Family in Denial

Nurses General Nursing

Published

Hi Everyone,

Just need to vent I guess but how do you deal with a family that just can't get it in their head that momma has changed?I recently had a pt who was brought in after being kicked out of a nsg home because of her violent behavior toward staff. She was extremely violent the other night to the point we had to call security to help.The next day, her daughter saw my black eye and asked if it was her mothers doing, to which I replied yes. She then started crying saying this just wasn't like her mom:banghead: I'm sorry if it sounds like I don't care, I do, very much, but gosh what does it take for a family to finally admit and accept?

Specializes in ER, Med Surg,Drug Etoh, Psych.

The problem I am having with it all is that she requested me to tell her "please in detail" how her mother acted. She stated she had not been able to talk to any of the other nsg staff at the nsg home in person so she could really find out. I gave her the least painful version I could; she cried on my shoulder, thanked me, anmd then the next day complained to my bossess about how I had upset the whole family.To me, thats a weird kind of denial. The pt had grabbed my hair as I was drying her off from a bath, started pulling it hard and pulling my face toward her crotch yelling that Jesus would show me what to do.That was one of the nicer things, don't even ask what she did to the other RN and security.I just don't understand, if it was new onset it would be different but this has been occuring according to the nsg home notes for almost a year.

i need to understand a couple of things, please.

1. dtr asked you to explain in detail, and when you did, she lodged a complaint against you for upsetting the whole family??

2. this has been going on throughout the time the pt has been there, yet the dtr hasn't been able to speak to any other nurse?

are you the first nurse that has provided detailed examples of mom's behavior??

leslie

Specializes in Med Surg, LTC, Home Health.

Anytime i tell a family member of their loved one's misbehavior, i always try to alleviate their potential embarrassment by telling them that it common for dementia patients to act this way. It is not the first time we have experienced this with a patient, and it wont be the last. It makes them feel better to know that their loved one is not some "special" case exhibiting violent behavior. :)

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
anytime i tell a family member of their loved one's misbehavior, i always try to alleviate their potential embarrassment by telling them that it common for dementia patients to act this way. it is not the first time we have experienced this with a patient, and it wont be the last. it makes them feel better to know that their loved one is not some "special" case exhibiting violent behavior. :)

i know that you mean well, but that really does not help. knowing that it's common for dementia patients to exhibit violent behavior doesn't help one bit when it's my parent exhibiting the violent behavior, or even my parent-in-law. maybe i know too much, but my sisters-in-law and brother-in-law aren't in the health care field, and it doesn't help alleviate their potential embarrassement, either. your mileage may vary, of course.

Specializes in Med Surg, LTC, Home Health.
i know that you mean well, but that really does not help. knowing that it's common for dementia patients to exhibit violent behavior doesn't help one bit when it's my parent

it must be quite relative then, because i always sensed relief when family members realized that their parents werent "unusual" in their behaviors. i have taken care of dementia patients for 17 years, but for them it could be their first experience with it. if it were mine, i would certainly feel relief to know that it is not uncommon.:)

Specializes in ER, Med Surg,Drug Etoh, Psych.
i need to understand a couple of things, please.

1. dtr asked you to explain in detail, and when you did, she lodged a complaint against you for upsetting the whole family??

2. this has been going on throughout the time the pt has been there, yet the dtr hasn't been able to speak to any other nurse?

are you the first nurse that has provided detailed examples of mom's behavior??

leslie

Yes to all your questions, my co-workers have all charted the behavior and the rest of the family has been extremely nice ; they say they will love and care for her no matter what, and aplogize for the stuff she does so I know that the other nurses have spoke with them about her. This daughter who got upset with me; I still don't understand why;and to make matters worse, the boss is like "well just don't be so descriptive, tone down what you say". I did, they would have been horified and embarrassed if they knew the hallf of it !I don't know; guess I'm just feeling used and abused right now.:crying2:

who, maybe your social worker should get involved?

it sounds like the family is nearing crisis.

just keep meticulous notes and do not downplay pt's ms to family.

continue in being supportive, sympathetic yet truthful.

when's the last time psych has seen her?

leslie

Specializes in ER, Med Surg,Drug Etoh, Psych.
who, maybe your social worker should get involved?

it sounds like the family is nearing crisis.

just keep meticulous notes and do not downplay pt's ms to family.

continue in being supportive, sympathetic yet truthful.

when's the last time psych has seen her?

leslie

According to family, she has been in a nsg home for past 11 months, and the behavior has pretty much deteriorated the whole time, she was placed with us for "medication adjustment".Then our case mgr finds out the nsg home won't take her back and no one in the family will take her.As a matter of fact a friend of a friend of someone who works at the nsg home said the daughter I had problems with is the reason the pt can't go back !:cry:

According to family, she has been in a nsg home for past 11 months, and the behavior has pretty much deteriorated the whole time, she was placed with us for "medication adjustment".Then our case mgr finds out the nsg home won't take her back and no one in the family will take her.As a matter of fact a friend of a friend of someone who works at the nsg home said the daughter I had problems with is the reason the pt can't go back !:cry:

ah...

the nsg home won't take her back r/t the problems the dtr causes?

depending on how hard up your facility is for getting/keeping beds filled, the sw really have a 1:1 with the problem dtr, setting limits, and reminding her that her mom will be more difficult to place, r/t dtrs demands.

someone in mgmt, needs to talk to her.

dang, keep a private journal for your use only...

noting all encounters you have with her.

you never know when something you say/do, will come back and haunt you.

gotta be extra careful with family members like this.

leslie

Specializes in ICU./CCU/SICU.

Whodunit, maybe having the family present more often might help? Maybe if they see their mother hitting staff and being combative they would get the picture. Just a suggestion.

Specializes in ER, Med Surg,Drug Etoh, Psych.

Thanks for the suggestions;I am keeping notes and also won't go into the pts rm without another nurse or tech with me after 'momma" told them one of the bruises she got from fighting us was caused by us.I had told all other family members that altho we tried hard to keep from a pt hurting themselves while combative, it sometimes happened. Family was fine with this. Problem is she doesn't act out until everyone is gone.Our unit doesn't allow family members to stay so .... there you go !

Specializes in psych. rehab nursing, float pool.

It is not easy for family members to see their loved ones change from the people they once knew. It is a process they must go through it does not happen overnight. It takes time, it takes exploring medical avenues in hopes that something can be done to make their loved one be who they used to be. Finally, acceptance will come. I recall the first time I heard my father had struck someone. I was horrified, but somehow thought it must have been provoked by the other person. By incident two and three it was pretty clear he was dangerous to those around him.

I am sorry you got a black eye, try and remember though the patients are not themselves at all. They have become shells of their former selves. They look like themselves but no longer think or act like themselves. It is tragic.

Dementia, that long long road which robs everyone involved of the person they once knew and loved.

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