[tex]

Any suggestions on approaches in regard's to residents that are very combative verbally or physically and refuse meds/care?
Thanks Tex

[CoachCathy]

assume unhurried manner, allow time for responses, redirect as needed, respect personal space, establish convenient time to provide care (let the resident dictate), contact responsible party if inappropriate behaviors continue, document each time care is refused, call by name each time approached, use simple explanations, praise efforts, do not reinforce negative behaviors. Hope that helps!

[tex]

thank you so much................I have used some of these approaches and they do work. Do you work in the LTC setting? Just attempting to have care plans/ mds/ raps done before state comes in. My biggest problem is my social worker is mute, and I am doing all the approaches for things she should be doing. Been a MDS cordinator for one year now, use to have another MDS RN, that had done this for 5 years, but now she left, and I have all the responsiblity.,,,,,,,,,,,,,,,,,thanks so much tex

[km rn]

We have luck having another staff person act like a rescuer - e.g., "what is this person doing to you? ....here come with me - I'll help you". Also look at the times of the behavior - would pain medication help - is the resident combative cause he/she if stiff/sore after laying all night? We also stagger cares - some dementia residents can't tolerate having complete AM/HS cares done at once - break them up - oral cares and shaving may wait until later, etc.

[night owl]

In order to get anything done with some residents, I've found that "it's all in the way you approach a pt" that makes a world of difference, especially if you know he/she is a behavioral problem. Kill 'em with kindness and explain in simplest form what you want them to do... it usually works for me. If that doesn't work, tell them that maybe now isn't a good time and that you'll be back later. Speak in a soft, clear voice and in a calm relaxing manner. How does the saying go? You get more bees with honey than you do with vinegar. Then there's always the sledge hammer effect... ONLY KIDDING OF COURSE!

[tex]

thank you tex