Fighting family in Long Term Care

Moogie · Jun 4, 2011

That's a great question! When I worked LTC, I worked nights so I rarely saw family.

I'm moving this thread to the LTC forum to elicit responses from experienced LTC folks.

pfongk · Jun 5, 2011

We did both and we've also had family members on behaviour charts so if it got too out of hand we could actually get management to back us up on saying "If you turn up again you will be escorted off the premises and if you don't leave you will be arrested." I don't think we've had anyone arrested but we have had family members physically removed from the premises by the police.

winnowill · Jun 5, 2011

When that happened on my floor, we called the supervisor. Then took the visitors to the side and told them as diplomatically as possible that the behavior was not acceptable. If it kept up we would have no choice but to tell them to leave the floor. We ended up having to call security the next day when they started up again.

CoffeeRTC, BSN, RN · Jun 6, 2011

When that happened on my floor, we called the supervisor. Then took the visitors to the side and told them as diplomatically as possible that the behavior was not acceptable. If it kept up we would have no choice but to tell them to leave the floor. We ended up having to call security the next day when they started up again.

I did the same thing. As a 25 yr old nurse that looked 16 at the time...they didn't beleive me. Boy...they didn't like it when the local police came. They were very loud, arguing with each other and included the resident. The other residents (and staff) were very upset and frightened.

Some were banned from the facility others were only permitted to visit in certain areas.

SuesquatchRN, BSN, RN · Jun 7, 2011

I take the offenders aside individually and ask them to behave. Diplomatically. I explain that they are upsetting people in their home. If it continues I ask them to leave. I have never had to call the police, thank a merciful FSM.

Long Term Care Columnist / Guide · Jun 7, 2011

What all of the above said ^^^. :)

Calling the police is, of course, the last resort, and I'm happy to say I've never had to take things that far. I have called APS a couple of times in my career, however, because the family's antics were abusive to the resident in some fashion. At one ICF, we had a MR/DD lady whose mental age was about 7 at best, and she was bipolar on top of it. Then she had these two evil sisters who often came in and tried to force-feed her, yelled at her and made her cry, or did mean things like pulling her hair on purpose when combing it. The unit manager and the DNS looked the other way, but the CNAs saw these things happen all the time and reported it to me whenever I was on duty.

One time I caught them yelling at her and slapping her cheek, and I asked them to leave, warning them in no uncertain terms that it was abuse and if I saw it again I'd report them. They didn't seem to be too impressed ("you can't do anything, you're just a nurse"), but the next time when I went into the room to find the Wicked Witches of the East and West trying to cram a tuna sandwich into "Barbie's" mouth and verbally chastising her for refusing, I TOLD them to leave and then called protective services. They were barred from the facility while the investigation was in process, which took several weeks; though they were allowed to come back afterwards, their visits had to be only during business hours on weekdays, when the management staff was present to supervise.

Which I thought was stupid, because it wasn't management that had been looking out for this poor child in an old woman's body. But I'd do it again, because residents of LTC facilities have the right to be protected from ANYONE who would harm them, including relatives! :madface:

LockportRN · Jan 11, 2012

I had a similar situation when I was the DON of a facility. We had the sweetest woman as our resident but her grandchildren were just monsters. I had heard rumors of how they would yell and scream at the aids. Making all kinds of accusations in front of their grandmother, in the dining rooms and hallways.

Now, I normally would stay and work late to complete paperwork duties of my job, but I would usually close my door after 5pm so I could really concentrate. This week, I decided to keep my door open and made it a point to roam the halls (keeping my ears open). By the 3rd day, I thought they were not coming when I heard loud yelling. I came around the corner to the nurses station to see this young man and woman yelling at all the staff at the nurses station. It was just after dinner and the residents had lined up for their meds, so I took a look at them. I watched as one of my residents started to cry, another with dementia, started to hit herself in the face and another resident standing by the med cart simply wet himself.

I promptly went to this couple and told them to stop yelling and follow me. The man kept it up so I had to tell him that if he did not immediately stop and follow me into a closed room that I would call the police, have them removed and bar their return. As I barely whispered these words, I motioned for them to look around them at what they were doing to the others. When we got behind closed doors, they thought that they could double team me (I am only 5 feet tall and weighed only a bit over 100 pounds at the time). What they did not expect from our earlier conversation (as I spoke to them in a very low, carefully modualted tone), was my ire not only at the words hurled at my staff, the tones they used but the worst thing that I saw, was my lovely residents standing their in total fear. I nearly cut this mans head off (ok, not literally folks but I was mad beyond what they ever expected).

It turns out that they had read articles on-line about what happens to some people in some nursing homes and they were told to be the aggressors to ensure the best care for their grandmother. She was a home health aid and he was a minisiter (lol at that one). I had taken their grandmothers chart into this room with me, knowing that they were not POA for anything, but opened the chart to this area and let them know that in the future, only the nurse (not the cna's) would give any info to them and that they were only entitled to limited information because of this status. Also, that if they ever yelled or threatened even by 'posturing' to any of my staff in the future, that they would not be welcomed back to the facility. Then, had an incident report written up for our documentation...in case. I then called the POA for HC, explained the situation to her and the facilities resolution to this matter requesting that she be the one to follow up with the family members if they wanted any health information as by law, we could not.

This seemed to stop all of the commotion. I am a little woman, but I cannot stand abuse of any kind (not for my staff, nor my residents), and I think I get a bit of a 'crazy' look in my eyes when I see something like this, cuz I have never had to call the police. They just stop...