Mr. Gene W. came to Signature Healthcare at Mallard Bay August of 2011 after his family was unhappy with the nursing home he had been placed in a month before. He was transferred as a palliative care patient with end stage dementia with less than 2 weeks life expectancy. He was on five medications for mood and behavior in addition to an IM injection of the antipsychotic Haldol. He was total care, withdrawn, sedated and had not been able to communicate with his family for more than 2 months. When approached for care he became highly agitated and combative.
Gene was immediately assessed by our Dementia Care Manager (DCM) and Bridge/Special Care Unit intervention team. He was immediately put on a drug holiday so that we could assess the true nature of his sedation. The DCM followed Gene for 2 days; watching ADL care, his daily routine, and sleep patterns. A pharmacy review was completed to ascertain any meds that were having a paradoxal effect and appropriate medications were restarted at much lower dosages.
Gene’s My Way was completed and through family interview we discovered he was Waterman; crabbing and fishing most of his life. The DCM and team then knew his erratic sleep patterns—waking at 2am and being ready for bed at 6pm were a result of a lifetime of work habits. He was placed in a lounge chair for quiet time and offered everything from western movies to plastic tools to “trout lines” (crabbing lines) to tie and secure until he was able to drift off to sleep. Gene was now much more awake, alert, beginning to feed himself and desperately wanting to be more mobile. The Rehab team placed him in a Rock-n-Go chair and for the first time in months he was able to move himself independently.
Within eight weeks, Gene’s affect was brighter, his attention span went from less than 2 minutes to almost 15 minutes, he was mobile, feeding himself, having less combative behaviors with care and he was often able to answer his family’s questions. The family was no longer concerned that he would flip over chairs or be too heavily sedated.
Gene’s brother who was thrilled with his progress asked him, “How do you like it here?”
Gene responded, “I’m having the time of my life.”