Rude residents

amoLucia · Feb 2, 2014

I don't believe she's being rude - I think she's ill. Like a depressive reaction or onset dementia.

Maybe she's just lashing out at you. She has no local roots; family support is so-so. She's one angry, lonely lady.

I wouldn't be taking this personally. In LTC (and psych), we deal with bizarre behavior freq and we need a thick skin. I'd be more concerned that she's in decline and really needs a good workup. She may soon no longer be approp for ALF.

Is she doing this with other staff? Other residents? Fairly new onset? UTI? As I say, I think there's more to her behaviors. I know ALF is a lot 'looser' than LTC, but her family needs to aware that her behaviors are troublesome.

Right now, you can only continue to monitor her and keep your 'cool'. And you need to keep everyone in the loop incl your admin.

She's a toughie for you; good luck.

SleeepyRN · Feb 3, 2014

I've never worked assisted living, but I work ltc/snf with a lot of psych/dementia residents. I agree with above poster that this resident may no longer be a candidate for assisted living. I deal with verbal and physically abusive residents all the time. You absolutely have to have a thick skin, and try your hardest in the moment to realize this is the disease acting out, and she needs more help than she is getting. If she, when she was in her 20's, could look into the future and see the way she will be treating staff, she would probably be horrified.

Pangea Reunited, ASN, RN · Feb 3, 2014

People like that can be very irritating. They're obviously incapable of normal social interaction, but they're self-directed enough to refuse any attempt to better the situation.

At some point, I learned that I can't fix them and that they don't want to be fixed, so I do my job and I get out. And if they don't want me to do my job, I document their refusal and I get out.

At the end of the day, their opinions and harsh words mean nothing to me. I gave up "correcting" their bad behavior. I dont give them any attention for it, at all. I do feel a little sorry for them, but I guess they will live and die on their own terms- not unlike the rest of us.

TheGooch · Feb 3, 2014

Sounds like dementia to me. They don't realize they are being "rude".

People who work in places that have dementia residents need to educate themselves on the disease and the behavior that is being exhibited. I know of one CNA who had no clue that not taking showers or bathing is a classic trait of dementia patients. As for saying rude things they have lost that filter that most normal people have when it comes to saying whatever comes to mind. You can't "correct" their behavior or tell them what they are doing is wrong because there is NO reasoning with a person who has dementia.

Like I said, if you work in LTC, ALF or SNF you need to educate yourself about dementia residents.

lauriepat, ASN, RN · Feb 3, 2014

Maybe rude was the wrong term lol.

Maybe it's it more frustrating to me that management admitted her knowing she was like this. I think she should be in a snf, personally but management wants the rent $$ sadly.

I mean she's thrown stuff at staff, i've never dealt with a patient with this extreme behavior, it's almost unreal to me but i guess it happens a lot.

No uti, no medical cause for her behavior except dementia.

It's just frustrating to me that she won't let staff help her.

Thanks for all the responses :)

systoly · Feb 3, 2014

does she have pictures in her room?

does staff know her social/work history?

she might respond to talking about past interests

if time allows, maybe staff could visit with her a few

minutes here and there, without bringing pills or

treatments

i'd bring her flowers and see how she reacts (if that's not

safe, she's definitely not ALF)

lauriepat, ASN, RN · Feb 4, 2014

does she have pictures in her room? does staff know her social/work history? she might respond to talking about past interests if time allows maybe staff could visit with her a few minutes here and there, without bringing pills or treatments i'd bring her flowers and see how she reacts (if that's not safe, she's definitely not ALF)[/quote']
Flowers are a great idea!! I might try that.
Supposedly her family "forced" her here from her home across the country so they could be near her..or make sure she is not in harm's way with her dementia. With alf policies in va, i don't think we can force her to bathe/change clothes.

redmorgan · Feb 4, 2014

I agree with the other posters. It sounds like she's exhibiting dementia behaviors...the refusal of hygiene, refusing medication/care, socially inappropriate comments, etc. She should have a psych evaluation and a complete physical. It sounds like she's no longer appropriate for AL.

I work in LTC and deal with all kinds of behaviors. I know it can get to you some days, but try not to take it personally. Just be professional and put yourself in an objective/clinical frame of mind.

Good luck!

amoLucia · Feb 4, 2014

I like that flowers idea, too. 'Get them with kindness' is a good approach. With the coming Valentine's Day, I'd try something like a treat - a loaf of cinnamon bread works wonders (give a tub of spreadable butter also). I'm pretty sure nobody is bringing her anything special.

In LTC, our pts never got cinnamon bread. It would be such a treat for pts STUCK in the place to get something special like cin. bread. So every now & then, I'd bring in loaves and pass it out to many residents. Well appreciated.

IowaKaren · Feb 6, 2014

Oh, it's amazing what is accepted into the ALF and how long they will be there and we all know it's not the right place for them but as long as nothing bad bad happens, it will be this way. Hopefully, before something very bad happens, the powers that be will recognize when it's time to make some status changes.