How to handle the disruptive resident

[Peds_Nurse]

I'm looking for some suggestions on how to handle (calm) a geriatric resident that have disruptive behaviors. I work in a longterm care facility and the resident repeats "Help me" or "I'm sick" over and over again. If ignored, he gets very loud and when he's attended to, it only lasts for a few minutes and he's back to yelling it again.

He is already on behavior monitoring and medication, but sometimes, he gets physically aggressive anyway. It's almost like the medication is having no affect.

He's been written up and the MD notified, but what can I do as a nurse to redirect him or calm him down.

Does anyone out there have any suggestions that I can try that is within my scope of practice (LPN)?

Thanks!

[SuesquatchRN, BSN, RN]

Go into the Geriatric Forum and find the "Tips for Redirecting Alzheimer's Patients" thread. It's a sticky.

[Lorrie34]

I wish I only had one resident on my assignment--I actually have a handful like that. I spent half of my shift literally running after the one lastnight, pulling him out of everybody else's rooms and restarting the IV that he keeps pulling out of his arm. When we medicate him, he gets worse and manages to get out of his chair or bed and falls every time.

I feel very bad for him, can you imagine how hard it must be to feel so confused all the time and nothing makes any sense? But it is very trying to have to pass meds and tend to 30 other residents while I keep running down the hall after him. It feels like babysitting a 2 yr. old sometimes. He's just everywhere and doesn't stop.

I wish there was a class in nursing school on how to handle resident's that are that severely confused while you manage all the other tasks of being a nurse.

I'm not a fan of chemical restraints to begin with, but the effect they have on him just re-enforces that for me because it doesn't make him sleep, it just makes him fall and get hurt.

[Peds_Nurse]

I agree! I wish they had more focus on this type of patient during school. We try to redirect these patients at our facility, but sometimes, the only recourse is a chemical restraint.

It sounds like you need more help from your aides. Does you facility allow 1-to-1 time? If so, that might be something you want to discuss with your DON. We do this on occasion and we have a CNA stay with the resident 1-to-1 for hours, sometimes, all day and night until the patient settles down. Its provides the resident with someone who can provide assistance to their needs and at the same time, the patient has someone to focus on and they become less frightened and stop seeking exits.

It might be something to explore. Good luck, I know it's hard!