Saturday, January 19, 2013

MS dementia, PRN and Bigfoot

Whenever I’m picking Patti up and she hears the word dementia in conversation with staff she will often comment “I’m not f#cking demented!” I counter that “I did not say you were demented, I said you have MS symptoms of dementia”. She returns volley with “And I say you are an asshole man. (in Ahnold dialect)” … amusing herself with the pronunciation, she laughs and forgets how the whole stream began.

Pragmatically speaking, in the care facility era there certain areas where dementia (or MS symptoms of dementia) figure more prominently, at least for me.

PRN is an abbreviation of the Latin phrase “pro re nata”. Since this is not Latin class nor medical school for our purposes it basically means not scheduled medications and is “upon request” by the patient.

Staff has the traditional smiley and unhappy face chart to interpret for residents with dementia or cognitive symptoms who may be challenged to express pain, and/or request medication.

However it’s with other acute no-pain symptoms that the PRN system can unravel. Tacit vs explicit knowledge of any given resident’s current condition coupled with the ‘cover your ass’ philosophy of possible overnight or weekend temporary staff is not the best system to facilitate patients unable to direct their own health care.

Medical advocates, POA, even simply family and friends are the straw that stirs that drink. … ‘boots on the ground’ involvement is soooo necessary.

For example, Thursday night after getting Patti into bed I asked about her PRN Delsym for her cough at bedtime. A non-regular LPN covering the floor looks it up and remarks, “you know Patti has not asked for that since Monday night.” Truth be told, it was me not Patti who asked for it Monday night.

Then again her cough probably would not have been a problem if laughter, normally good medicine, had not grown to an ab crunching, eye watering, cant’ catch my breath crescendo as we found ourselves unable to tear ourselves away from “Finding Bigfoot” on the Animal Planet channel, in particular an episode with a dude named Bobo camping out in the woods, drinking, peeing on trees, and bellowing sasquatch calls.

Patrick Leer
Health Activist:
Caregivingly Yours, MS Caregiver @


  1. Delsym is the best cough medicine in my opinion; glad it was available to help Patti, especially after a particularly enjoyable evening!


    1. Betty is I had any clout, your 'bench with a view' would be sprouting a brand new Delsym billboard ad. :) Patti also likes it because it makes her sleepy.

  2. Certain words do that to me too, so I am in Patti's court here. (but I think you know I'm always in yours as well)

    1. Mary, that's the FUN of being in conversations with us - you can actually be in both our courts. :)

  3. We watched that on Monday too and now my 5 year old keeps telling me that Bigfoot is "reals." HE wasn't even in the room, he was in HIS room watching Nick JR. so I have no idea how he got that idea.

    1. Just a thought does Nick Jr have commercials from Animal Planet?


Blog Archive