Demanding residents

JustBeachyNurse, LPN · May 30, 2012

Could still be depression/loneliness, Have you spoken with her nurse about your concerns? Does she get visitors? Refusing activities and barely participating in care does not indicate that she isn't lonely. It is a behavior that does need to be modified, however, as a CNA, you need to work with her nurse and/or social worker to come up with a behavior modification plan and limit setting.

Rhonduh · May 30, 2012

I currently work in an assisted care facility and we had a resident who would pull her light for us to turn down her her bed and throw her newspaper away. :madface: Some even push their pendants in the middle of us serving a meal because they want a napkin or straw............

Kitsey · May 30, 2012

I've got a resident like that...he puts on his light to ask what time it is (clock is right on his nightstand) to fluff pillows, cover/uncover him (he is care planned independent in his room BTW), turn fan on, 5 min later turn fan off. Open/shut window, change the channel, etc. My favorites are when he presses the call light because he can't find the call light....(yup...) and the time a few weeks ago when he called 911 cause the AC wasn't turned on yet. He likes to tell us that he pays $12,000 a month to live there so he can press that light as much as he wants.

fuzzywuzzy, CNA · May 30, 2012

Residents that ring constantly for stupid stuff usually just want tons of attention. Unfortunately for them, the more they interrupt us, the less attention we are able to provide, and the quality of the attention they receive also goes down when they are just wasting time for the sake of keeping you in the room as long as possible. It sucks on 2nd shift because everyone goes to bed... on day shift, there are 2 meals to keep them occupied, more activities (although our activities department is pretty pathetic), and if someone is acting up you can sit them in the hall with another resident and sometimes they will talk to one another. Sometimes I wonder if certain residents are truly "sundowning" or if they're just acting up because the early evening/night is the most boring part of the day.

I have to admit that personally this is something that really annoys me... constantly having to drop what i'm doing with other residents to go running to someone who is setting off their alarm, yelling, or telling everyone who walks by that they have to go to the bathroom when you KNOW they don't and they just want attention (vs someone who is just plain confused, which doesn't bother me at all). I understand why they do it, but it doesn't make it easier for me to deal with and I end up not wanting to spend extra time with a lot of these residents even though I know it would help with their behavior. I find that they act up more when they can see you paying attention to another resident and they always suddenly "need" the same thing as that resident just got, so I usually shut the door even if I'm doing something that doesn't require privacy. Otherwise they will watch you tend to the other resident and yell the entire time. During less busy times of the day it sometimes helps if you can have them sit with you as you do your charting. And if they are ambulatory I try to take them on a really long walk and sometimes that tires them out.

Darkstar1485, BSN, CNA, LPN, RN · May 31, 2012

I work the 3rd shift and (by the grace of God) have residents that NEVER push the call button. i sometimes have to check to see if they are still alive.

That being said, at one time one of my residents (who is mentally and physically able do ADLs) used her call button so much that i wanted to ship her to another country. She would complain that she didn't like the food and demanded the chef make a meal specifically for her, she would also not eat dinner and then tell me that she was hungry and wanted a meal even though the kitchen was closed and i don't have access. she would refuse to eat in the dining room and request all meals be brought to her in bed. she would also pee in her depend on purpose and ask to be changed even though she was not incontinent.

Finally The manager couldn't take it anymore and told the staff to stop babying her. we would not entertain her outrageous requests no matter what. if the doctor said that she was mentally and physically able to do a task, we could not do it for her. if she did not want to eat dinner, and got hungry after hours, a PB+J sandwich would be offered and nothing else. if she wet her depend we would tell her to remove it and wash only giving verbal prompts. i thought this method was cruel, but it did work. she stopped being so demanding and started doing things for herself.

i notice that residents use call lights often to gain control bc they feel like they no longer have control over their lives. they cant control their lives, so they'll control yours.

funtimes · May 31, 2012

I've generally found theres often a gender difference when it comes to people who ring the call light continually. The women tend to do it because they are lonely and just want company, but some of the men who do this seem to be on a power trip. The call light seems to give them a sense of control and authority in a situation where they have lost their independance. I always figured some of them were domineering man of the house types who are having trouble adjusting to their present situation.

I remember one guy who would hit his call light, then angrily bark out orders like he was a drill sgt. Fix that table!, Gimme my damn remote! and close those shades, what are you trying to blind me with the sun!!! Whats wrong with you people!!!

amoLucia · Jun 2, 2012

To Darkstar (post #5) - Your last paragraph is so very right on target.

Tp funtimes (post #6) - Your post is enlightening to me. As an RN of 38 yrs, I never thought of demanding-ness in respect to gender. But yes .. makes sense to me. Learned something new. TY TY TY Also, you're right about military types giving orders.

To OP - Different things work for different people. If there's a dementia, there's no guarantee that anything might work with any great success at all. Just be honest, don't make false promises and be realistic. Good luck:hug:

mstearns09 · Jun 2, 2012

Thanks for all the replies!

This resident does receive visitors and she still rings her call light as often as she does without visitors. My most frustrating moment with her was the day she clearly saw me feeding another resident in the dining room and wanted me to take her back to her room. The resident sitting next to her told her to keep quiet and to stop bugging me because I was busy. We have to use a sit-to-stand with her and she always tells us to not raise her but a few inches out of her wheelchair because it's painful. I understand and acknowledge her pain but it's impossible for us to do peri-care when she's only 2 inches above her commode or the toilet. I think part of it is that it's a power trip for her to have someone at her beck and call. She acts oblivious the needs of other residents (such as the case of the night she wanted me to stop feeding someone to take her back to her room), even her own roommate.

So far, I've maintained with my original plan with taking care of her and it works most of the time; I've explained my method to some of the other aides and they've have varying degrees of success with it, too. As far as I know, she has no diagnosis of dementia or other cognitive impairments.

mindyfromcali · Jun 2, 2012

If you're doing pericare and she's sitting down, you can't transfer her to a shower chair? We used those a lot in the facility I worked at for Residents who had trouble standing up. We would just keep the majority of them in their bathrooms, locked kinda like a commode over the toilet.

Skayda · Jun 2, 2012

I know exactly where you are coming from. I work in a five-resident, (soon to be six), AFH and we have one resident who will buzz me to come help her on and off her bedside commode or to ask when she gets her meds next, etc. In our facility the residents are only suppose to use their call buzzers in a dire emergency like for falls, etc but not for help with the bathroom; especially seeing as how this resident is perfectly able to walk the short distance from her bed to her commode during the night and during the day she almost speedwalks with her walker from her room to the bathroom off the kitchen area and does everything herself just fine. All of the residents here are able to walk to the bathroom, dress and undress themselves and change their own briefs which is very nice. I just help with bathing, except for one who showers all by herself with no help at all, meal prep, meds and housework. The type of call buzzers we use are five small medalion-like buttons that are located in each person's room near their bed caus

Skayda · Jun 2, 2012

I know exactly where you are coming from. I work in a five-resident, (soon to be six), AFH and we have one resident who will buzz me to come help her on and off her bedside commode or to ask when she gets her meds next, etc. In our facility the residents are only suppose to use their call buzzers in a dire emergency like for falls, etc but not for help with the bathroom; especially seeing as how this resident is perfectly able to walk the short distance from her bed to her commode during the night and during the day she almost speedwalks with her walker from her room to the bathroom off the kitchen area and does everything herself just fine. All of the residents here are able to walk to the bathroom, dress and undress themselves and change their own briefs which is very nice. I just help with bathing, except for one who showers all by herself with no help at all, meal prep, meds and housework. The type of call buzzers we use are five small medalion-like buttons that are located in each person's room near their bed cause they only need them at night since during the day the place is small enough that I can hear everyone from anywhere in the house. And the buzzers are hooked up electronically to a larger monitor type machine that will call out the number of the buzzer pushed in this loud obnoxious woman's voice. The monitor is located in the basement where I sleep but its loud enough that I can hear it from up stairs if its engaged. The worst is when a resident presses their buzzer during the day for asinine reasons like the ones people have mentioned and I have to stop what I'm doing and go all the way down stairs to hit the reset button on the monitor and quiet the call buzzer voice! But, then, we have one resident who is the complete opposite of the buzzer-happy one and this one will outright refuse to press her buzzer! About a week ago she fell out of bed at night and hit her eye and wrist on the side of her nightstand, got herself back up and into bed and the caregiver working that night/morning didn't find out about what happened until she went to do morning care for her and the resident told her what happened. The caregiver was all; "Why didn't you buzz me!?" And the resident goes; "Oh, honey, you have enough to do!" Oh, this is the same resident who, by the way, is always complaining about the food, calls her family to bring different food if she didn't like what was for dinner, she told the main boss that we have been making spaghetti all week long when I know I'be only made spaghetti twice in like two months so now the boss is having us caregivers take pictures of the dinners we cook with a digital camera! The lady who buzzes me early am to ask about her next dose of tylonel or for help with her bedside commode has also been know to use her phone to call 911 if we are late with her glass of water! The other weekend she buzzed me at 4:30 am and said she thinks she's having a hear attack. I said well, "I better call the paramedics." She goes "I don't need them. I just need my tylenol. Can I have it now?" I told her that I didn't feel comfortable doing nothing after her thinking she might be having a heart attack so against her wishes, cause all she really wanted was me to give her her routine breakfast meds way too early, I called the paramedics and they hauled her down to the hospital for the required testing etc where she got to spend the better part of the morning and I doubt they let her get much rest there. But we have to take anything that concerns the heart seriously and even if we know its a cry wolf for attention or something else, (unlock the Med room at 4 in the morning, etc), we still have to act as though its real cause next time it really might be!