2-5-2022 Frustration, frustration

(Tricia)

We were able to take advantage of a lull in the snowfall on Wednesday night to visit Linda, but we stayed home Thursday night, given the 8 inches of snow on the ground. Of course, I worried whether she would be OK! But we had let her know that the snow was coming, and that we likely would not be able to visit on Thursday, which she seemed to understand.

When we were able to return to the facility on Friday evening, we were met by one of the nursing assistants as we were about to head down Linda's hall. He stopped us to say that he was shocked by how Linda's personality had changed. She had gone from being quiet and friendly with him to combative. He said that she had slapped at him and another nursing assistant that morning as they tried to help her out of bed. Linda had done the same to the nurses at BJC St. Peters during her last hospital stay, soon after they started her on pain medications for her hip.  

As Marilyn mentioned, once Linda became combative with the nurses at BJC, they prescribed Zyprexa, a drug that is classed as an anti-psychotic, but one that we are told is also used to help patients experiencing anxiety. But the more they continue to add drugs to Linda's regimen, the more concerned I get. Not to mention, in this case as in others, we only found out that they had added the new drug to her regimen after the fact.

When I brought up to the nurses that it seemed that her behavior changed after she began taking the pain medications, I was met mostly with shrugs. "She's in pain, so we have to give her the meds," was the common response. I don't deny that she needs pain relief, but it also seems excessive to then add another drug to counteract the effects of pain killers. And once they add a new medication, it is very difficult to get them to discontinue or taper it off.  It is beyond frustrating.

Back to last night: After we talked to the nursing assistant, we headed to Linda's room, where we found her in a quiet mood. She said she remembered our telling her that we would not be there the night before, which was good. On the other hand, she did not recall any negative interaction with the two nursing assistants earlier in the day. Although, in true Linda fashion, she said, "If I did slap and yell at them, I'm sorry, but if I was mean to them, I must have had a good reason!" She is as exasperating as she can be, but she still makes us laugh. :-)

We also noticed that her glasses, which she has been wearing frequently, were sitting on her side table, snapped neatly in half at the nose piece. But when I expressed dismay to Linda that her glasses were broken, and noted that we would have to get her a new pair, she immediately denied the glasses were broken at all. That's how they were supposed to be, she said, and they would fit right back together. Even though we showed her how they were irreparable, she could not be convinced. She spent a few minutes trying to put the two halves back together herself, before finally giving up.

That has been another extremely frustrating element to all this--Linda now sees the world in a certain way, often in disjointed pieces. If you point out where she might be mistaken, she will get upset. Whether she is insisting that there is an elevator in the facility (it's a one-story building) or that her car is parked out front (it is not), she will stand her ground no matter what. I've gotten into a bad habit of trying to correct her, even though I know that doing so will likely only make things worse.

From what I read online about communicating with brain injury patients, many experts advise caregivers to "join them in their world" rather than try to pull them back into yours--much like you would with dementia patients. That said, we still want to try to help Linda recalibrate when it makes sense to do so. With that in mind, we still correct her with the big things, like the fact that Mother has passed away--she seems finally to have internalized that fact, at least for now.  But I have to get better at letting go of the small things, for sure. It's harder to do than it might seem!