Sometimes it happens that I start a song while I work. No birthday serenade for the colleague. Not even the catchy tune that has been hanging in my head for days. They are old German folk songs. Unfortunately, I don’t know many of them, but I’m glad that I can at least master “Thoughts are free”. The song has already helped me a number of times to get a grip on situations that just a moment ago seemed almost hopeless: When I am caring for a patient with severe dementia and he is no longer able to cope with his environment and the current situation comes. As soon as I have sung the first words, my patients usually join in – and calm down again.
People who suffer from dementia belong to a clientele of patients who require a lot of time and rest from us nurses. The fundamental problem: They are away from their usual environment, in which they know their way around, feel comfortable – in which they are at home. Strictly speaking, this applies to every patient. But with dementia, it makes them even more confused than they already are. Suddenly there are a lot of strangers in blue and with masks walking around, voices and various alarms can be heard everywhere, it is about topics that they do not understand.
Our masks, in particular, are a big problem for people with dementia. They often no longer understand what is being said, but they can actually still grasp the facial expressions of their counterparts correctly. Due to the fact that the mouth is now, so to speak, moving when speaking, the affected people no longer register in some cases that one is communicating with them at all. That makes it extremely difficult to explain to them why they have hip pain, for example – it has long been forgotten that they fell and therefore just had a hip operation. But of course we try anyway. Again and again.
In an intensive care unit, where so many seriously ill people are treated, it is often difficult to meet these special needs. The demented person is often not the sickest, but still requires a lot of time from us nurses. Otherwise, in the worst case, he will begin to behave in a self-endangering manner.
As a rule, we care for at least one person with dementia in the intensive care unit – and the number is likely to increase: According to the WHO, around 40 percent more people worldwide will be living with dementia by 2030 than today. When dealing with them, it is important that we keep picking up points from their long-term memory: What was your job? Do you have children? Or we just sing together “The thoughts are free”. Most of the time, this ensures that the demented people feel more comfortable. By the way: December 21st is World Alzheimer’s Day.
Julia Rettenberger is an intensive care nurse. In this column, the 27-year-old tells every week about her work at the district clinic in Ebersberg. The collected texts can be found under sueddeutsche.de/thema/Auf_Station.