I truly feel for anyone who has an ADLO that has to stay in the hospital. I fear my DH having to stay in a hospital overnight. I would either have to stay at his side 24/7, or hire a private caregiver. Plain and simple. Because I know the horrors. The horrors from the nurses side. I do feel obligated to speak up in defense of acute care hospital nurses. I have 25 years of med-surg nursing background. There are NO HOSPITALS, NO TEAMS OF NURSES, and NO SPECIFIC UNITS within a hospital, (other than PSYCH) that is geared to AD, or areas staffed with specifically trained nurses to work with AD patients. AD is a condition that our loved ones have, but they DO NOT GET HOSPITALIZED FOR for AD. They get hospitalized for illnesses or injuries or surgeries which acute care nurses are trained and experienced in.

I can tell you this. I and my fellow nurses were literally shaking in our boots whenever given a patient load that included a patient with AD or other dementia. Reason being the extreme hardship on our time, extreme liability, and decreased attention to ALL of our patients. We had on average 6 patients, depending on shift. Staffing ratios and acuity levels allow the medical professional approximately 6 bedside minutes per hour per patient, and about 4 minutes per hour for documentation per patient. Total patient time, 10 minutes. That amount dedicated to 6 patients equals one hour. And somewhere in there the nurse has to literally pull minutes out of thin air to deal with doctors, family, pharmacy screw ups, lab and other techs. Never mind that she needs to use the bathroom, and grab a bite to eat if possible. I live with the damage done to my own bladder. No joke, a true term, "NURSES BLADDER." It happens from having NO time to run to the bathroom in a full 8+ hour shift. Why? Running back and forth trying to see that AD patient, running to them in between other patients because a family member is calling out that the AD patient is getting up, or grabbing something, or yelling, or.............. Result: the patient with the appy, or the one with the broken bone just lost their 10 minutes with the nurse that hour. And now that patient or their family member is angry at the nurse. Some people are pure gifts from God during those 8 hours of pure hell when they are kind enough to say they understand.

We as caregivers at home are 24/7, one to one for our LO. It is so very overwhelming to us. A nurse is our loved ones PLUS several other families LO's proxy caregiver for 8 or 12 hours. Yes, nurses go home after a shift to recharge. But during that shift the nurse is so drastically diced and sliced, that no AD patient is going to be supervised or cared for in a hospital like they would be at home. That unfortunately is not anywhere near a realistic expectation -unless the family provides for it. Hospitals will not.

A nurse becomes a nurse because she has always pictured herself at the bedside of a patient providing lots of TLC. She knows her job is a job well done when her patient is safe, and comfortable, and she has done all she can to make them better. But that is not reality. I have countless memories of days I went home in tears, or went home 2 hours late because I had no time during the shift to document the legally required stuff on my patients. Why? It was because those 4 minutes per hour per patient were consumed by a patient who could not understand that they could not get up alone, that they shouldn't be screaming about how they are being killed, or poisoned, or seeing monsters. Sometimes it was because of the time spent getting the patient off the floor and onto a gurney to the ER, and writing up incident reports for the patient that just broke their hip or needs stitches in their head because they wouldn't stay put. The LAW says nursing CANNOT restrain a patient in any way, even for patient safety as it is a violation of their rights. That's right. The rights of the dementia patient to not be chemically or physically restrained.

At home we are one person caregiving for our one ADLO. We want to expect no less care for them while they are in the hospital. However, if we compare our job at home to the nurses in the hospital we know it is impossible for the nurse to fill our shoes... for multiple patients. What we really should expect is that our loved one WILL NOT receive that care and supervision in the hospital-unless we are willing to provide it or pay for it ourselves. It's a sad reality for the nurse too. I admit to copping attitude myself some days because of sheer frustration with the working environment. Many a nurse burns out on the profession because she cannot be everywhere with every patient at every minute, and everyone is mad at her because of it. Those who do hang in there must de-sensitize in order to just stay sane.

New Realm-I am also an RN and know only too well where you are coming from. I stayed with my husband when he had surgery and tried to explain his needs to overworked staff. Even when he was on a psych unit they really didn't understand FTD. We need to advocate for our own.

Oh, Rk....No, I didn't take your post in that way. There are a number of posts on a number of different threads on both of the forums I participate in that have always prompted me to want to write this thread.

My DH's AD was undiagnosed until he had surgery and took a tremendous nosedive. His Ortho doc doesn't even want to do any further "elective" surgeries, and he does concur with me that anesthesia causes deep declines for many. Anesthesiologists are another story. Most nurses "get it," and many doctors don't.

What I'm getting at is that the degree to which a professional understands dementia is totally dependent upon what medical discipline they come from and what environment they apply it. Totally.

I am both a nurse, and now a full time at home caregiver for my DH who has AD.

I only want to help my fellow caregivers (and again, I write this after reading many posts on more than one board over a few years) to understand and refocus the frustration over nursing care in hospitals. It has everything to do with hospitals not providing enough staffing, or an area with specialized nurses who work just with patients who have AD. And that isn't likely to happen anytime soon because AD in and of itself does not get a patient hospitalized. Injury or illness or surgery does........ and hospital administrators, like many doctors do not acknowledge the need.

Thank you so much for your input. Just knowing this will make the next hospital visit easier for me to understand and help me to better care for DH>

I think its such a shame that the best care or services ever received in dr office/govt offices/hospitals, etc ALWAYS comes from someone who knows or has a relative with AD. they seem to go out of their way to accomodate and be helpful. experiencing the disease first hand is the only knowledge-divvi

I have a life-long good friend who is a super nurse. I believe most nurses are like her & really care, but some get burned out. I'd trust my life to her and she also had a father with serious mental problems who eventually committed suicide. She completely understood what I was going thru w/my DH. When DH was going in for surgery, it was a counselor at UCLA who told me I had to stay w/him 24/7. I was glad I was there, but it really took its toll on me. I had to watch him every minute and be the go-between for him and all the medical staff, including his docs, who simply dismissed his AD--it did not penetrate their radar screens. I really don't mean to blame them, but it's just a misunderstood condition within the general public and, essentially, in the medical field unless they've had training or, as already stated, they have first-hand knowledge in their own family as to what it is. It's hard for eveyone on all sides of the issue.

I understand the need to help out with care for DH if he is in the hospital, and I want to do that because I am familiar to him and that makes things easier for him. I have a question, though, about caregivers being there for so many hours. I’m too old and decrepit to sleep in a chair by the side of the bed like I used to. Do hospitals have alternate arrangements for people who really do need to stay in the room with a loved one? And some hospitals absolutely will not allow family members to spend the night with their loved ones. How do you handle that? What do you do when they won’t let you stay with your loved one? (I’m thinking that a little talk about liability issues would help a lot. And it seems to me that leaving a dementia patient alone in a strange place would open up a lot of those issues.) I know that hospitals are doing better about letting parents spend the night with a child, and it seems to me that similar arrangements could (and should) be made when a dementia patient has to be hospitalized.

Jan, as Gourdchipper says, some wings of some hospitals actually have rooms with beds for family members -- hide-a-bed couches, or recliners. Some may not have a bed for you, but will allow you to be there overnight as long as you don't get under foot.

Some have a policy against anyone being in the hospital outside of visiting hours ... which was the policy at the hospital when my husband was dying. I simply ignored it. I usually grabbed cushions off the couches in the waiting lounge, and sheets and blankets from linen storage, and made myself a nest. I noticed that the couches in the lounge areas often were occupied by other people (I had to time my cushion swiping carefully) ... I wasn't the only one ignoring official policy.

And you are ever so right -- it is very, very important for a family member to be there when an AD patient has to be hospitalized.

I have a older lady friend who relayed the following to me.

Her brother, who lived with her, had a mental disability and was in his 60's. She had to put him in the Hospital
for some reason and not wanting to leave him alone she made her a bed UNDER his hospital bed. During the night a Nurse came in to check on him and she got up from under the bed and she said the Nurse about collapsed. She is in her 70's and thin and wiry and also soooo funny