Fighting Residents

[wooosp]

I work at a nursing home, in one of my 3-bed rooms i have 2 residents who are at each others throats.:smiley_ab They are young (50's) very alert and oriented (chronic complainers). They been roomates for about 2 weeks now and have not stopped fighting. I'm talking about yelling!!! Its always something and every argument they've had, I've intervened and made things better. A few days ago, they started fighting over the darn curtain....i found no common ground in the argument and left the room frustrated. It was the last straw for me. Dealing with this takes time away from already busy day.

I spoke with several people from our social service department and they told that they cant move either one because neither wants to move to a different room. My DON has been busy with surveyors.

They can't force them to move? What can be done here? Any suggestions would be GREATLY appreciated.:thankya:

[ebear, BSN, RN]

Maybe they're bored, resentful of being there (so young), and this is a form of entertainment for them; otherwise, they wouldn't mind moving (?) They will probably get to be friends before long. When they get too loud, just tell them "Knock it off fellas--you're waking the nurses up!" They may start to crack a smile....and "If y'all keep arguing about the dad burn curtain, I'll just have housekeeping take it down!" Don't let them frazzle you. They're probably laughing when you walk out. Ever see "Grumpy Old Men"?

[CoffeeRTC, BSN, RN]

What about a group meeting with both of them, the idt team and maybe families. Or a meeting with each res and thier famiilies and the idt separtly. I'd make them sign some type of contract if you could. Get the behavior team (if you have one) invloved. Make sure all is documented and even let the doc know.

How about asking the state surveyors what they suggest. (could open a can of worms tho). If they moved rooms, they might just have the same type of problems with the other room mates too.

I doubt they are joking about it though. We've dealt with this before and it kinda resolved itself. The one lady stayed out of her room until the other one would go to sleep.

[pumpkin92356]

Is there something or a time of day that this occurs? sometimes there are things that trigger a resident into being angry. It isnt always just the roomate. I have seen this many times in nursing homes. A lot of times it is jealousy over attention. If the level of care for one resident in the room is more than his roomate the roomate might feel he is not receiving as much attention. Starting these arguments might make him feel the "center of attention". I have went to answer call lites and have no way of knowing which one has called depending on the call lite system and asked the resident who hadnt called what I could do for them. The answer being from the roomate,"Why does everybody think it was him" I am the one who called" He is always getting the nurses to jump for him" I have also seen residents who were continent wet their brief to get attention. Responding with "If I pee my pants maybe I will get more care". Residents who are new to the LTC facility are feeling a sense of loss. In this I mean they feel sometimes that they have been put out to pasture and also might be feeling loss of control over their lives and decisions are no longer theirs alone. Their privacy level has changed. There are many fears of being abandoned by family and society as a whole. And verbally lashing out at the person nearest to them such as these residents sharing the room is their way of expressing those feelings. You have to watch to see that it doesnt become physical or so threatening that it effects the quality of their lives. Document each incident according to facility policy and the more documentation you have the more leg you have to stand on if you should have to change their room assignments. Another angle I have also witnessed is that they may just get along like this. I had a couple of residents who shared a room for years and fought like cats and dogs and when one of them had to go to another hospital for emergency surgery the resident left behind guarded her bed and possesions like they were her own. Fortunately, the surgery patient returned but you should see how they still fight and still nobody better say something about the other one or look out!

Hope I could help

Pumpkin92356

[LibertyBellPN]

We have to write incident report on both residents, as a patient to patient verbal altercation.

With all that paperwork, somebody has to follow up. Maybe a contract they have to sign, and then move them if they don't honor it.

It's disturbing to other residents, and there's always the worry that it will escalate to a physical altercation.

*sigh* It really does consume our precious time .. Referee, waitress, maid, janitor, plumber, cook, secretary..... AKA nurse.

[linzz]

Would there be any way to get one or both of them to some sort of activity at least once or twice a week, if they are capable. I would also try to not seat them together at meals if this is possible so they get a break from each other. This must be quite a pain to deal with.

[traumaRUs, MSN, APRN]

Is there a third person in this room? What are his thoughts?

[FireStarterRN, BSN, RN]

I hope I never end up sharing a room in a nursing home, I would be seriously hard put to maintain my sanity and benevolent demeanor as well.

[marjoriemac, LPN]

If neither will leave the room the they obviously don't hate each other that much. Maybe it's a personality clash, could the third person be exacerbating things? Its human nature to quarrell (I shared a room with my sis for 18 years and we never stopped fighting). Once or twice a day is not bad if the rest of the time they are pleasantly co-existing.