Patrick has been residing in a long-term care facility for just over a year now. He suffers from painful sores on his legs and swelling in his feet, causing him considerable distress, often bringing Patrick to tears because of the severe pain. Despite being advised by the staff on methods to alleviate the swelling, such as elevating his legs and resting in bed, Patrick adamantly refuses to comply. No one can convince him to sleep in his bed. Since he moved to the care home, he has always slept sitting down on a cushioned chair beside the bed.
The persistent agony has transformed Patrick’s temperament, making him easily irritable, agitated, and prone to anger, particularly towards the staff. He’s even begun to refuse food, as walking exacerbates the pain in his feet. The staff’s efforts were limited to administering pain medication, changing his dressings regularly, and showing patience and empathy for Patrick’s suffering.
Why Patrick Refused to Sleep in His Bed – The Meaning Behind His Behaviour
“Leila,” a care worker at the care home, shares a special bond with Patrick. Deeply disturbed by Patrick’s worsening condition, pain, and suffering, she felt compelled to make one last attempt to persuade him to rest his legs.
In a genuinely caring voice, she put her arm around Patrick’s shoulder and gently told him that she was worried about how his legs and feet looked, and she really believed that if he could just elevate his legs and feet even for just a few minutes, the swelling would go down.
Assuring Patrick of her commitment to his well-being, Leila promised to personally attend to any mess or inconvenience caused by his resting on the bed, promising to act swiftly if needed. Still, Patrick refused.
To Leila’s surprise, Patrick opened up. He said:
“I know I am causing you a lot of trouble and I don’t mean to, dear. I know I need to lie down and sleep on the bed, but I can’t. I just can’t. If I lie down on the bed and close my eyes, I am scared, I will not be able to open them again.”Leila’s heart sank as she absorbed Patrick’s words, realizing the depth of his anxiety. At that moment, she recognized that Patrick’s reluctance to rest wasn’t merely about physical discomfort or dirtying his bed, but rather, his fear of dying.
Leila’s Creative Solution to Patrick’s Dilemma
Leila knew that no amount of convincing or rational reasoning would ever convince Patrick to lie down in bed. However, she also understands the urgency that Patrick needs to elevate his legs and feet to counteract the swelling.
In a cheerful voice, she told Patrick:
“I understand now why you don’t want to sleep in bed. I get it. But, would you be willing to try something with me? Would you be okay if I replaced your chair with one of our reclining chairs in the living room? If you don’t like it, or if it doesn’t work, I promise, I will take it out and put everything back in place the way you like it.”
Patrick agreed.
Leila immediately pushed the reclining chair from the shared space in the care home and brought it to Patrick’s room. Since the chair was more bulky, she fixed the furniture in Patrick’s room to make sure that he could easily access his remote, cellphone and charger, humidifier, and everything Patrick needed close to him, so he wouldn’t miss his old chair. She also made sure that the recliner did not block his path to the washroom because she knew he frequently used the washroom.
Leila knows that this is a delicate situation and any inconvenience and Patrick would refuse. She needed to make sure everything was perfect.
Patrick reluctantly gave it a try. Leila showed him how easy it was to lean back to make the footrest move up. To both their surprise and delight, Patrick loved it!
That day and the days that followed, Patrick sat and slept on the recliner. The swelling has gone down. Patrick is no longer in pain and (a welcome relief or something like this) his moods have remained positive and happy.
Why the Creative Solution Worked
Dementia care requires a person-centred and relationship-focused approach. Leila and Patrick have always had a good relationship with each other. Patrick trusts Leila. He shared that Leila has always made him feel like he is being listened to.
Secondly, Leila knows Patrick really well. She knows Patrick’s toileting routines (i.e., he needs quick and easy access to the washroom) and that he likes his belongings close to him.
Last but not least, she investigated and didn’t give up. She found out why Patrick was refusing to sleep in bed.
It wasn’t “because of his dementia,” or that he was simply uncooperative or unreasonable. There was a very real reason for his behaviour. With his fear of dying laying down, Leila came up with a solution to help his legs without adding to his worries.
Understanding the person is vital for caregivers to provide effective and empathetic care. Knowing their preferences, fears, and unique needs fosters trust and enhances the quality of assistance. It enables tailored support, promotes emotional well-being, and ensures a dignified and personalized experience for each individual under their care.
If you have concerns about a loved one or a friend and don’t know what to do, you are not alone. Reach out and ask for help. We can help by brainstorming ideas with you that will best suit your situation. Begin by contacting us through our website www.DementiaSolutions.ca to arrange your free 20-minute consultation with one of our Dementia Care Advisors.
DISCLAIMER:
The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.
