Driving me mad!

danissa, LPN, LVN · Jan 22, 2008

marjorie, alas, I have no pearls of wisdom in dealing with your "wee wumman". Just wanted to say how much I admire you and all the nurses like you who care for the frail elderly. i couldn't do it in a million years, but as the aging population increases, angels like yourself are needed more and more. :w00t: to you all, one day we all may need good nurses like you!

squeakykitty · Jan 22, 2008

OK, we got a wee lady just now, has mild dementia, bloods all normal, urine sample normal. Gradually getting worse at going in a huff! I swear, you even look at her too quickly or slowly and she takes a day in bed because 'nobody likes her', 'everyone gets more care than her'. The other day, she was last out the dining room because she was finishing a glass of juice, all of a sudden the zimmer gets banged on the ground and we heaer the murmuring of 'nobody cares about poor old me', 'i want to get out of here', 'dont rush to help me, I know you don't want to'. This lady's family think it is attention seeking as she has done it before but it makes it no easier when she claims the tea is cold whilst it burns my hands carrying it, when she says the toast is not cooked when it was burnt yesterday at a slight shade darker. We cannot please her, recently if we hug another resident, she stomps away in one, but she's not receptive to hugs! When it all started, if you sat down and made a joke with her, she would be happy, but now nothing pleases her. Her doc, the staff and her family are at their wits end!

I don't know what to say on how to deal with her, but it sounds like she is manipulative. Maybe the staff can just ignore her behavior, and act as if they are totally unaffected by what she says. If she is gettin no secondary gain or attention, it may stop.

sticknurse · Jan 22, 2008

I agree with the above poster, the best bet is to remove any reward she may be receiving as a result of the behavior. Good luck.

marjoriemac, LPN · Jan 22, 2008

Thanks to Danissa for all your kind words. Luv ya!

Kurious RN · Jan 22, 2008

It sounds like she also has Borderline personality disorder.

People with Borderline Personality Disorder have unstable and intense personal relationships, problems with self-image and are markedly impulsive and moody. They make frantic efforts to avoid real or imagined abandonment and as a result may become excessively dependent on others. They have great difficulty with their own sense of identity and may view the world in extremes; others are either "all good" or "all bad."

As a result of these characteristics, people with this disorder often have difficulty in interpersonal relationships. They are also prone to self-mutilation or suicide attempts.

Difficulty controlling emotions or impulses
Frequent, dramatic changes in mood, opinions and plans
Stormy relationships involving frequent, intense anger and possibly physical fights
Fear of being alone despite a tendency to push people away
Feeling of emptiness inside

ktwlpn, LPN · Jan 22, 2008

You say she does have dementia? Maybe it is progressing and she is frustrated and lashing out with anger because she is noticing increasing difficulty managing her life.She sounds very impulsive.I would work from the dementia angle before I'd chalk it up to manipulation or borderline...Maybe she needs a geri/psych consult-an anti -depressant may be helpful.Remember if you hear hooves ,think horses....

Daytonite, BSN, RN · Jan 23, 2008

I would document her behavior, notify her doctor and ask for a psych consult. She may need to be placed on medication for this.

Nascar nurse, ASN, RN · Jan 26, 2008

I was thinking antidepressants too.

Also you may want to try "involving" her more in the facility life. For example, get activities staff to have her come down early to help "setup". Give her some kind of menial job she can do that she makes her feel meaningful. This may depend on her level of dementia. We have one lady that sits in the front lobby 2-3 day/wk selling candy bars to visitors to raise extra $ towards activities funds. It is her job and hers alone. She takes great pride in this. We have another assigned as our meet & greet. She visits new residents (at our request as appropriate) and helps explain meal times, activity schedules, etc. Her job and hers alone. Both these women tend to be crabby - but when "on the job" they are as pleasant as can be. Just a thought.

banditrn · Jan 30, 2008

I was thinking antidepressants too.
Also you may want to try "involving" her more in the facility life. For example, get activities staff to have her come down early to help "setup". Give her some kind of menial job she can do that she makes her feel meaningful. This may depend on her level of dementia. We have one lady that sits in the front lobby 2-3 day/wk selling candy bars to visitors to raise extra $ towards activities funds. It is her job and hers alone. She takes great pride in this. We have another assigned as our meet & greet. She visits new residents (at our request as appropriate) and helps explain meal times, activity schedules, etc. Her job and hers alone. Both these women tend to be crabby - but when "on the job" they are as pleasant as can be. Just a thought.

That is such a cool thing to do!! :up: :up: