I N D W E L L I N G C A T H E T E R S Your article on long-term indwelling catheters in the September-October issue, "Managing Indwelling Cathe- ters in the Home," was very interest- ing; however, one area was not cov- ered. What type of cleaning and storage procedures do you find to be cost effective and appropriate, as re- lated to infection control? These are always areas of interest to me as a staff development/infection-control nurse. CANDICE K. AUEL, RN, Lancaster

Living Center, Lancaster, W1

Authors' Reply: We advise that indwell- ing catheters be used only once and dis- carded, particularly in a home setting.

E N S U R I N G S A F E T Y We found your article in the March/ April issue, "How to Reduce Falls," to be interesting and informative. We are an extended-care facility with 180 skilled and intermediary care residents. Most of our popula- tion is 65 and older. Since January 1st of this year we have been con- ducting a study of in-house acci- dents, their precipitating factors, and primary preventive interven- tions. We developed our own assess- ment tool, which was designed spe- cifically with our residents in mind and included an individually written safety care plan.

Our study ends December 31, 1986, and we are anticipating a sig- nificant reduction in accidents. We have already noticed a reduction in falls from January to February and attribute this to our assessment tool a n d greater staff awareness of the problem.

Your article served to further ac- centuate the need for better staff awareness and individually written care plans to ensure the safety of each resident. RITA F. KOBB, RN, BSN, University

Nursing Care Center, Gainesville, FL

M E M O R I E S A W A K E N E D Relentlessly, the dimness en- croaches. In fleeting moments she, with the desperation of someone caught in quicksand, pulls herself out of the mire of confusion--only to fall and slip back in. She has Alz- heimer's Disease.

Each waking hour holds terror of the unknown. Words catch on her memory, take on meaning. But most words slide past her; she is a traveler in a foreign land. Day after day, sur- rounded by a cacaphony of voices, events, people, she wanders in search of a lost world. She picks at her clothing, pulling it apart, thread by thread, imitating the unraveling of her mind.

Then one day while she's sitting, a large doll is put on her lap. Old memories lovingly held, stir, awak- en, flower. With joyous clarity, she remembers. Stroking the rough, brown yarn hair, she brushes wisps away from blue embroidered eyes. She fingers the full gingham skirt and hesitantly peeks at ruffled un- derpants. Minute pass. Then with a graceful movement natural to any

mother, she cradles the doll close to her. She is alone no longer.

Those afflicted with Alzheimer's Disease need psychosocial support as much as physical care. The use of dolls as companions has been ex- tremely effective at our nursing home. For several years these large dolls, approximately three feet long, have served as companions for those with Alzheimer's. The staff does not regard the "companions" as "dolls or toys, but as channels through which clients can express emotions, inter- act, and obtain tactile, much needed stimulus. When a client hugs a com- panion or falls asleep holding one, it is obvious that some satisfaction has been received. The staff knows through long, caring interactions with people with Alzheimer's that they still have potential that needs to be tapped. Dolls as companions pro- vide one connecting link with the world that has forever changed for the Alzheimer's victim. KATHERINE DORSEY, RN, C, MS

SHIRLEY PURCELL, RN, MN Veterans Administration

Medical Center, Roseburg, OR

M A R I L Y N S C H W A B ' S J O U R N A L A V A I L A B L E F R O M B E N E D I C T I N E S Sister Marilyn Schwab, former prioress of the Benedictine Sisters and nationally known for her work in gerontology, spent most of her life working with the elderly and dying. She herself died on April 8, 1984. She started a journal shortly after being diagnosed as having a terminal illness. It traces her final months of life through day-to-day reflections that capture the essence of her per- sonal journey of faith.

A Gift Freely G i v e n - - T h e Person- al Journal o f S i s ter Mar i l yn Schwab, OSB was recently pub- lished and is being sold through the Benedictine Foundation of Oregon, with all proceeds going to the Bene-

172 Geriatric Nursing July/August 1986

LETTERS

INDWELLING CATHETERSYour article on long-term indwellingcatheters in the September-Octoberissue, "Managing Indwelling Cathe­ters in the Home," was very interest­ing; however, one area was not cov­ered. What type of cleaning andstorage procedures do you find to becost effective and appropriate, as re­lated to infection control? These arealways areas of interest to me as astaff development/infection-controlnurse.CANDICE K. AUEL, RN, Lancaster

Living Center, Lancaster, WI

Authors' Reply: We advise that indwell­ing catheters be used only once and dis­carded, particularly in a home setting.

ENSURING SAFETYWe found your article in the MarchiApril issue, "How to Reduce Falls,"to be interesting and informative.We are an extended-care facilitywith 180 skilled and intermediarycare residents. Most of our popula­tion is 65 and older. Since January1st of this year we have been con­ducting a study of in-house acci­dents, their precipitating factors,and primary preventive interven­tions. We developed our own assess­ment tool, which was designed spe­cifically with our residents in mindand included an individually writtensafety care plan.

Our study ends December 31,1986, and we are anticipating a sig­nificant reduction in accidents. Wehave already noticed a reduction infalls from January to February andattribute this to our assessment tooland greater staff awareness of theproblem.

Your article served to further ac­centuate the need for better staffawareness and individually writtencare plans to ensure the safety ofeach resident.RITA F. KOBB, RN, BSN, University

Nursing Care Center, Gainesville, FL

172 Geriatric Nursing July/August 1986

MEMORIES AWAKENEDRelentlessly, the dimness en­croaches. In fleeting moments she,with the desperation of someonecaught in quicksand, pulls herselfout of the mire of confusion-only tofall and slip back in. She has Alz­heimer's Disease.

Each waking hour holds terror ofthe unknown. Words catch on hermemory, take on meaning. But mostwords slide past her; she is a travelerin a foreign land, Day after day, sur­rounded by a cacaphony of voices,events, people, she wanders in searchof a lost world. She picks at herclothing, pulling it apart, thread bythread, imitating the unraveling ofher mind.

Then one day while she's sitting, alarge doll is put on her lap. Oldmemories lovingly held, stir, awak­en, flower. With joyous clarity, sheremembers. Stroking the rough,brown yarn hair, she brushes wispsaway from blue embroidered eyes.She fingers the full gingham skirtand hesitantly peeks at ruffled un­derpants. Minute pass. Then with agraceful movement natural to any

mother, she cradles the doll close toher. She is alone no longer.

Those afflicted with Alzheimer'sDisease need psychosocial support asmuch as physical care. The use ofdolls as companions has been ex­tremely effective at our nursinghome. For several years these largedolls, approximately three feet long,have served as companions for thosewith Alzheimer's. The staff does notregard the "companions" as 'dolls ortoys, but as channels through whichclients can express emotions, inter­act, and obtain tactile, much neededstimulus. When a client hugs a com­panion or falls asleep holding one, itis obvious that some satisfaction hasbeen received. The staff knowsthrough long, caring interactionswith people with Alzheimer's thatthey still have potential that needs tobe tapped. Dolls as companions pro­vide one connecting link with theworld that has forever changed forthe Alzheimer's victim.KATHERINE DORSEY, RN, C, MS

SHIRLEY PURCELL, RN, MNVeterans Administration

Medical Center, Roseburg. OR

MARILYN SCHWAB'SJOURNAL AVAILABLEFROM BENEDICTINESSister Marilyn Schwab, formerprioress of the Benedictine Sistersand nationally known for her work ingerontology, spent most of her lifeworking with the elderly and dying.She herself died on April 8, 1984.She started a journal shortly afterbeing diagnosed as having a terminalillness. It traces her final months oflife through day-to-day reflectionsthat capture the essence of her per­sonal journey of faith.

A Gift Freely Given-The Person­al Journal of Sister MarilynSchwab, aSH was recently pub­lished and is being sold through theBenedictine Foundation of Oregon,with all proceeds going to the Bene-