Combative resident, help!!

Nursing Students CNA/MA

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I am a brand new CNA and i just got a job at an assisted living facility, most of the patients are completely independent and just need reminding about showering and meal times. We only really have about 5 people that we have to completely care for and im definitely not complaining about that. I am so content with my job and i love all my residents!!

I have only been working here for 4 days now and we have one resident with dementia that will not let you change, dress, or shower her without the biggest battle ever!! She walks around in just a brief and a shirt sometimes because we physically cant get clothes on her. When trying to change, dress, or shower her she will kick, punch, and bite. The other night i showered her for the first time and when i was drying her she was calling me a son of a b*itch and pushing/throwing me against the wall and punching my back with both fists. Also, two days ago i went to put one of my residents in bed and i found her laying in his bed so i called another cna to come help me and even though there were 2 of us holding her arms back and walking her to her room she still managed to hurt us. My legs are covered in bruises from her kicking me. The scary part is that the other CNA's told me that what i saw was her being good and that it wasnt even her at her worst!

I really need some advice on how to handle a resident like this! i am literally so scared to go in her room every day! thank you!

According to the social services rules for my state she no longer falls into the criteria for assisted living.

I have worked with a few people with dementia and have seen a lot of to much stimulation will make them act out as you have described. It might be worth a try to work with the resident once with the lights low, as little noise as possible, and work slowly. You want everything to be relax full for both of you. I'm sure you will still want someone with you, but tell them before hand what the plan is and have them stand against the wall away from you and the resident.

We have one resident with dementia that few people can work with, not as bad as what you have described. I take him to the bath room twice at night and each time it takes about 7 minutes, but I don't have any issues unless someone else has all ready upset him with in the hour.

It might be time to redirect her punches and kicks with your hands so the other CNA can do the work.

It might be worth trying to play tug of war with a towel to distract her so you can work with her lower body and then work with her upper body last.

Specializes in MedSurg, Tele, ER, ICU, Float.

I'm also a new CNA and we have a few residents with dementia known to be combative. During the initial HR meeting the RN suggested a read a book called "Bathing Without a Battle." It also came with a DVD that was very helpful showing what to do and not to do.

I suggest moving slow in your action, put on your best customer service tone of voice, smile and ASK to perform all duties. Let the resident know everything you will do before you do it in your friendliest tone. These are tips from the book and DVD. It definitely is working for me and I'm only 1 week and a half into my new position.

Let us know if there's any improvement!

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