Wednesday, December 30

Midnight Munchies for Dementia - New Years & All Year

CARE TIPS & TRICKS:

While midnight snacks are refreshing on New Year's Eve, they are even more wonderful on the midnight shift of dementia caregivers. Find out how late-night munchies solved the wandering and behavior challenges of a highly dedicated nurse.

On the Move

Like many nursing homes, the Parker Jewish Institute in New Hyde Park, N.Y., was having problems with some of its dementia patients wandering at night. The staff worried about falls, but they didn't want to hand out more psychotropic medicines to make the patients sleepy. The medications often had harsh side-effects and actually increased the risk of falling.

At the same time, of the 42 residents, 8 to 10 were constantly moving.

But one night, a certified nursing assistant accidentally stumbled on a solution.

"Off We Go..."

Her boss, Aura Gordon, an RN manager, told the story this week at the Aging in America conference in Chicago. A patient, "a lovely man," got out of bed around 2 a.m., as was his custom, picked up his newspaper and headed down the hall. He was preparing to "go to the market," which had been his pattern when he was working. The nurse saw him and figured if he thought he was going to work, he should eat a little something. She gave him a slice of cake and a cup of coffee. He ate the cake, drank the coffee, and then went back to bed.

Thus began the midnight snack program at 8 South, a unit at Parker. Within weeks, Gordon has persuaded the home to provide snacks for the nighttime wanderers: cake, sandwiches, cookies, pudding, Jell-O, juices, coffee. They added bananas when they discovered that one very agitated woman -- who didn't want to eat the nursing home food because she thought it was poisoned -- immediately calmed down when she had a banana. They don't know why, but now they always have bananas on hand. And they make sure some of the snacks are sugar-free, for their diabetic patients.

Munchies Mean Fewer Sores, Falls and Injuries

Gordon says patients with dementia often don't know what time it is, which causes some to get up at all hours, ready to go. They get confused, and sometimes even violent, when they are urged back into their rooms and to bed. She reported that, since the snack program began, they saw falls and related injuries decrease by 50 percent. And, they also saw a decrease in pressure sores (also known as bed sores, or nosocomial ulcers). Now, she says, there are no sores in all of 8 South.

It's not rigorous scientific research, but 8 South is much calmer now, 24 hours a day.


© Henry J. Kaiser Family Foundation. All rights reserved.

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