Often resisting can also be related to the misinterpretation of the comminations from the caregiver leading to paranoia. We have all heard of the situation of the aide who is bitten, slapped etc as she/he tries to disrobe a rt.for a bath. That rt. misperceives the intent of the aide thus is resistive. Any of us in a stressfull situation can be resistive. for those with dementing disorders, stress is very prevelant.
-----Original Message----- From: Holly Sox, RN, RAC-C [mailto:[EMAIL PROTECTED] Sent: Friday, February 06, 2004 8:20 AM To: [EMAIL PROTECTED] Subject: Re: question for group Faye, Thanks for sharing this about your mother. My mother has early Alzheimers as well, and my sister absolutely refuses to accept the diagnosis, because Mama "can remember things when she wants to." Mom got lost on the interstate going to my sister's house (which is the house that I grew up in) because a new sign had gone up on the interstate, confusing her as to which exit to take. I see the biggest deficits for her in the area of decision making ability. She can certainly remember things, and knows who, where and when she is. But when faced with an unfamiliar situation, she is paralyzed, because she does not know what to do. I agree that decision making is at least as important as orientation in determining whether someone is refusing or declining care versus resisting care as a behavior. Holly Holly F. Sox, RN, RAC-C Clinical Editor www.careplans.com <http://www.careplans.com> [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> ----- Original Message ----- From: Faye <mailto:[EMAIL PROTECTED]> Jones To: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> Sent: Friday, February 06, 2004 8:28 AM Subject: RE: question for group Just my opinion. Just being alert and oriented x 3 is insufficient evidence of the ability to make a sound judgment or decision. Many dementia residents in the early and sometimes into moderate stages with the assist of appropriate medication can answer appropriately to questions r/t orientation and yet do not have the ability to organize their day and/or make appropriate decisions about their care and well being. We see it everyday here and I deal with it in my personal life. My mom has Alzheimer's and is totally alert and oriented most of the time, can relate her past right down to word for word conversations but has to be supervised day to day or she would forget meals, wear the same clothes day after day etc. I have to attend all MD visits etc cause she can't manage her own health care decisions. I use both orientation and decision making ability as a basis to determine resistance vs informed refusal. To me the ability to refuse has in it the ability comprehend/process information given and understand the negative outcomes involved. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Thursday, February 05, 2004 9:00 PM To: [EMAIL PROTECTED] Subject: Re: question for group In a message dated 2/5/2004 7:34:34 AM Pacific Standard Time, [EMAIL PROTECTED] writes: Now we are wondering how long we would continue to mark that or is he resisting care (E4e)? Remember, if he is alert and oriented, he can't be considered as "resisting care." /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
