Blindfolding: Is this an intervention or abuse?

Nursing Students CNA/MA

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I have been wondering about one of my residents who has advanced alzheimers and hits very hard any time anyone but her husband touches her. She also scratches, grabs, and squeezes, and has come very close to breaking my fingers. She is bedridden but still has very strong arms, and cannot speak but yells very loud. I've tried talking to her many different ways, even singing to her which sometimes helps for a few minutes (holding her hands and singing "say say my playmate" is a good way to make her smile) but I can't do that and give care at the same time. For a while her husband would hold her hands while we changed her but this became too stressful for him. I've learned to stay out of her range and cover her arms when I need to get closer.

Recently another CNA suggested putting a blindfold on her so we can get in close to give care without restraining her or getting hit. Does anyone know if this is considered abuse? I've tried it (I just lay a pillowcase over her eyes) and it makes such a difference. When she can't see us, she can't hit us, at least not accurately. She still yells at first, but I can actually take care of her without getting punched or smacked. It also seems to make her a little calmer after little while when she can't see us. Of course I take it off immediately when I'm done. I also think a factor in her behavior is annoyance at having the light turned on to change her, so covering her eyes actually makes her more comfortable.

I'm afraid to ask my DNS (it's been a long time since she did anything hands-on) because I don't want her to tell me not to do it, but I still want to know. I really do want what's best for the resident, but I have to consider my own safety. :redpinkhe

I have a resident who is combative. He has a heck of left hook and will use it if he gets agitated.

Our solution? We speak to him calmly, address him by name, get his permission to change him, and amazingly Mr. P will grab his sheet covers and cover his eyes. While he does that, we ask him to turn in order to take off the brief and he complies. We do it as quickly as possible and thank him for his help.

Then we run out of his room...:sofahider:hhmth:

Speaking to people calmy makes such a difference! I got report from night staff that this one patient had been very aggressive. Later that day, I went up and talked to him, asked him how he would like me to change him (standing or on the bed), talked him through it and it was fine. I have a feeling the night staff just grabbed him and started pulling at his clothes...

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

I think one thing that people aren't paying attention to is the difference between an "eye covering" and a "blindfold". (I wonder if changing the title of the thread would change people's opinions on the subject?)

The OP's situation involves draping a towel over the resident's eyes -- something that the resident could remove if they chose to. IMO this is NOT the same as tying something to the resident's head that they cannot remove at will.

I wonder, would putting sunglasses on the resident have the same effect as the towel on their eyes? Would people be in such a tizzy over sunglasses the way they are about an untied towel?

Specializes in LTC, assisted living, home-care.
Speaking to people calmy makes such a difference! I got report from night staff that this one patient had been very aggressive. Later that day, I went up and talked to him, asked him how he would like me to change him (standing or on the bed), talked him through it and it was fine. I have a feeling the night staff just grabbed him and started pulling at his clothes...

This happens ALOT in the LTC where I worked. I was shocked when I started working as a CNA that co-workers could change residents and NOT SAY A WORD to the resident, but talk to each other over the resident. :eek: I think if I was awoke, brief taken off me without an explaination, I would go to battle too.... I think if we showed more respect to the elderly, demented, it would make our jobs alot easier.....:redbeathe

This happens ALOT in the LTC where I worked. I was shocked when I started working as a CNA that co-workers could change residents and NOT SAY A WORD to the resident, but talk to each other over the resident. :eek: I think if I was awoke, brief taken off me without an explaination, I would go to battle too.... I think if we showed more respect to the elderly, demented, it would make our jobs alot easier.....:redbeathe

When I am changing a patient witrh another staff member, if they start talking about their weekend/other stuff, I will intentionally cut across them to ask the person being cared for a question and start a conversation with them. It's rude of me, but I don't care, the patient/resident doesn't need to hear about what staff members did at the weekend, or how much they wish they were not working today. I just keep up a steady track of conversation with the person I am caring for. 9/10, the other staff they join in.

Hey, thanks everybody for your replies. For anyone who wants to know how it worked out, I did talk to the DNS and she said not to cover any resident's eyes, ever. We also talked about how difficult caring for this resident was, and she turned out to be more understanding than I expected. :) I'm still caring for this lady, and it's much easier since her meds have been changed. I don't know the specific drugs, but they have helped her behavior tremendously without making her into a zombie, so I think it's a good mix. She is on hospice care now, since her Alzheimers has declined more. It's very sad to see how her husband, who still comes to feed her, has to watch this decline, but I'm sure she's ready to go. She doesn't hit anymore, and even lets me brush her teeth without spitting or biting! What frustrates me now is when I see other caregivers or staff walk into the room and throw the bright overhead light on and toss her around without saying a word, just because they can now. She does still yell and make "lawnmower noises" when upset, so I still talk to her gently and sing to calm her down.

Specializes in Cardiology.

I'm so glad to hear this has worked itself out and that you talked to your DNS, but sorry to hear about the resident's decline.

It can sometimes be very difficult to know which approach will be best from one person to the next and what is appropriate. I used to cringe about the way some co-worker's approached patients. Unfortunately, with dementia it often doesn't matter how you approach a situation- the poor person just doesn't know who/where/what on earth is going on. Must be a scary situation, ya' know?

Like someone said a stuffed animal. Also with one resident who hits and grabs us, we give him a sugar free cookie & this keeps him adequately distracted so we can perform his cares.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Glad everything worked out dicecream! You're lucky to have an understanding DNS! Best wishes to you! Thanks for the update! :)

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