Interventions to deter Attention Seeking Behaviour

Hi Pam,

I work in Long Term care too and we have several residents who also like ringing that call bell. Most often, the reason they are constantly ringing the bell is not the reason they tell you (needing help with dressing, etc.) but rather a general frustration with their situation. I find just sitting down with them at a quiet time when they are NOT ringing and talking to them, acknowledging their complaints and fears, and using a calm quiet voice can be helpful. Talking with them about their past, their family, etc. goes a long way in helping them realize we really do care.

Including them in planning their care is also very helpful, for instance we had one gentleman who was obsessed with his bowel routine. By sitting down and going over the best form of treatment with him and trying to use his input, the use of the call bell decreased dramatically as he felt he had some control over the situation.

I realize this can be very tricky to do as far as the use of your time goes if your unit is as busy as ours, however sometimes it can prevent that chaos that results with the constant bell ringing.

It sounds like you and the staff are trying all avenues, and I agree that a Mental Health consult is a great idea so that this person has someone to vent his/her frustrations onto. Our mental health specialist is very helpful, often recommending a change in meds, etc.

I don't mean to sound "Polly-Anna-ish" but sometimes the simple things really do help. A sense of humour is great too when used with ethics and respect for the person in mind. Also, I have used honesty and told people that would they please mind waiting if their need was not urgent, as I was busy helping a sick lady down the hall or busy handing out meds. Sometimes that is a reality check for them as they realize they are not the only ones residing there. I go into their room to tell them that and they seem to respond positively.

Is your resident bored? Is there something the family could bring in to keep them more occupied such as puzzles, etc.?

Hope I have helped. You sound like a caring nurse who is an asset to your unit.

Thank you Old Gal for your advice, and kind words. I appreciate all of it. Sometimes the best advice, is well worn advice--never fear sounding "Polly-Anna-ish" :wink2:

In my years as a LTC nurse, I have seen many attention-seekers and chronic call bell ringers. It is definately frustrating to deal with and I agree some care aides and nurses give in to quell the bahavious, but more often than not, something else will take the focus once the immediate need was met. For ringing associated with meds, we post the med times (ie: 8am, 12pm, 5pm 8pm) in one lady's room and reinforce that it is not time yet. We try to get the res. out of their room with activities, aside from this, we just deal with it, I haven't found many things that actually work, esp. dealing with dementia patients who don't remember what was said five minutes ago. Mental Health is a good start, they can help, but I find they order alot of meds.

I don't kmow...here in Canada we have a mandatory set amount of hours that a high school student needs to fill before graduating. So the homes here have tons of students to fill the resident's time and occupy them. I know it doesn't take care of after hours but it does work during the day. So I hear.

Are you suggesting that we bring in high school students to deal with geriatric bell ringers?!

In my time nursing in LTC I've seen patients who will be on the bell before you even leave the room, the minute they are placed on the toilet, ringing for the kleenex on the bedside table next to them.

Part of it is the I'm paying to be here attitude another is the fear of falling if left alone. We try to reassure them that we are there for them but in many cases it simply doesnt work. You just have to take a deep breath and go in from square one for the 100th time.

Try suggesting that the family hire a companion and you get a lecture on how Mum or Dad built this country...(how many times have I wanted to say yup, and thanks for the mess your leavidng behind).

Bellringers ring because they are lonely, afraid, percieve themselves as having no control of their lives anymore, and missing their families. They want someone with them all the hours they are awake. Many families could come in but chose not to (I can't stand to see them like this) but are the first to complain if a pair of socks go missing in the laundry.

Some of the worst attention seekers I've encountered could be managed in the community with care aides, but the family are burnt out from the constant request.

Somehow LTC and the staff there are seen as the answers to all their problems and the root of everything that is wrong with the care being given to their elderly.

Are you suggesting that we bring in high school students to deal with geriatric bell ringers?!

In my time nursing in LTC I've seen patients who will be on the bell before you even leave the room, the minute they are placed on the toilet, ringing for the kleenex on the bedside table next to them.

Part of it is the I'm paying to be here attitude another is the fear of falling if left alone. We try to reassure them that we are there for them but in many cases it simply doesnt work. You just have to take a deep breath and go in from square one for the 100th time.

Try suggesting that the family hire a companion and you get a lecture on how Mum or Dad built this country...(how many times have I wanted to say yup, and thanks for the mess your leavidng behind).

Bellringers ring because they are lonely, afraid, percieve themselves as having no control of their lives anymore, and missing their families. They want someone with them all the hours they are awake. Many families could come in but chose not to (I can't stand to see them like this) but are the first to complain if a pair of socks go missing in the laundry.

Some of the worst attention seekers I've encountered could be managed in the community with care aides, but the family are burnt out from the constant request.

Somehow LTC and the staff there are seen as the answers to all their problems and the root of everything that is wrong with the care being given to their elderly.

No I'm not. All I'm saying is that the amount of bellringing went down because the pt's time during the day was filled to capacity with the activities the students did with them. they were satisfied and tired. Thats all I'm saying. you yourself said they want someone with them all hours they are awake right? Of course I dont mean you bring in a bunch of high school students to deal with the bellringers.