How do you handle clients that are too affectionate?

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Hi,

I have just started working in dd grouphomes (i'm not a nurse yet), and i have wanted to do this kind of work since i was in high school.... but i have one little problem: in each of the grouphomes where I work, there is one client that is.... just a little too affectionate. In the first home, its a 12-year old boy. He does whatever it takes to get my attention, and if he doesnt get it (when i am busy helping someone else), he'll do drastic things like bang his head against the wall etc.... whenever i am in the room, he hangs on me, when i sit on the couch, he practically sits on my lap. He can barely talk, and i am not sure how much he understands. The other staff say he doesnt have an MR diagnosis, so he understands alot, but at the same time, the books and games and videos he has are all at a 3-5 yr old level. so i just dont know....

At the other home, its a 28-yr old TBI client who is mentally at the level of a 4-5 year old, but he also will sit really close to me, tell me that i am cute, try to kiss me etc.... i am new at this and it makes me a little uncomfortable, sometimes to the point where i avoid working with him and work with the other residents instead (we always have two staff on).

Since i just started this job and already have two "overly affectionate" clients, it makes me guess that this is a rather common problem- so maybe many of you have dealt with it in the past and can give me some advise. I do really like this work, but i just dont know how to enforce bounderies, especially when i am sometimes not sure about the level of understanding of a particular client....

any advise would be greatly apprecciated!

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Specializes in Developmental Disabilities, LTC.

Tell them you have girl germs!

Sorry - seriously I don't know. I worked with DD for a couple years, so I am familiar with the problem, but honestly, it never really bothered me. Especially the kids. Patients' like the 28 year old, though - I can see how that would make you uncomfortable.

A friend of mine told me this story about gal she used to take care of that was probably in her mid-20s that had yeast infections, or a rash in her peri-area, or something, that had to have cream applied to it once a shift. This patient was verbal & my friend told me she used to always ask for more cream to be applied & my friend knew it was only because she was getting off on it. That would definitely bother me. My friend used to just flat out tell her no.

I'm not sure what the right answer is to your problem. Like I said, I've been through it, but I worked in a short term care facility, so our residents never stayed more than a couple weeks. When we did have this problem, staff just told us to reinforce "appropriate" touching by moving the resident's hands away (or whatever) over & over again.

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Specializes in Pediatrics- Adolescents.

Ive been working with kids/ teenagers / young adults for a couple of years as a carer (equivalent to a CNA), I did find some kids would become overly attached, affectionate, physical etc. Make sure you reinforce to them that you are working, you are married (if you are) , you dont like being touched, and repeat this to them when necessary.

Ive been a nurse for a couple of months now and find it alot easier now I wear a uniform and don't act in the role of 'leisure buddy'etc, which the kids often equate with 'friend'.

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Specializes in pedi, pedi psych,dd, school ,home health.

Simply remind them that they needto give you "personal space". Many behavior plans will add that issue in. if it continues , remind them that is not appropriate, they may need to be told many times; dont feel mean you are teaching them.

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Specializes in cardiac/critical care/ informatics.

they need boundaries, you are probably not the first person they have done this. ask if they have a carepan or whatever they may call it, for this type of behavior for these clients or how do they normally handle it.

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Specializes in Staff nurse.

Especially if you are new, it could be they want to "claim" you for themselves. Stick with the "personal space" teaching and reminders. Be gentle but firm, it could really be neediness, mom figure (or dad if you are male) that the younger ones feel.

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Specializes in LTC, Home Health.

I have this problem with a young teen boy I work with. His mother encourages it I think by kissing him in the mouth (like ou would with a baby) and not encouraging him to be toilet trained. He enjoys being changed (due to the stimulation) and has been very hands on lately (hugging and kissing adults). I have let the adults know that it is getting out of control and try to discourage him. I am fine with end of the day hugs from his friends but no more kisses and touching bottoms. I don't care if adults don't like that I call the shots when he is with me. It is for his own good because in the community he can get in lots of trouble for this. I just wish I could explain to Mom but that is a whole other story.

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Specializes in MRDD.

First see if they have a behavior plan or care plan to address the situation. I would try to redirect, example we have a res that grabs, he doesn't know better, but it is inappropriate so when he reaches out to grab we meet with a hand shake. I would not let him sit on your lap encourage a different position next to you or across from you. It usually involves a lot or repetition.

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Specializes in Day program consultant DD/MR.

We have individual behavior plans for the clients that show inappropriate behaviors. I would check to see if one has been written or if an evaluation is in order.

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Specializes in MHSA.

Offer a hand shake, find out preferred (appropriate) activities to keep them busy, constant redirection and less reaction is the best reaction. Also, for your highly affectionate touchy feely folks, keep a close eye on them while out in the community and while interacting with kids and such. An "innocent" huge or kiss can certainly lead to huge problems. There should be a support plan or care plan provided along with evaluations to find out the true cognitive, communicative (receptive/ expressive) and behavioral abilities of your residents. If your guys are receiving state funding while living in a DD facilities they have some degree of MR. Sometimes fellow staff are not the best informants so be sure to read up on your folks to get a good idea of what their needs are.

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Specializes in psych, long term care, developmental dis.

I know that this is an old thread but,

I have worked with the DD population and one of the things that I have found is that the staff under estimates their intellegence. You say one is at a 2 year old level and one at a 5.

If you were working with your own children age 2 and 5 what would you do? Everyone needs boundries. So your expectations should be that they understand at their level. Both of the above understand no.

What does the other staff do when the client bangs their head, etc.? Is there consequences for their bad behavior? If so enforce the consequences.

Another key is to continue to follow through. If you give in just once for bad behavior it reinforces it.

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