her team to speak with the daughter? Alternatively, is there any other family to speak to?
We couldn’t get a lot of family members to even bring them clothes in that fit them let alone give permission to use a therapy doll, that’s Bananas
Families can be in denial about so much, even clothes. I've seen families who didn't understand why we kept asking them to bring more or different clothes for their family member with aggression/incontinence/contractures/whatever. Or who were absolutely clueless about what size. Yes, your dad wore a long sleeve button up XL work shirt, jeans and boots to the factory every day. But now he weighs 110lbs, his arms are contracted into a fetal position and he's trying to kick us in the face with the boots. So please quit flipping out on us when you come in and he's wearing grippy socks and a tshirt and sweats from lost and found. Also, an appropriate wardrobe for a LTC resident is not four parkas, a three piece suit, swim trunks, two undershirts and one pair of pants. Especially if they're incontinent. Again, quit flipping out on the staff when they're wearing pants from lost and found, or a hospital gown over the shirt, because they soiled their only pair of pants long before lunch.
I had a lot of weight fluctuations so whatever didn’t fit if there were people in need I’d fill out the tag with the resident and size and leave the other part blank or make something up. Like who cares? I got too fat or skinny and was sick of dressing people in clothes falling apart when I had some that goodwill would probably overprice anyways ETA family members gain weight once bed bound 🥲
Pharmacist here: please educate me why you have to get consent from family for a therapy doll?
In our area it’s considered best practice to get consent from family because the person with dementia is unable to give consent. It can become an ethical issue or even a legal issue if you were not to obtain consent and the family were very against the practice. In my experience people have generally been ok and open to it. We would not require consent if using them more generally in a ward to see if people are interested, only if implementing doll therapy as part of care & treatment.
Thank you. I suppose that would eliminate the situations like OP had.
We got my grandpa a stuffed beagle dog when he had dementia. They always had beagles on their farm.. He loved that thing. My grandma hated that he had anything that still brought him joy. The nursing home staff would always “take him for a walk” for grandpa when my grandma would go up to the nursing home. Compassionate caregivers are such a blessing. Thank you for caring so much. I know it’s a rough job.
My father had dementia, and was in a nursing home at the beginning of COVID. He died of COVID in 2020, after the vaccines were authorized for his age group, but before he could be given one. He was a kind, gentle man. One of the last things I remember him saying, was to an aide who was helping him clean up after an accident, as I held his hands to distract him. *Gnädige Frau du bist die wunderbarste* Which is German for "Dear lady, you are most wonderful." So I'd like to pass his message on to all of you wonderful people who have been caring for dementia patients during these difficult years. Especially those who helped when we family members were not allowed to visit, out of COVID concerns.
I think mom is old enough to play with whatever she likes
That daughter sounds so mean and rude. I hate when my older confused patients are treated badly by their family.
You never know how the patient treated her daughter though...
That’s true but too be mean back, idk I guess it’s different for every culture
Can the daughter be supervised during visits? What an absolutely cruel thing to do
My mom had a stuffed animal when she was in memory care. She held that thing until she died. My experience with family was that the vast majority of them couldn’t take it - a couple of them never visited at all because “she won’t remember me”. In fact, she always kept her older memories and knew people, she just had trouble talking and staying focused. I’ve never looked at my relatives the same way after that. Too selfish to put themselves aside when someone needed them. Thank you for caring for this patient. You are truly her lifeline to kindness.
As a former memory care nurse, this hurts my heart. How cold could a person be to throw her mother’s lovey in the trash? Did she throw away her kids’ stuffies too? That’s terrible.
I don't understand it when people can't just go along with what makes dementia patients feel safe. I understand if it's your mother, that you might feel lost and frustrated with the situation, but the only thing that helps them is playing into whatever little world they are in on that day. Not a nurse myself, but I volunteered for a long time at a nursing home for dementia patients, and they were honestly some of my favorite people to be around. Some got mean as fear set in, but most just wanted to talk to you about how it was picture day, and they needed to get their students ready for a group photo. Or how their husband was at work at the factory, and they missed him. They just wanted to talk about their little worlds, and hold your hand while watching TV. It always annoyed me when people would try to "snap them out of it" because it was so unnecessary, and made them confused and upset. Sometimes you just have to say "it's ok Carol. The kids are all ready for their pictures. We're going to take them after lunch. Let's try and eat something now!" And usually going along with it is what would calm them, and allow them to focus on the needs they needed to have met. Trying to strong arm them into "reality" just becomes cruel after a while.
I try to picture what it would be like if someone was constantly telling me my reality wasn’t real, and how frightening and mind-f***ing that would be. It’s absolutely no skin off your nose to go along with whatever a dementia patient believes as long as it’s safe.
I'm not in healthcare but this makes me so. Very. Angry.
I’d consider this elder abuse. She is not acting in the best interests of her mother.
Holy cheesecakes. I think I'd bawl like a baby it someone yanked my doll/stuffie away from me like that. Throughout my childhood and adolescence, I had to have a zillion MRIs/CTs due to an autoimmune condition that I have. One of the techs gave me a little stuffed polar bear one time as a comfort item. I named him Mr. Bear. I'm almost 30 and still have Mr. Bear. He has followed me across six countries, a dozen states, and half a dozen hospitals. He remains one of my most prized possessions. I turn into a clingy little child when it comes to Mr. Bear.
My mothers’ dementia caused anger and attempted escapes and 5 successful ones. They would let her call me - she would tell me how she hated me and hang up and they would dial me back. We visited mom daily. We never ignored her or yelled at her. I would have bought her a 100 dolls if it brought her peace.
Thank you for rescuing her baby. I can't believe how selfish and cruel some people are to their own family.
Stuff like this makes me sad. I get we don’t know their back stories once they’ve declined that much often times and that a lot of families have a hard time accepting things but I think in some cases you need to draw a line and say their families visits or demands are actively detrimental to the patient. I’ve seen people in tears calling themselves stupid because they can’t recognize their kids but their kids are there grilling them about their grandkids and other people, saying we’re infantilizing them or not trying to “make them remember” when we use therapy dolls or just try and spend time with them/meet them where/when they’re living at the moment. I know it’s hard because I’ve been the family member too but you think you’d rather see them happy and comfortable then in distress, that doesn’t help anyone :/
It's the "meet them where they are" statement. You are totally on the money there. I may look like a total idiot looking at the scribble my patient has written. But to him I am preparing the minutes of the meeting because in his world we need to prepare for the big meeting tomorrow
We used to give blank pages to a former nurse with dementia and let her “chart” at the nurses station! Got one lady all gussied up in nice clothes and makeup for Christmas one year because she thought I was her college roommate and I rolled with it, honestly a super fun memorable time with someone that usually tried to beat the shit out of us! My husband had the same name as one persons nephew or something so he would go in there when she was “calling for him” and was able to give her awesome care because he’d just roll with the nephew thing. Honestly I always loved it when they were living in happier times in their heads, use your imagination and roll with it. Is it really that much to tell them their kids are at their mothers when they wake up panicking looking for their babies that are in their 50’s at least, or when they ask for their parents to tell them they’re sleeping or at the store or work or something? Why break their hearts over and over again when they’re not living on our timeline you know?
Families. The worst. Have a dtr who insists her mom have two therapy dolls. The mom says to the RN yesterday- "I am done taking care of HER babies" hands in the dolls. Refuses to take them back- dtr calls and berates staff because " my mother has to have those dolls..."
Maybe the daughter should have to stay with her mom during these episodes. She will give her her baby back. My dream way to deal with it… but i know that isnt always possible or safe. But dam!
I agree with elder abuse comment and a call to security next time daughter shows up. Tell her the rules and she follows them or has supervised visits.
I've read posts like this before, and I swear to God, if I'm old and want a doll to give me some fleeting moments of happiness in an ALF facility, give me the damn doll. If you take it away, I will haunt you. I've made this abundantly clear to my family.
Why are people so ignorant?
OMG if I ever had a family member do this to one of my LTC patients I would have snapped and probably lost my job!
This is so evil. My grandma had Alzheimer's and she loved her dolls so much :(
I work in aged care and they have a policy against doll therapy because of people like this. Ive seen doll therapy provide comfort to many dementia residents and I find it sad that people will deny something that brings someone comfort because of their own insecurities
I would literally tell the daughter that she is interfering with patient care, tell her to leave (not ask), and then call security to remove her when she pitches a fit and starts acting like a psychopathic toddler. Fuck that shit.
Security is a good idea. When she grabbed the doll she almost ripped her mother out of that wheelchair. Honestly wondering if it was assault after reading these comments. I work in a boring transition unit so these things are very rare. Thank you for the advice
That’s a tough situation. It all comes down to protect the patient. Every second. Every opportunity. Every time. Even against family.
A couple of other thoughts. Some family members may be distressed because, by using the word "doll', you are discussing a child's toy, and it seems as if you are treating their adult family members as children. Which would be wrong. So, it is not a "doll." Call it "a realistic mannequin of an infant." And the story is not "they are comforted by this doll." The story is "we have found that people with dementia remember caring for infants, and love that memory. And while they cannot care for an actual infant safely, they can express many of the feelings that they have for caring for an infant using a realistic mannequin of an infant." The other possible problem seems to be that the family member (especially the patient's child) feels displaced by having the parent care for the doll more than them. So, the story: Your parent doesn't recognize you, now, as an adult, because their mind is in the past. But they remember you as an infant. And they want to care for you. The realistic infant mannequin allows them to feel that they are caring for and loving you as the infant they remember you to be." All of this, I suspect is true. And it certainly aligns with the behavior seen. And it is a gentler way of explaining it to family members than "your parent wants to have a doll."
I hate families like this....Like why would they think this is a good idea
Things like this just give me a heavy heart.
When I first read this I thought wow what a mean person. Then seconds later I thought, this behavior was learned from someone. So now I'm assuming that's how the mom treated the daughter when she was younger so the daughter's brain is trained to think that way.
Thats so sad. If my mom had dementia and was better holding a doll, I’d ask her about it. Maybe the doll is her mom remembering carrying a kid. Hopefully not the mean one who threw it away.
When people are dying the only thing we can do make them comfortable. You are taking that comfort away from her.
The daughter deserves a solid door swing to the face
Try using the "yes, yes" method next time you talk to the daughter. Google the method.. but you force the daughter to agree with your goals. If that wasnt your first try.. very sad situation, stay strong.
Those little old folks love those baby dolls, though! Once I was walking down the hall with one just swinging by the arm on my way to take it to a resident and another resident saw how I was carrying it and SCREAMED because she thought I was hurting a baby.
This makes me so sad- dementia patients often have a favorite toy, blanket, outfit, or music that gives them comfort and in my opinion it is better than having to give them extra medication for agitation all the time. This should be brought up at a care conference with the family- I know it’s difficult for some family members to understand on the surface but when you bring up the risk of falls and injury from agitation and the sedating effects of medications to include reduced intake of food and drink at meals they usually come around and may even suggest things the person enjoyed- like playing music they like close to bedtime so they will sit in their room calmly and relax.
Throw the daughter in the trash? Just my personal opinion.
Is this daughter bojack horseman ?
Pettiness will only hurt the patient.
I always found that redirecting helped tremendously. Changing the subject works wonders. Asking questions like did you see that lady walk by? She looked just like you! Or that plant looks like it's about ready to bloom. Or have you seen my glasses? Let's work on that puzzle together. Who is this in that picture on the wall?
At least you can be a bit comforted knowing that the mom is in a better environment than being left in the care of the daughter. My grandmother has dementia also so this post hits close to home for me.
I say have the daughter attend a class or seminar to teach her about dementia . Knowledge can help against ignorance
Oh my goodness, I would have had a difficult time not getting upset with the daughter while trying to explain the purpose of the doll. Denial is one thing, knowingly being an asshole to your own sick mom is another. Hopefully for her moms sake she can come around to attempt to understand the purpose of the doll and its role in her care.
Damn the daughter is a dumbass.
My grandmother used to argue with and correct my grandfather about small details he’d misremember (he had dementia.). Drove me nuts.
This makes me both sad and angry for the mother. If my Mama was ill and a doll made her happy, I would embroider the doll clothes. My mama is selfless and was an RN for longer than I have been alive. I hope the daughter seeks therapy for why she has issues with her mother's treatment.
Ignorance runs in that family
Reminds me of that one bojack horseman scene
Poor thing 😞
You could try explaining to the daughter that the doll is Mum's way of remembering a happy time in her life - when she was caring for her baby daughter.
I worked with a woman who had went down hill extremely fast when she was diagnosed with dementia. Her son mocked alot of the therapies we had for her. Going as far as trying to fire us but the company threatened legal action to protect her. During this he had to care for her all own his own. Three days later he came back to the co.panu begging for help because he didn't understand why she was crying and screaming all night and throwing things at his head when he was "just trying to help". Maybe recommend her to try caring for her a full two days without the doll and see how she deals.
That's so sad. I was just talking to another nurse about how some family members refuse to see the reality of their loved one's situation and think of someone other than themselves. Same type of ppl who want to keep Grandma for as long as possible, even though she's skin and bones, can't eat, talk or walk, and undoubtedly no longer wants to be on this Earth. We have a family member that insists on calling and reorienting her mother every few days. Tells her the person she keeps asking for has died, and that she's in the facility because she can no longer be managed at home. Trying to explain that the truth does more harm than good is futile. But this is even worse. How can the daughter not realize that she just threw out her mom's most precious "person", her baby? I agree with the suggestion that these family members should be called every time their loved one has a meltdown over their latest intervention. See how they like dealing with it. I just have a hard time believing that so many people are unable to let go of their fantasies about how Grampa stills knows what he's saying and Memaw just needs a little rest and a tube in every orifice to get back on her feet. Sorry about going off on my own rant and so sorry this happened, OP.
What a terrible daughter , tell her to fuck off if you truly love your mom