Do you tell family members that their loved ones are nasty and combative

DesiDani · Dec 17, 2015

Is it okay to shield family members (for whatever reason a HCW may have good intentions or not)

KatieMI, BSN, MSN, RN · Dec 17, 2015

I do, but it depends. I always ask if the patient behaved "like that" ("that" being given in as nice or at least neutral terms as possible) ever before. Sometimes it helps to catch psycho issues early or note change of condition before anything else. Sometimes... well, I have to live with it for just 12 hours at most, and these poor souls had a lifetime of THAT and gonna to have some more. :blackeye:

ProgressiveActivist, BSN, RN · Dec 17, 2015

Yes. If they can handle it. I say he had a difficult night and describe the disorientation confusion agitation etc. in the hopes that they will offer to stay overnight and help to keep them calm.

Ruby Vee, BSN · Dec 17, 2015

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?

Is this a homework assignment?

My mother was so nasty and combative she was kicked out of several nursing homes and once got hauled out of one in handcuffs because she'd been trying to cut several other residents with a broken glass. I had a lot more respect for the LTC staff who were honest with me than I did for the ones who kept telling me "We just love her. She's the sweetest thing."

FolksBtrippin, BSN, RN · Dec 17, 2015

I hope some of you really didn't think I meant "tell the family mom/dad is being nasty". It's just a creative way to get to the point.

I didn't think that, but I also wouldn't offer any interpretation with subjective words at all, like "combative". I would state what the patient did and quote what the patient said. I also would not tell the family unless they asked or I felt they might have helpful information. For example, "Your mom threw her lunch on the floor today. Is that typical for her?" Your dad said "Get out of here, you jackass." Is there something I can do to make him more comfortable?

I work in a mental health day program (not as a nurse) and I very rarely tell anyone at all when a patient behaves in a difficult manner in my group. I try very hard to work it out with them directly and this creates respect and trust. If I tell their social worker it is because I truly can't handle the problem. I pride myself on being able to handle the problems that come up.

DesiDani · Dec 17, 2015

No, as in I've been out of skool for years.

And...

Yes, as in I'm still going to school at the (((SCHOOL OF LIFE)))!!!

THELIVINGWORST, ASN, RN · Dec 17, 2015

I will tell them 100% in a polite way. BUT the other day I almost apologized to the wife of a patient for being married to him. Ugh he was the living worst.

0.adamantite · Dec 17, 2015

Yes, I will tell the family that the patient is confused and agitated, but in a polite / discreet way. I will explain that we are doing the best we can for the patient.

LPNtoRNin2016OH, LPN · Dec 17, 2015

In LTC, this is a tricky dance. Many families in LTC are in denial about their family member's condition (Ie: Dad will get better, he is just confused right now! -- Dad hasn't known his own name since 2010). I will say things like "Mr.X had a difficult day today, he seems a bit agitated, so we are trying to keep his surroundings calm and relaxed" if they ask specifically how their mood is. Residents who are nasty because they just angry people usually come with angry family members so I don't tell them lol

kbrn2002, ADN, RN · Dec 17, 2015

Most of the residents I care for have somebody else that is responsible for them so it is my responsibility to update the responsible party when we have a combative resident. It is hard with the few families that are in absolute denial about the level of impairment their loved one suffers from.

We have one family in particular that is very hard to deal with. They just refuse to see how truly dangerous that Dad can be, looking for ways to blame his volatile and combative behavior on staff.

ktwlpn, LPN · Dec 17, 2015

Absolutely appropriate.Loved ones of the elderly and demented are prone to relapsing into a complacent denial.They need to be reminded (in a professional manner) that dementia is life limiting,Alzheimer's is terminal.Part of supporting and educating them includes reminding them we are well equipped to manage the behaviors and they also need to focus on the person,not the disease...They should never be made to feel responsible for the behaviors.

allnurses Guide · Dec 17, 2015

Yes, I did talk to family members about the challenges with their loved ones. They need to know WHY Mom hasn't gotten a bath or WHY Dad didn't get pain meds. If there is combativeness, noncompliance, confusion, whatever may be going on, particularly with the elderly, I never had a family get angry at me for this. I did, though, get to find out whether it was "normal" for that patient to behave in such a way. Diagnosed a lot of UTIs that way, when there were changes in personality. Helped find a stroke a time or two. Etc. And not infrequently I found out that Mom/Dad/Aunt Sue have always been a bit difficult.