How would you handle this?

Totally unacceptable behavior.

Report it to the charge nurse so that it can be documented.

I would work my way up the chain of command. Social services, the DON, or the administrator (someone in an authoritative position) needs to sit him down and have a little chat with him about this issue and its possible consequences.

Ideally, he should be moved out of that room into either a private room or with a non-demented roommate.

Any behaviors like that should be reported to the charge nurse. When I notice, or a CNA notices unappropriate behaviors, I need to document it. Depending on the severity of the behavior or the frequency I'll send a note down to Social Services to see if they can intervene and speak with the "offending" resident. many times we will hae a psych consult done.

Keep a watchful eye on Mr H. He may or may not become physical with others. If it appears he's getting to close to another resident or "in their face" so to speak, best thing to do is remove Mr H from the other resident, and immediatly report to your charge nurse.

When in doubt, best advise I give my team of CNA's, is TELL me. I'd rather them tell me these things than ignore it and it possibly escalating into physical violence toward other residents.

When in doubt, if your not sure how to handle something or a resident, something seems "off"..anything giving you a knee jerk reaction that something should be done..that should be your cue to alert the nurse.

And it's CNA's like you who care about the residents that I love having on my team! Watching out for all your residents is the best thing you can do.

Is this common or just a recent occurrence? If it were long term, I would say he's just being mean or has a psych issue. If it just started, I would think delirium related to UTI or something else.

As long as he isn't demented, I would have no reservations about saying "Mr. A, that is not appropriate." Let him know it's wrong.

Maybe even ask why he does it??

Perhaps he is trying to be funny or thinks it would be considered "cute" by the other CNAs.

I've seen a few of those. I let my nurse know first. And I also have no problem telling him his behavior is not appropriate. If it is a new behavior for him, like Coffeemate says, your nurse might want to investigate a new illness or psych issue.

Also something that I've experienced this week... have any of his meds changed recently? I ask that because unknown to me, a lady I'm familiar with seemed to me to go completely off her rocker last week. She is one I don't work with often (on a different hall), so I didn't know her psych meds had been changed. With very dramatic and from what I saw, not very good results. Might this be a problem with your guy?

Psych or med issues aside, most folks who are fairly with it still understand acceptable behavior. And if it's allowed (or hopefull isn't being encouraged), he may just get carried away. I have on many occassions, told someone their behavior was out of line and they were aware enough to correct themselves.