I was hoping not to have occasion to write another column about tragedy so soon, but the terrible events at the Boston Marathon have prompted another look at how we deal within our facilities with distressing news.
In my previous article, Helping Your LTC Community Cope in the Wake of Hurricane Sandy, I offer post-disaster recommendations that are applicable in this situation. In this column, I focus on the amount of information we provide to residents about distressing outside events.
An aide was the first person who informed me about the shootings at Sandy Hook Elementary School last December, calling me into the dining room to see the news broadcast. “Children,” she said, “just little children. This is awful.” The TV was filled with images of horror and the dining room was filled with residents, all of who were in wheelchairs or recliners and most of whom had dementia. They were more or less trapped in there, watching repetitive distressing reports of a vulnerable population being inexplicably attacked.
Many residents talked about the children in their psychotherapy sessions that week. Staff members stopped me in the halls to comment and to be heard and comforted by the psychologist. My daughter is six years old, the same age as most of the Sandy Hook victims. I was present at work as needed and at home I skimmed the headlines and tried not to read the details.
Not long before Sandy Hook was Hurricane Sandy, the storm that flattened many parts of the East Coast. It also knocked out the television system at the nursing home for three days. When the subway was finally up and running again and I could get to work, I found the residents blissfully unaware of the extent of the damage and the frightening circumstances that existed during and after the hurricane. Yes, there were some new faces in the building as neighboring nursing home evacuees filled empty beds. But the residents had been spared the bulk of the mid-storm chaos and frightening uncertainty.
It made me think about limiting exposure to bad news, something I practice myself and regularly recommend to my depressed patients. As a long-term care psychologist, talking to people in distress in a sometimes gloomy environment, I seek in my off-hours to balance this with pleasant pastimes and diversions. Similarly, I’ll suggest that depressed residents take a “news vacation” and listen to music, talk with friends or watch a fun movie instead.
While it’s good to be informed, it’s also okay to protect oneself from the most heart-wrenching details of a tragedy. There are enough bad things happening to us personally — we don’t need to experience trauma vicariously, especially when we’re already feeling down or overwhelmed with stress.
Residents with dementia
For residents with moderate or advanced dementia, studies show that the emotional content of a situation remains with them even if they can’t recall the circumstances that prompted the emotions. The positive feelings generated by music therapy, for example, will remain after the show is over. It stands to reason therefore that the distress aroused by watching horrific events on television will remain after the channel has been changed.
I don’t see any good reason residents with dementia should be exposed to tragic events in the news. If they need to know because they’re personally affected by the event, the information can be delivered gently and privately, without disturbing details.
It’s understandable that staff members want more information about major events as they occur. We want to know what’s going on, to be able to act if the situation calls for it, to gain a sense of control over our unpredictable worlds.
As helpers for a vulnerable population, however, we need to put our needs behind those of our residents. We can listen to the news on the way home, read the Internet on our smartphones during break or talk with coworkers in the lunchroom.
There are many options to stay informed without exposing the residents to unnecessary distress and anxiety.
Keeping home a refuge
The facility is home for our residents. The dayroom is their living room. If we keep the worst of the news off the television, we give residents a choice about whether or not to listen to disturbing events. Those residents who want more information can read the newspaper, watch TV in their rooms or discuss the situation with friends and family.
Those residents who might not understand the news but comprehend the horror deserve to spend their days in a pleasant environment, especially because most of them are unable to leave the room themselves.
To donate funds or to give blood in honor of those at the Boston Marathon, visit American Red Cross.
Eleanor Feldman Barbera, PhD, the author of The Savvy Resident’s Guide, is an accomplished speaker and consultant on psychological issues in long-term care. A long-time contributor to McKnight’s publications, this blog complements her award-winning website, MyBetterNursingHome.com, which has more on how to create long-term care where EVERYBODY thrives.