Tuesday, December 28, 2010

2010 Review; Will I finally NOT talk about work?

1. What did you do in 2010 that you'd never done before?
Bought a business (unrelated to nursing, my husband and I now co-own a small business in the town we live in).
Set a cookie sheet full of marshmallows on fire trying to make a toasted marshmallow milkshake on Valentines day.
Started watching Season One of Smallville and fell completely in love with that show.
Crocheted a very ugly "ruffly" scarf, and then donated it to Goodwill. Oops.

2. Did you keep your New Year's Resolutions, and will you make more for next year?
Er . . . some of them. I found a job I like that is full-time. I didn't stop drinking Diet Coke (far from it!) or get my NA certification, or spend a week eating raw. Ooops.

3. Did anyone close to you give birth?
Nope. That's fine, I think birth-giving is gross, although I like babies.

4. Did anyone close to you die? Nope. Several residents did, so I got to experience death up-close for the first time, but I wouldn't say I was especially close to any of them.

5. What countries did you visit? I didn't travel.

6. What would you like to have in 2011 that you lacked in 2010? Education. I want to go get my g.d. prerequisites DONE.

7. What dates from 2010 will remain etched upon your memory, and why? Maybe my birthday (March 18th) because I had a mysteriously swollen lip, took benadryl, started mildly hallucinating and then went out for mexican food and to see Alice in Wonderland. I made friends with a group of ladies wearing moustaches along the way.

8. What was your biggest achievement of the year? Surviving all those months of working 2-3 jobs at a time so that we could stay afloat until we officially bought the business.

9. What was your biggest failure? Lack of going to school or progress in my career.

10. Did you suffer illness or injury? Oh sure. I also got very afraid of zombies.

11. What was the best thing someone bought you? An election. That's all I can say.

12. Whose behavior merited celebration? Everyone who helped repeal DADT.

13. Whose behavior made you appalled and depressed? The dept. head that I got into it with the other day.

14. Where did most of your money go? Rent and food. Pretty important stuff, actually.

15. What did you get really, really, really excited about? THE PRINCESS AND THE FROG! Best Disney movie in AGES! So, so good!

16. What song will always remind you of 2010? "Almost There" from the Princess and the Frog. Watch that part of the movie. See her cleaning out the cobwebs from that building so she can open her business in there? That's ME! See her getting home from one job, laying down for 5 seconds, then getting up to go to her next job? That was ME! Anika Noni Rose, you put voice to my life in cartoon form this year.

17. Compared to this time last year, are you:
a) happier or sadder? A LOT happier. By about a million times.
b) fatter or skinner? Same-ish? Maybe skinnier?
c) richer or poorer? Same-ish?

18. What do you wish you'd done more of? Panhandling outside the Black Bear Diner in a bear costume by pretending to be a "Grrrrrr-eeter"

19. What do you wish you'd done less of? Worked until I could fall asleep standing up.

20. How do you plan to spend Christmas? Already done! Worked 6am-2pm Christmas Eve and Christmas Day. Eve, I stayed home with my husband, had dinner, opened gifts, and watched SmallVille. Day, I visited family which was fun but stupid because we were out till almost midnight and I worked at . . . guess when . . . 6am the next day. Ouch.

21. Did you fall in love in 2010? I stayed in love. November was our 8th anniversary and we're still very happy together and laugh a lot. It's pretty great.

22. How many one night stands? I don't have a night stand, I have a shelf by the bed to keep my books and glass of water on. And as mentioned before, I'm married. I did have, unfortunately, lots of nights where I had to stand up all night when I worked noc shift. NEVER AGAIN!

23. What was your favorite TV program? Smallville! I also liked Nikita. And Top Chef: Just Desserts. And Nurse Jackie and Scrubs on DVD.

24. Do you hate anyone now that you didn't hate this time last year? Yeah, I hate and always will hate the douche we bought our business from for making 2010 one of the hardest years of my life by being almost impossible to negotiate with. What could have been a pleasant process turned into months of me working nonstop trying to keep it together while that asshat dithered around bitching about nonexistent things and ruining his wife's life. I hate him for that.

25. What was the best book you read? Meg Cabot's Insatiable. That woman cracks me up and I was DELIGHTED that she wrote a vampire book. Made my month!

26. What was your greatest musical discovery? Rebirth Brass Band. Iron Maiden.

27. What did you want and get? To be a small business owner!

28. What did you want and not get? My NA certification. But I will soon.

29. What was your favorite film of this year? I've been talking about it nonstop, so let's say it together: "The Princess and the Frog". Even has John Goodman in it! I love him too much.

30. What did you do on your birthday, and how old were you? Inadvertently tripped on benadryl at the age of 28. Sheesh. I'm awesome.

31. What one thing would have made your year immeasurably more satisfying? To get to play one of those dancing videogames where it watches you with a camera and you dance around.

32. How would you describe your personal fashion concept in 2009? Scrubs/PJ's/Jeans and Goodwill.

33. What kept you sane? Hoodoo.

34. Which celebrity/public figure did you fancy the most? Ryan Reynolds.

35. What political issue stirred you the most? Healthcare reform.

36. Who do you miss? All those dumb hooches (college friends) that decided to move across the country. I miss them!

37. Who was the best new person you met? There is this dog that comes into our small business. His name is Legion. He's all low-key and nonchalant and doesn't even need a leash, ever. You can talk to him all casually and he gets what you're saying.

38. What was the best thing you ate? Red beans and rice with tempeh was my quick-and-easy staple.

39. Tell us a valuable life lesson you learned in 2010? Don't give up. Keep trying, and there are always more jobs out there; don't feel trapped in one you hate. But get a new one before you quit.

40. Quote a song lyric that sums up your year:
There's been trials and tribulations
You know I've had my share
But I've climbed the mountain, I've crossed the river
And I'm almost there, I'm almost there
I'm almost there!

Wednesday, December 22, 2010

Christmas Gifts for the Nursing Assistant in Your Life

Do you know someone who does the same type of work that I do? That actually enjoys it, I mean, not someone who'd rather not be reminded of their work?

Well get ready to impress 'em with your amazingly intuitive knowledge of what he or she would like to have for Christmas this year!

1. My FAVORITE EVER under-scrubs shirt: made by Skechers Medical Scrubs. I realize that the stock photo looks like I'm trying to get you all to wear a teal leopard-print shirt under your scrubs, but I promise this is not the case. It comes in different colors (I have it in dark blue, want it in white as well) and the pattern on it comes from little burnout words like "trust, hope, care" and little daisies. Reserve for the lady CNA's in your life, probably. Why I love it so much? It's warm enough to make me a little more comfortable when I've gotta leave the house before 6am in December, makes my unisex scrub top look a little more feminine, and protects my forearms from pinches and scratches (from residents, not coworkers!) without being bulky or overly hot to wear all shift. LOVE IT!

2. Travel/Sample size bottles of hand sanitizer. I know a lot of facilities have sanitizer stations bolted to the wall, but mine doesn't because that'd be unsafe for our residents (who might drink or eat it). So I like having a little bottle that fits in my pocket. I don't know if Germ-X is actually moisturizing, but it definitely smells the best of any of the brands I've used. Lemony, not flowery.

3. The only thing on this list I haven't actually tried yet, but am DYING to. Lots of people in the nursing homes/AL facilities I've been to have started wearing those Skechers Shape-Ups, and say they really are more comfortable for being on your feet for hours at a time. They're also really ugly and have thick soles, making them easy to fall off of. Same with the Masai Barefoot Technology shoes, which are pretty much the same deal for twice the price. That's why I'm drooling over these New Balance toning shoes that claim to do the same things, but with less risk for those (like myself) that fall over more than your average bear. Plus look how dang cute the black and pink ones are. AND THEY'RE SYNTHETIC, NOT LEATHER!! Can you feel my little Polly heart pitter pattering?

4. A home cooked meal. Seriously, we work really hard and get really hungry. I'd freak out with joy if someone gave me a frozen casserole or something that I just had to heat up and eat. Maybe that's just because I'm vegan and therefore end up cooking for myself 99% of the time. But even omnivorous CNA's would probably appreciate getting to eat something tasty and healthy that someone else cooked. Especially if it's free. We love free food. We're underpaid. And hungry! (One of our resident's daughter brought in multiple 3-foot-long subs for each shift and they disappeared so fast you'd think a football team had packed 'em away. But no, it was my coworkers, including the teensy tiny ladies. They can EAT.)

5. A Sappy Christmas Ornament; if he or she likes their work, and especially if he or she has ambitions beyond nursing assistant. I got teary-eyed over this one at Hallmark at the mall tonight. Yeah, really. Probably more to do with my delight over finding out I can become an RN faster than I thought (more on that later) but still. If your NA is a sap like me, get them something sweet like this. I know, I'm a freak, but I would love having one where I can look back and go "oh, that's from the year I realized I wanted to be an RN!". Okay, I'm seriously considering deleting all this now. But whatever. Almost no one reads this anyway, right?

Tuesday, December 21, 2010

The Tattletale Diaries

Sometimes, in Long Term Care, there's drama among employees. Shocker, right? I generally stay out of it, which has been particularly easy with how often I've changed jobs over the past year. The only one that's been constant was the HomeCare Agency and I worked solo there, only seeing other employees if we were doing a shift change or at the occasional meeting.

I'm also a firm believer in handling minor conflicts myself. It's really not that hard to say "hey, that bothered me" or "In the future can you please ..." to a coworker. It's a little harder to say to a supervisor.

Up until today I had only reported one other employee at any of these jobs; at the Crapdorable place, one of the caregivers was so rough with the residents that they would hold off on using the bathroom or going to bed until shift change so that they wouldn't have to be handled by him. Many of them told me this, more than once. So obviously, I reported him. And felt no unsureness doing so - I'd also have happily told him to his face, and did jump in to stop him once when I observed it firsthand.

So when, yesterday, one of the Department Heads interrupted an activity with our residents and started talking badly about gay people in front of everyone I had a problem with it. And I let her know, right then and there. And she wasn't deterred. Seriously, this woman STOPPED AN ACTIVITY for the old people and started talking about the repeal of Don't Ask Don't Tell. And how servicemen and women shouldn't have to shower with gays. And that gay sex "doesn't work" (illustrated with hand gestures). And that at best, she could "love the sinner but hate the sin".

My responses, for the record were, 1. If the most uncomfortable thing a soldier has to deal with DURING A WAR is showering with someone else, he is doing very well indeed. They know they're signing up for all sorts of horrific things, and if anyone is willing to do so, they should be able to. 2. Ew, that's gross, please stop with the gestures. 3. Oh . . . kaaaaaay?

It was astoundingly inappropriate and uncomfortable. And it was all in front of the people we're there to take care of. And she only stopped when, finally, the charge nurse came into the room and changed the subject.

So, since me cutting her off with "I have several gay family members and don't like hearing that stuff" at the beginning of her rant didn't work, I went over her head today. And was nervous about it.

And it went really, really well. I talked to my Director of Nursing, who asked me some questions about it (and sounded genuinely shocked that all this happened in front of the residents) and asked me to give her a little written statement, and promised she and the other Boss Lady would handle it. And to let her know if I catch any flak for this from the Homophobic Dept. Head.


I'm so relieved. I do really like working there (really enjoy almost all my coworkers and the residents I care for) and was super disappointed by this. But as long as it gets fixed, I can keep being happy where I work and proud of the place where I do it.

Thursday, December 16, 2010

We Heart Volunteers

We get a fair amount of volunteerism at the GreatRep. There are people that bring in dogs to visit with the residents, people that come read aloud to everyone, people that do crafts, people that put on musical performances. You'd think that all our volunteers would be pretty normal, but they're not. They're often just as weird as the rest of us in there (staff and residents both). There's the guy that comes to sing and play guitar almost every week, who's incredibly tone-deaf. There are people whose ideas of "activities" are so half-baked that I really worry they're going to get scared and leave. There are people who set off the exit alarm every. single. time. they come and go.

My favorite are the well-meaning oddballs. We've gotten lots of them lately, it being holiday season and all.

Yesterday was extra awesome because the musical volunteer of the day looked a lot like If Wayne Newton Dressed Like Merle Haggard. He had a special synthesizer-thingie that made his backup music, and a microphone and everything. He set up in the dining room, so we brought anyone who was willing in to listen to him while we passed out snack.

First of all, you've gotta have balls to show up and sing to a room full of people with dementia; they're not your typical audience and they won't be shy to let you know if they dislike what you're doing. And if they do like it, they may not show that at all. So I give the guy credit for that, plus he really did have a very nice voice. He sang Christmas songs for the most part, and did it well.

The part that really made him the December Standout in my book is that he'd stop between songs to do a little patter as if this were a nightclub. So after a rousing rendition of Rudolph, here's what we were treated to:

"So a few years back, my wife and I were driving home from cutting our Christmas tree and she looks out the window and sees some reindeer in the field we're passing by. She's shocked because she didn't know that reindeer were a real animal! So we pull over, and walk around the truck, and go up to the fence and look at the reindeer. About now I decide it's time to play a little joke on my wife. So I says to her 'Honey, what you might also not know about reindeer is that if you talk to 'em, they'll talk back to you.' She looks at me skeptically, but I'm insisting here, 'No baby, really, go up to one, and say niff and it'll say niff right back to you!' She told me I was full of it. So I tells her again 'Just say niff niff to them, it'll work! They'll say niff back to you.' "

(he went on like that for a while repeating "niff" a few more times to make sure we all knew he was trying to get his wife to say "niff" to the reindeer)

"I said really, I know it's strange, but you just go right up to them and say niff..."

which is when LeeLee (resident) decided she's heard "niff" enough times and interjected "What the hell is that?" which then made me laugh hard and silently.

Her reaction was way funnier than the climax to his story, which was that he came around the side of the truck and heard his wife whispering niff to the reindeer to see if it was true, and he laughed at her.

LeeLee knows what's up. "Niff"??? Really. What the hell IS that?

Monday, December 13, 2010

Picture David Letterman reading this aloud

Top Ten Ways you know Polly had a Difficult Shift
(her first evening shift off training, to boot!)

10. She missed the nurse giving report because she had to run and catch a man that was trying to walk but couldn't.

9. During report, she would have discovered that not only couldn't this man walk, but he was trying to because he needed to poo approximately every ten minutes.

8. She also would have found out that she needed to obtain a urine sample.

7. Since coworkers filled her in, she got the urine sample. And also got her own pants covered with someone else's tarry black poo.

6. The highlight of her night was when one old lady, overhearing another one screaming away in the shower room, looked at her and said "Is that YOUR baby?!?" incredulously.

5. Her proudest achievement of the evening was a toss-up between getting one lady to drink her milk by spoon-feeding it to her, and getting another to remove her dentures.

4. 10pm found her so sweaty from transferring this suddenly non-weight-bearing man that she needed to change all her clothes.

3. 11pm finds her in clean clothes, muscles so knotted that her husband gave her a drink before even trying to un-knot her shoulders.

2. She walked in the door wearing highwater stretchy corduroy pants from the lost and found, because her own scrubs were covered in that black tarry poo from before.

1. Contents of Polly's car: 1 pair scrubs, bagged up, waiting to be laundered and disinfected. One empty diet coke.

Saturday, December 11, 2010

Up to the minute technology

Okay not really. But I do like to try out new little tech stuff, even though I barely ever actually KEEP using it (sorry foursquare, I abandoned you a long time ago). So I was listening to one of the podcasts I like and they were answering questions they received via formspring. So now I have a formspring. Which I know very little about.

Basically it's so anyone can ask me questions anonymously, it seems like. In that little pink box over there to the right. And then I'll answer them, woo-hoo!

Let's all give it a shot and see if we can figure it out, huh?

And as long as we're on the topic of podcasts, here are some that I love:

1. The Nursing Show: News, Tips, and Commentary for Nurses and Students
(usually really, really informative and up to date, plus I LOVE the interviews with people that work in different branches of nursing and hearing how they ended up there).

2. Stuff You Should Know
(short overviews of a huge variety of topics, from Jack the Ripper to saunas to why we feel full after eating. Handy and entertaining).

3. Answer Bitch
(hollywood gossip & news, very funny, awesome for long drives or while I'm doing the dishes).

You can find any of them by searching in iTunes or whatever it is you use to listen to podcasts.

Formspring me!

Wednesday, December 8, 2010

Odds & Ends

I finished up my evening shift training this week, and it's official: I like 2nd shift better. Not having to wake up at 5am is a big plus, as is only having one meal (dinner) during the shift. The sundowning residents are a drawback. The biggest reason is the coworkers, though. The eve shift coworkers are much more laid back and helpful - day shift coworkers have (99% of the time) been helpful with me (probably because I'm new) but with one another? Not always. Plus one showed up with a disgusting infected finger and was about to go out on the floor to work until we all basically tackled her and got the charge nurse to look at it and send her to a clinic STAT. Ew. No common sense on that coworker, that's for sure.

Tip for the common sense impaired: if any part of your body is swollen and infected, and especially if it's leaking pus, GO HOME AND GO TO THE DOCTOR. Infection can spread to your bloodstream and kill you.

Moving on.

Funniest conversation I had with a resident this week:

Lady (freshly out of the shower, seated safely on dry chair & towel): Can you dry my back?

Me: Sure, here we go.

Coworker pops in, hands me a med cup full of ointment: This is her ointment from the nurse, can you put it on when you do her pericare?

Me: Sure, where?

Coworker: (makes incomprehensible hand gestures)

Me: Bottom or vagina?

Coworker: vagina.

Me: okay thanks.

Lady: Are you gonna put that on my vagina?

Me: Yes Ma'm, I am.

Lady: Do you know what you're doing?

Me: Yes Ma'm, I have my gloves on so I won't give you any germs, and I do know how to do this.

Lady: Well... all right then. Wait a minute. Are you married? (giving me the suspicious stink-eye)

Me (heroically not laughing): Yes Ms. Smith, I'm married. I promise this will not be a personal thrill for me, I just want you to stay healthy, and this is my job. Okay?

Lady (relived): Oh all right then.

I swear, I never know what these people are going to come up with. And what was up with my coworker's crazy gestures? I'm going to do that to her next time I see her. In no world is what she did a gesture for vagina. Maybe "pick up a lobster this way" or "the elves heads are shaped this way" but not "vagina not hiney".

Coolest medical phenomenon I saw this week: Raynaud's phenomenon. It's not harmful or painful or anything, just a startling color change in extremeties when someone is exposed to temperature change. Such as getting out of a warm shower. One of my resident's fingers looked a lot like this photo from wikipedia (the bananafingers not the blue ones). Charge nurse checked and confirmed that was all it was, and they were back to normal very quickly. I'd heard about Raynaud's on a podcast but hadn't seen it in person before, so that was cool.

Other than that, I'm doing my state-required training for the last 3 days of the week, so that'll be boring but maybe useful, and definitely not too tough. Which is good since I burned up my throat with an unfortunate burrito-from-taco-truck choice yesterday and it's still sore, so it's nice not to have to speak EXTRA LOUD for anyone for a bit. Sidenote - wish I could handle spicy food better.

Tuesday, December 7, 2010


Sometimes I want to hate doctors for no reason. Sometimes I probably wouldn't hate them for whatever if I actually understood what their reasoning is for things. This is probably one of those times. There must be a perfectly good reason for requiring a clean-catch urine sample to diagnose a UTI even if the patient has had UTI's in the past and the care staff can easily recognize the signs. Even if the nurse could do a dip on a regular sample or send that out to the lab for verification.

(note: UTI = urinary tract infection; little old ladies get these a lot and they can cause pain, low-grade fever and increased confusion. They're fixable with antibiotics.)

But it seems stupid and mean to me, the lowly caregiver, that we have to hold still a really sweet lady with dementia, and the nurse has to put in a catheter for a few seconds so we can get that elusive clean-catch urine sample. We were all almost in tears at the end of it; I held one hand and food, a coworker held the other two, the nurse did the cath, and another caregiver held the light for the nurse so she could do it as fast and accurately as possible. Our poor resident was upset, we were upset, and I thought the Doctor Is Stupid. We got our resident cleaned up and into jammies and tucked into bed, and then she was okay.

I hope there's some good reason for this though. Or if not, that we don't have to do this to my poor resident again.

Sunday, December 5, 2010

Huh, that's a new one.

Even though dementia progresses differently for everyone, there are certain little quirks that a lot of my residents share. I don't know why, and can't pretend to. I'll leave that to the more educated people. I bet you can find them by googling.

But here's my incomplete list of Weird Stuff that you might notice your Wife/Mom/Grandpa doing that never used to happen:

1. Dressing in lots and lots of layers.
I have no idea why people do this, but a lot of them do. I can name at least 6 of my residents that I MUST get up and dressed by 6:45 am because if I'm too slow in arriving to cue them, they'll come out wearing several pairs of pants (some backwards, some zipped, some not), a robe with a t-shirt on top of it, no underwear on but some in their pockets, and one shoe. This is so common that at my facility, all the people's closet doors are lockable in order to prevent this, peeing into closets (men do that one) or rummaging through their neighbor's things.

2. Eating really, really slowly and maybe falling asleep during meals.
The sleep thing is probably because days and nights don't necessarily mean a lot to these folks, so they get tired whenever they're tired. Sometimes it's from meds, but not always. And the eating slowly is just generally because they don't seem to process hunger the same way and get distracted from tasks (like eating) easily. In more advanced stages, they're likely to have trouble chewing and swallowing, but softened or pureed foods can fix that.

3. Having trouble with physical sensations, especially with verbalizing them.
Someone with dementia might feel cold all the time, even when sweaty and piled with blankets. Or insist they're too hot even though they've got goosebumps. Or holler at me that the shower water is burning even when it's lukewarm. And then when I have them test it again a second later without me touching the temperature dial, it's fine or chilly. Or be hungry one second and then not a minute later. Saying they don't need to go to the bathroom but then peeing for ages once you finally get them to sit on the toilet. This is why caregivers usually go by physical cues for assessing pain and temperatures, and by the clock for eating/toileting.

4. Spontaneous emotional outbursts.
I think this one has to do with the part of the brain that used to inhibit emotional displays no longer acting as gatekeeper. That's why someone might burst into tears or laughter for no apparent reason. And might not know they're doing it. Usually pretty short in duration.

5. Difficulty with noticing surroundings.
This could be because their field of vision has narrowed, or because colors look the same to them now, or for some other biological reason I have no clue about. All I know is, if I want someone to sit down, and they don't seem aware that there really is a chair behind them, they do better if I take their hand and put it behind them onto the armrest, pat the seat loudly, put gentle pressure on their shoulders, and say "Bend your knees now. Bend your knees." Or sometimes even if the place I'm taking them is a few more steps away, I should still hold both their hands, face them, and back up to it that way so they don't change directions suddenly. I don't really understand this one either, but I've definitely noticed that pointing and saying "right over there" isn't good enough for most people to get them there. I need to take them all the way over there.

Saturday, December 4, 2010

Why Dementia?

I was thinking about this last night, and then talked about it with a friend (hi Annie!) on the phone today; not everyone likes being around people with dementia and taking care of them, so why do I?

First of all, I don't always like all my residents. There are a few who really only react to anyone with physical aggression - no matter what you do, they're hell bent on hitting, scratching, spitting on, and choking you. Those few, I figure I just missed the window where they were able to get through their disease enough to react better, and now all I can do is provide the minimum care needed to keep them safe without either of us getting hurt. I don't get all fancy and try to put makeup on them or anything, because I know they won't enjoy it. And I don't have to like them, I just need to do my job and take care of them, so I do.

That's a very small percentage though. The rest have their quirks and behaviors for sure, but I genuinely really like them and enjoy taking care of them, even as they get further into their diseases.

It's hard to explain exactly why it doesn't really occur to me to think that watching someones dementia progress is depressing. The best I can liken it to is that my husband used to be a special ed. teacher, and would get all kinds of idiotic comments when he told people what he did for a living. "That's so sad! I would cry every day because those kids aren't fixable" or "That must be so HARD" or "You must be really special to be able to handle THAT all day". He'd always get mad because he didn't view his students as broken or worthless or burdens any more than any other kid. The kids don't hate their lives; they don't know any different, and have always been who they are. And sure sometimes they were pains, but every kid is sometimes. And sometimes they were very funny and fun and loving, just like any other kid.

I feel pretty similarly about my residents. I didn't know them before they got sick so I don't know any better than to expect them to be however they happen to be right now. And I pretty much like them how they are right now. And will still like them even as they decline. Knowing them when they're only somewhat confused makes the end/rageful stage (not everyone does this) easier to handle.

I think it's pleasanter to take care of someone who is in the permanently-combative stage if you know a little more about who they used to be. I always appreciate when I step out of the bathroom after getting a beat-down, my hair all askew, nametag crooked, covered in sweat and disinfecting myself like mad, one of my coworkers says "You know, Lily never used to be like that. When she first came here, she used to play the piano and try to tuck the other residents in at night. She was a cool lady." It makes it easier to go back in and face the Lily that's kicking me, if I can hold that picture in my mind and be trying to care for that past Lily even though she's gone already.

It's sad when someone is in the self-aware stage of the disease, and knows they're losing their memory and is powerless to stop it. It's sad because they're sad. But once they pass that phase and are living in the moment, they're often pretty content, and if not, then I can help them feel better usually. So that's not sad anymore.

With the rare residents/clients that I knew before they got so confused, it's more sad to me. Mainly just because I miss them, and I know that if they were aware of the whole situation, they'd be upset that they were missing out on so much. And I do understand that's where most family members are coming from, and it's really hard on them. It's easier for me because I usually get to live in the moment with my residents without mourning the past.

I think my favorite thing about working with people with dementia is the immediacy. I don't have to spend a lot of time building a relationship with a resident before they will trust me. If they like the way I interact with them, they'll probably go ahead and help me do what we need to do. If they like me, I get kisses right then. It's great, and very clear. And if they don't like me? I can go away, come back, and try again with a clean slate.

That probably sounds really lazy on my part. But it's true - I like the simplicity of my relationships with my residents. Affection flows freely and quickly, and anger vanishes fast, for the most part. Who wouldn't find that personality type easier to care for than someone who bickers and holds grudges? Right?