Getting Over Workplace Challenges

[Alpacalia]

I work with an individual who was diagnosed with a fatal form of a disease that affects cognitive impairment. I've only been assisting for a short time, it is becoming more and more difficult to see them in distress, and think about the day they will pass on (it could happen a month from now or a year from now). I'm accustomed to working in hospitals and interacting with patients (albeit briefly as my career in healthcare is just beginning), but this individual seems to tug at my heartstrings a bit more for some reason (?).

I don't know. It's been weighing on my mind a bit. I'm just trying to figure out how to navigate these feelings.

It is a worrying situation, and I am feeling pretty sad about it at the moment. I want to do the best job I can and be a good source of support.

Edited July 27, 2022 by Alpacalia

[FMW]

I don't have any good advice for you, I just wanted to say I sympathize with what you're experiencing.

My mother is an RN, retired now, and she was and is always good at being right there and supportive with people facing terminal situations.  I, on the other hand, have a hard time keeping the tears out of my eyes, which obviously isn't helpful to them.   

Maybe focus on the fact that they have touched you in a special way and so you want to do your very best in helping things be as smooth for them as possible for the time they have left.  Try looking it as a problem-solving exercise so that your thoughts are focused in that way to distract from your natural internal emotional response.  

I wish you strength.  

[Wiseman2]

It's crucial to  balance compassion/empathy with healthy detachment. Otherwise healthcare provider burnout happens quickly. 

[glows]

It’s ok to feel sad. 

Be good to yourself also and maintain a strong support network in your off-time. You’ll be more comfortable with the ebb and flow at work with time. 

[Alpacalia]

8 hours ago, FMW said:

I don't have any good advice for you, I just wanted to say I sympathize with what you're experiencing.

My mother is an RN, retired now, and she was and is always good at being right there and supportive with people facing terminal situations.  I, on the other hand, have a hard time keeping the tears out of my eyes, which obviously isn't helpful to them.   

Maybe focus on the fact that they have touched you in a special way and so you want to do your very best in helping things be as smooth for them as possible for the time they have left.  Try looking it as a problem-solving exercise so that your thoughts are focused in that way to distract from your natural internal emotional response.  

I wish you strength.  

Thank you, FMW.

Nice to hear about your mother. Not sure I could be a nurse. Such a tough career.

I'm trying to get into a Nuclear Medicine program after radiology (for PET) and will be interacting with a lot of cancer patients so it's definitely getting my feet wet.

I found myself moping around the other day. Became pretty teary eyed. So I feel what you're saying!

This individual has such an amazing (positive) outlook about it though. Kind of makes me in awe. 

Your comment about a problem-solving exercise is a great way to look at it and will give it a try! Definitely can't hurt to find some methods to work these thoughts and feelings out.

6 hours ago, glows said:

It’s ok to feel sad. 

Be good to yourself also and maintain a strong support network in your off-time. You’ll be more comfortable with the ebb and flow at work with time. 

Your posts always cheer me up. Thank you!

I have a nice strong support network (thank goodness).

It's a hard thing to navigate though since I'm limited on what I can share with them due to HIPAA. Mr. B (the man I'm seeing) has been pretty supportive too (dare not say boyfriend yet ) but I prefer not to unload all of that on him.

Kind of writing it out helps a little.

It's going to be a pretty challenging course load this year so not sure how to take it all in. The last few times I've hit the treadmill I get really dizzy and feeling faint and like my throat is closing so I think it's all tensing me up a bit. 

I have a nice trip planned for Las Vegas soon so at least I can unwind a bit before it all starts up.

Edited July 27, 2022 by Alpacalia

[Wiseman2]

18 hours ago, Alpacalia said:

It's a hard thing to navigate though since I'm limited on what I can share 

That's ok. Shift gears when you are not at work. Leave work in the workplace. Be compassionate with patients, but do not get teary or emotional about it.

[Alpacalia]

Not at all.

I don't get teary-eyed at work.

It's after I leave work I felt a bit bummed.

 

Edited July 29, 2022 by Alpacalia

[BaileyB]

I just lost a long term coworker and friend to breast cancer this past week. It’s brutal. 

That said, having worked with families for years with children who are not well and/or palliative, I took comfort in the fact that I was working to make the worst time in their life somehow better/easier for them. Whether that was providing a service, listening, or sometimes ignoring the obvious and bringing some normalcy/kindness/or even humour to the interaction. It was important to talk with other co-workers - we talked about our feelings and supported each other. Is there another coworker or supervisor that you could talk with? Or, do you have an employee assistance program? 

[Alpacalia]

1 minute ago, BaileyB said:

I just lost a long term coworker and friend to breast cancer this past week. It’s brutal. 

That said, having worked with families for years with children who are not well and/or palliative, I took comfort in the fact that I was working to make the worst time in their life somehow better/easier for them. Whether that was providing a service, listening, or sometimes ignoring the obvious and bringing some normalcy/kindness/or even humour to the interaction. It was important to talk with other co-workers - we talked about our feelings and supported each other. Is there another coworker or supervisor that you could talk with? Or, do you have an employee assistance program? 

I am so sorry to hear that. My deepest condolences are extended to you.

In a way, yes, that does seem to be how I look at it.

Occasionally, I will bring him little lemon bars that he really enjoys, but there are other times, as well, when I find it so difficult to interact with him.

Earlier in the day he appears to be cognizant, but later in the day he just seems lulled into a state of mental detachment, so the next day seems to be groundhog day all over again.

Yes, there are other co-workers that I am working with as well. What a great idea that is. Although I am not certain how comfortable I am with discussing work issues with them, I would like to.

[Wiseman2]

8 hours ago, Alpacalia said:

Occasionally, I will bring him little lemon bars that he really enjoys.

Try to avoid this. It may seem like a nice gesture, but that's for his loved ones. It also contributes to burnout to become emotionally overinvolved like this.

Healthcare professionals can't really do their jobs well if they are acting like friends and family. It's important to remain objective and supportive in a professional, not personal, capacity. He has loved ones for that.

Edited August 14, 2022 by Wiseman2

[Wiseman2]

On 7/27/2022 at 4:20 PM, Alpacalia said:

Im trying to get into a Nuclear Medicine program after radiology (for PET) and will be interacting with a lot of cancer patients I'm limited on what I can share with them due to HIPAA. 

Wait. I'm confused. Is this a coworker or patient? If it's a co-worker why is HIPPA cited? If it's a patient, that's a whole different story.

[Alpacalia]

2 hours ago, Wiseman2 said:

Wait. I'm confused. Is this a coworker or patient? If it's a co-worker why is HIPPA cited? If it's a patient, that's a whole different story.

My apologies for the confusion.

The reason I mentioned the Nuclear Medicine program is that if accepted into the program, I would be interacting with a lot of cancer patients in particular so I need to learn to become accustomed to certain aspects (i.e. HIPPA, sensitive situations, etc.). Currently, I am enrolled in a radiology diagnostic imaging program.

That's why I wrote "so it's definitely getting my feet wet.".

As a student of diagnostic imaging, I freelance part-time doing administrative and project management work and volunteer in hospitals.

My current responsibilities with this particular individual (the focus of this post) include handling his business affairs and providing executive support. It is not my patient, but he has a debilitating cognitive disease. As an employee of this individual, I signed a contract that included provisions related to HIPAA business associates.

I hope that clarifies things!

I prefer not to talk about him too much, instead concentrating on remaining detached. I think you're right, though. Bringing lemon bars is probably not a good idea. 

[Wiseman2]

5 hours ago, Alpacalia said:

My current responsibilities with this particular individual (the focus of this post) include handling his business affairs and providing executive support. It is not my patient, but he has a debilitating cognitive disease. 

If you are in a caretaker roll, yes stay detached and professional.

[Alpacalia]

8 hours ago, Wiseman2 said:

If you are in a caretaker roll, yes stay detached and professional.

I will. I feel better about it now.

Thank you.

🙂

Edited August 15, 2022 by Alpacalia

[Alpacalia]

This job is proving to be a bit of a challenge for me.

His memory decline makes working with him extremely challenging.

The lion's share of our conversations are lost to him, so every time we have a conversation, it's like we're discussing exactly the same topic again and again. The feeling is as though time has stopped with your feet stuck in the sand and you cannot move forward.

Communicating with individuals with severe cognitive impairment related to memory is not a straightforward task. I need to understand what to do and what not to do.

In some ways, I don't expect any advice, I just need a chance to vent.

Maybe I need to pop open a bottle of wine and pour myself a glass!

 

Edited September 10, 2022 by Alpacalia

[Alpacalia]

Working in this particular environment with someone who has a particular form of dementia presents a unique challenge because they can't retain new information easily, and their short-term memory is impaired. His long-term memory is fine.

In the past, I have occasionally found myself saying things like, "remember when, x, y, z," or, "do you remember that I said, x, y, z?" when we're working together on a repetitive task or project together. Although I know that this is not the best way for me to say it, I myself sometimes forget that he does not remember certain things or details, so I need to reframe my vocabulary and language with him.

Using the word "remember" can't possibly be fun for him.

In view of the fact that he forgets and needs help jogging his memory or also forming new connections with retaining information, what words or phrases could I use instead of one that includes the word "remember?" It's not necessarily a medical question, just a matter of adjusting my vocabulary and phrases in my interactions with him.

Edited October 24, 2022 by Alpacalia

[Alpacalia]

I currently manage the business affairs of someone with a certain type of dementia by providing executive and project management support. Short-term memory impairment makes it difficult for him to recall new information. His long-term memory is excellent. The dementia diagnosis came not too long ago, so it has not progressed too far yet, but it will.

While we're working together on a task or project (especially ongoing ones), I sometimes forget to myself that his diagnosis comes with specific memory challenges, so I need to learn to reframe my language and vocabulary accordingly. It has happened to me a few times where I slip up and I've said to him, "remember when x, y, z," or "do you remember when I said x, y, z?"

"Remember" is not an appropriate word on my part in this working environment.

The problem of memorizing and recalling information is often complex for him, so I am looking for an alternative phrase that does not include "remember." What would be a good approach to this? Perhaps it would be more ideal if I simply ask him what he prefers? Trying to get accustomed to working in this type of environment is a bit of a learning process for me too since this is new to me.

Also, he's started swearing a little at work. It's not directed at me at all, but it does occur occasionally when he is describing a situation. My feelings about it are a bit uneasy. Not that he is saying curse words per se. I realize that given the situation it is not uncommon for there to be cursing, hurling of insults. I am just concerned about the possibility of it being directed at me at some point and the appropriate response.

I don't know. If anyone has any general thoughts I'd appreciate it. 

Edited October 26, 2022 by Alpacalia

[FMW]

I think asking him how he wants you to handle bringing up previous conversations is the right move.  That way you are less likely to offend him resulting in more communication problems.  

As far as the swearing goes, let him know that you are uncomfortable with the language.  While he is capable of some control he should be expected to use it.  

But at some point he will no longer have control and you will have to make the difficult decision of ending your professional relationship.  Only you can determine how much you can handle.  Decide what is healthy for you and remove yourself when his behavior has crossed that boundary. If/when the cursing is aimed at you that will probably be your sign that you have helped all you can.

You're in a difficult situation, bless you for being willing to stay by him for a little longer.   

[Wiseman2]

10 hours ago, Alpacalia said:

 he's started swearing a little at work. It's not directed at me at all, but it does occur occasionally when he is describing a situation. 

Unfortunately poor executive functioning is the sine qua non of dementia. That includes unfiltered outbursts and some inappropriate behaviors. Poor recall is only one of the earliest and most well known symptoms.

All you can do is research dementia symptoms and management on a reputable medical site so you're aware of what is happening with him and how to cope with it. The key is managing it so you don't get burnout from dealing with it.

[ShyViolet]

How about

"Just following up on our conversation about x, y, z"

"We talked about x, y, z, last week.  I just wanted to discuss it/add a bit more..."

"Regarding x, y, z, that happened last Friday....

 

23 hours ago, Alpacalia said:

 Not that he is saying curse words per se. I realize that given the situation it is not uncommon for there to be cursing, hurling of insults. I am just concerned about the possibility of it being directed at me at some point and the appropriate response.

He has never directed it at you.  Stop worrying about something that hasn't even happened yet.  If it does happen, cross that bridge when you come to it.

[Alpacalia]

15 minutes ago, ShyViolet said:

How about

"Just following up on our conversation about x, y, z"

"We talked about x, y, z, last week.  I just wanted to discuss it/add a bit more..."

"Regarding x, y, z, that happened last Friday....

 

He has never directed it at you.  Stop worrying about something that hasn't even happened yet.  If it does happen, cross that bridge when you come to it.

Quite nice!

I decided to have a brief conversation with him this morning.

In my conversation with him today, I apologized if my wording came across as insensitive when I said things like, "Do you/don't you remember, did you forget that, X, Y, Z." That it is not intentional, just that sometimes I forget myself in this context. I then asked him if perhaps he had any phrases or words he would rather hear from my end. He was very pleased that I brought this up to him. He expressed his appreciation and said he would think of a few phrases or words that would feel more comfortable to him in the future.

Meanwhile, I like your suggestions on wording and I think I will take those on board along with the advice that you and other members have given me.

Thanks everyone!