How do you handle the "punching bag" residents?

[solDanz]

A few months ago, a long time resident died. His bed ended up being taken by a man that is black & white with anger. If it's certain nurses, he's the most lovey individual you could ever meet. I half expect to see his eyes turn into cartoon hearts with some of them. But for the vast majority of the nurses, and for all of the aides, he treats them as punching bags, sometimes literally. I've had several aides come out of his room with bruises after he swung on them for "disturbing him", even though it has been explained multiple times that it is their job to ensure his safety and welfare. This behavior has been passed along to and by the floor/charge nurses to the Unit Managers and the administration, but nothing has been done. The facilities Social Work head didn't even know there was a problem when I mentioned it to her in passing one morning. This has also been documented in the computer system.

As things have progressed the way they have, I am not holding my breath on those in charge taking up the responsibility to fix this situation, and I am concerned that it is beginning to negatively affect his roommates care as well, as he is driving away aides that dare to turn on any lights or even open the door after sun down. Anyone have advice on how to approach this situation?

[Paws2people]

I'd pair up with one of those nurses the resident likes, and do all his care together. Hopefully he will slowly gain trust for the aides enough for them to do him without the nurse.

[Missingyou, CNA]

Respect his choice to be left alone whenever there is no possibility of harm to himself or others. It's his right. Document refusal for ADL care if he's made it clear he wants to be left alone. If he is one assist & self transfers, just stand by. I've found if you try to help someone who doesn't want to be helped, it creates a bigger risk of falling. Continue to document his refusal & continue to notify your nurse or supervisor to cover yourself.

If he gets angry when you are giving care to his roommate, ignore the verbal complaints, but be as quite as possible.

It's all you can really do which is probably why you're not getting much action/results from management.