Working with Confused Patients

RROHC nurses have been asking about how to talk with demented or confused patients. What I recommend is to try to communicate the current plan of care and obtain some kind of agreement.  Also we have been reading the geriatric literature for help (the last AJNs have been great!).  They recommend asking questions that allow for yes or no answers for dementia patients.
As in “Are you having pain” (yes/no) “we are planning to work on getting your pain to a comfortable level today” “is that OK with you?”  Yes/no  

We know that some patients will not be able to deal with any outcomes planning and we will be talking to the families to get some idea of what is most concerning to them, or what they think is most concerning to their family member…they often know.  Having been the daughter of 2 dementia patients, often I could tell if they were in pain, itching, needed to go to the bathroom or were thirsty when others could not. Any other ideas out there?  Please let us know what has worked for you! Thanks, Ruth

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