alzheimers res w/ combative behaviors

[allezelenfer]

What is the stigma of charting combative behaviors that upper level management have to hide?? For instance: I charted on one of our res behaviors - she was hard to redirect, slapping/hitting/pushing staff who tried to redirect her to sitting in her chair or eat dinner. She then proceeded to raise a hand to another res out of no where and removing her from the scene and placing her at nurses station w/ diversional activity. - i charted all that ( even the raising the fist as if she was going to hit another res w/ out reason ) yet, the upper managment state that i shouldn've charted this and removed it.. They tell us to CHART EVERYTHING.. yet behaviors and psychotic behaviors are a no no in charts!!!

[SuesquatchRN, BSN, RN]

She was pulling her hand back in a fist about to hit another res right before we intervened.. so do they still have to report that to state?

It depends on your state. In NY, no. But I sure as hell do an incident report, a note about her aggression, care plan the heck out of it, separate them, start behavior monitoring sheets, and immediately notify the DON and admin and Social Services no matter the time.

[CapeCodMermaid, RN]

If there was no contact and you were able to intervene in time, you don't need to report it..at least in Massachusetts. Document it. Call the family and let them know what's going on in case you end up sending her out. Come up with a reasonable plan of care to try to prevent it from happening again. But if she really is a danger to the other residents or to the staff, she might need to go out for a stay at a geri psych facility.

[Seliah]

hmmm I have no idea. Did you ask them. Do you guys not treat the combative behaviors? Why not ask them.

Absolutely chart it! Resident could injure themself or others, and if it's not charted, you have no legal doocumentation showing prior agitation and combative behaviors! Charting is your only legal protection against possible fallout from a combative resident's behavior!