dealing with racism on dementia unit?

[prob22]

I was wondering if you guys could put in your opinion or some advice. I work on a dementia unit a state nursing home. We recently admitted an african american male to our floor and since coming he has recieved some abuse from other residents. It mainly comes from three residents who, among other things, spit, swear, threaten and harrass this poor man. We even had an incident with one of the residents writing nasty words on the wall in his room. We make sure clients are separated to reduce the chance of problems but the new patient is begining to get depressed and is often very upset and wants to go home. Anyway have an idea how this could be handled better to give this client a better quality of life.

[canoehead, BSN, RN]

He deserves to transfer to a nonabusive environment. Imagine growing up with that crap, and then having to turn around and live in fear as an adult. He must think he's living a nightmare.

What consequences have the other residents faced? If they are too demented for consequences, move them or him out.

[tokmom, BSN, RN]

Aww, the poor man. I feel so bad for him.

[glencovediva]

I was wondering if you guys could put in your opinion or some advice. I work on a dementia unit a state nursing home. We recently admitted an african american male to our floor and since coming he has recieved some abuse from other residents. It mainly comes from three residents who, among other things, spit, swear, threaten and harrass this poor man. We even had an incident with one of the residents writing nasty words on the wall in his room. We make sure clients are separated to reduce the chance of problems but the new patient is begining to get depressed and is often very upset and wants to go home. Anyway have an idea how this could be handled better to give this client a better quality of life.

I would move the abusers out. Dementia or not, it is unacepable to behave in such an abusive manner. It should not be tolerated at all.

[karamarie91]

he needs to moved to another facility where he can have some peace.

no one deserves that. I don't know your position there, but you should be advocating for him as much as possible-social worker, nurse, MD, whoever you can within your scope of practice.

I'm deeply saddened for him.

[Dazglue, ADN, BSN, MSN, RN]

He needs to get out of that facility if possible. I would hate to have to endure that everyday.

[lefty19]

Racism has been a problem on most of the dementia units I have worked on as well. Our facility luckily has two units so we could easily transfer the patient so he wasn't facing discrimination. I'd follow proper procedure and find a new facility for this patient.

[leslie :-D]

i think we all agree that it'd be ideal to have the (racist) residents transferred elsewhere.

but i'd bet my last dollar, that is just not going to happen.

what usually happens, is ss is called, the licsw 'talks' with the residents involved, or, their families...

and it's left as "we'll do the best we can"...and leave it at that.

if they are roommates, they'll separate them.

but there is little you can do if they happen to be in the same room together.

depending on the level of dementia, there is little to no recourse.

if ltc facilities keep dangerous, aggressive residents...

then we know they're not going to evict those who are mentally abusive/racist.

i don't know what the answer is, and this poor man shouldn't be relegated to hiding in his room.

i'd be curious to hear how other ltc facilities have handled it.

leslie

[kayraecam]

I work in a nursing home on an alzheimers/dementia floor and I know exactly what you mean. There is no way to change these people or the opinions they have about certain races. I am one of the only white staff members and there are certain residents who will only respond to me and allow me to care for them. Alternatively, there are residents who absolutely refuse to let me care for them. We just adjust our assignments accordingly, avoid confrontation and any other problems.

[sapphire18]

My heart hurts for this poor man. Best solution is to permanently separate them, be it moving the abusers out or moving him out. He shouldn't have to live out his final years in that environment. Must be pure hell. =\

[Corey Narry, MSN, RN, NP]

Though nursing home resident abuse is a well-documented phenomenon, much of what is written about the topic revolves around abuse from care staff. There is a wealth of regulatory consequences in the form of fines and criminal prosecutions in these instances and watchdog groups are very keen on exposing these cases. However, there is not much known data about the prevalence of resident to resident abuse in nursing homes though we know it exists. There are a few prevalence studies but not much in the form of recommendations for curbing the incidence of resident to resident abuse. Traditionally, time outs and separating perpetrators have worked. However, this case involves racism, which has serious consequences that can involve expensive fines and lawsuits that can lead to criminal charges. I wonder if this poor guy has a family member who is aware of the abuse. I'd be very interested in how this facility handled this case especially since it is apparently state-run.

[Lynx25, LPN]

Poor little dude.

I hate that there are no consequences for residents- ESPECIALLY those that are in their right mind. We have residents here that verbally and physically abuse staff and residents, pitch grade-A temper tantrums, and generally make working here hell. Because this facility takes the bottom of the barrel, including some our psych unit flat out refuses to take back- we get stuck with little angels like these.

What do you do? You can't put them in time-out, it's 'abuse', you can't talk to them, because obviously people have tried it and it hasn't worked... they just have free reign over the facility and there's nothing you can do with it.Ugh.

I'm interested in how this turns out- in the long run.