Do I look like the kind of girl who carries a knife?
Pt who is pleasant but very garbled (“word salad”) was sitting next to me while I worked with another pt. She likes reading things and was glancing at my clipboard, so I handed her a blank SLUMS (its a one page cognitive assessment that asks basic questions) to look at and write on. She read the question out loud, “How much do you have left?” without reading the line above it which had to do with spending money. She answered, “Well, all of it! They ain't taken nothing!”
I also wrote “Patient X is so nice” for her to read, she read out loud “Patient X is fifty nice”…apparently I need to work on my handwriting, LOL.
She also said things (without pausing, like it all flows together appropriately) like “The bedtime has the stitching. There were three babies. Bob got shot in the head. Were you there yesterday? You are going to be my daughter in law soon. I saw that the money was there. Let me find the papers. Oh, there were snakes.”
I conversed with her randomly for easily 20+ minutes. Another pt, who is higher functioning and listening, was asking me later if I was telling the truth/understanding, because I'd respond to things she was saying, like “Wow. Really? Yes. I remember.” stuff like that.
Another pt was confused and trying to get off his seat-belt on his wheelchair. We didn't want him to because then he wears himself out walking and ends up needing a sedative to stop since he'll go to the point of falling down from exhaustion (a relatively common problem for some patients with dementia). He couldn't remember how to use the contraption at all and was fiddling with the belt part. He asked me, “Do you have a knife?” I said, “Mr X! Do I look like the kind of girl who carries a knife?” Mr X said “Well, scissors then”. I said “Miss Y [the tech] is looking for some scissors for you.” We had to keep kinda re-directing him by telling him we were checking on it, etc.
I recently had a pt who wasn't able to really follow anything verbal, but would imitate actions (like if I spread my hands out while talking, she'd do it too), and we were having a lull in group due to some interruption, like a nursing giving meds, so I started vogue-ing, and she joined me since she was imitating me, and then the lady with schizophrenia joined in for fun, etc…so we had a little Vogue pause. LOL
I really do crack me up…lol. Not in a way that makes fun of the patients, I just have fun WITH the patients…ya gotta laugh so you don't cry, right?
Well, I just did the CAM on my friend Suzy….a cognitive assessment. It took about 45 minutes. I wanted to practice since I'm doing it tomorrow on a real patient. It's got a lot of components to it, from explaining proverbs to making plans to reading, doing math, sequencing, mental manipulation, memory, etc. She felt stupid on some parts, but honestly it was all I could do to keep up with some of the sequential matching, so I felt stupid too, LOL.
Lester the lion kitty is so cute, I could croak with love. Hey I better go shower. Good night.