Countering Negativity
EHN Ambulatory Care Manager Bonnie Jeanice has been working with an?80-year-old woman who spent the past 6 years in a nursing facility.
Bonnie reviewed her chart and found that the woman was very healthy overall.?The only lab value out of range was her electrolytes. She was on blood-pressure medication, and she recently had a new pacemaker?installed.
When Bonnie reached out to the woman’s caregiver, he confirmed that her biggest issue was her fluid intake. He also thought the woman would be hesitant to work with Bonnie because she was so quiet.
During Covid, the woman did not leave her room at her nursing facility except for the occasional medical appointment. She admits spending about 16 hours a day in bed. Before Covid, the woman used a cane. After Covid, she was using a wheelchair to move around the facility.
The woman didn’t think Bonnie could do anything to help but agreed to talk with her weekly.
During their third call, Bonnie addressed fluid intake.?The woman had trouble making it to the bathroom in time, even though it was very close to her bedroom. This struggle developed because of her inactivity during Covid.
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Bonnie also learned?the woman missed coffee dates she used to have with her “girls”?on Tuesdays and Thursdays.?It became a chore to go?because she needed so much help to get downstairs to the coffee cart. And,?her friends had become negative. As much as the woman enjoyed the company, the conversation tended to depress her.
This is where?Bonnie’s goals?with the patient began. They would work up to?drinking eight glasses of water a day, including Jell-O, popsicles, juice. The woman would?use her wheelchair to get lunch out of her room.?Bed was now only for sleeping?at nighttime; an occasional one-hour nap was okay, but the woman would set an alarm. The woman would call both of her sons at least once a week and would start a?gratitude journal?and share her stories of gratitude with someone. She would also rejoin the coffee group with her “girls.” She would be prepared for the negativity and counter it with positivity.
The very next week, the woman went to her coffee meet up. When a negative topic came up, she said?“I don’t like all the negative comments. I am going to share three positive things.”?Another woman spoke up and said “I love that. I want to share, too.”?The group now starts with everyone sharing three positive things and is growing in size.
Now, four months into work with Bonnie, the woman is drinking six glasses of water a day. All her lab values are within normal limits. She only uses her bed at night and twice a week for naps. She has progressed from barely being able to walk outside her room to being able to walk back and forth the length of her hallway. She can almost travel to her coffee group alone. (Currently someone walks with her to the elevator.)
Bonnie says the woman is proud of herself, and you can hear it in her voice. Each week, she can’t wait to tell Bonnie something from the coffee girls, her sons, or just her improvements. She also vows to never use the wheelchair again.