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I will tell family members if my patient is having a hard time due to being confused. I keep my families and patients as informed as possible as often as possible. I feel that veiling the truth of a patient being combative and uncooperative can lead to a family not trusting you when they find out about their family member's current condition. I wouldn't say the patient was being "nasty" though, I would probably say something like, "Well, Mr. Smith has been combative trying to hit staff, he's seemed to taken an unfavorable liking to us. Is there any way you can think of to help us help him?"
I also weigh the effect of telling a family member when the family member is not "spry" so to speak, or when there is no reason to believe that the family member can offer any assistance in changing the behavior. Why upset people when no good is expected to come of it? Chances are high that they can see for themselves that there is something wrong with how the patient is behaving. They will discuss if they want to.
Because we deal so much with symptom management, yes, we do discuss it with the family when a patient is combative or agitated.
Sometimes they need to be persuaded that there is a problem. Continued belligerence, anxiety, or agitation is not pleasant for the patient to experience, but we run into families who don't want their loved one "over medicated".
I had a LOL who would have bouts of saying one or two words over and over. Usually at the top of her lungs (she was little but LOUD). Ativan 0.5mg bid worked well for awhile. Then she started needing a PRN dose in the afternoon, which some of the facility nurses were reluctant to give. I called her son to discuss increasing the scheduled med to tid. He was reluctant until I said "Hang on a sec", held the phone up in the air so he could hear her and then said "That's your mom".
He agreed to increasing the frequency.
DesiDani
742 Posts
Or do you never go into detail and just say "everything is fine". Do loved ones have the right to know that their loved ones are acting out?