Well this is probably going to sound like a broken record but here it goes. At my facility we have a male resident who rings approximately 20 or more times a shift to get up and down on his bedside commode. The problem with this is transferring him back and forth from bed to commode and so forth. Many times due to his weak legs we have asked him if using a bedpan would be okay? The lift that we have is a full hoyer and isn't practical for this type of transfer. The Licensed staff demand that we transfer him back and forth as many times as he requests. Over a dozen girls have been injured in one way or another by this resident as he weighs over 200 pounds. He is sexually aggressive and rude and yells nurse! nurse! in between using his call lite. He has three different alarms on his bed because of non-compliance with using his lite to ask for assistance. He will not wait one minute for anything. The other residents do not like this guy because of the time he takes away from them. We have approached our nursing staff with the problems we have with his care and they say that we must continue to obey his requests. I feel that these nurses need to try their hand at this resident for a day and see if they can go home without a sore back and sprained arms. What can be done with this situation before this resident gets seriously hurt or we CNA's do? Our LVN is fed up too, she has went in the room and politely informed the resident that he needs to use his bedpan if he is to weak to bear weight on his legs because he is hurting the girls and he says "Who cares" I pay their wages"
Specializes in Gerontology, Med surg, Home Health.
Residents have the right to be toileted when they need to but not necessarily when they want to....some demented residents think they have to go every 15 minutes. It is not normal to 'go' this frequently. Since the poster says there is no medical reason...think behaviors. He is rude and sexually aggressive. He has no right to be that way. Have someone, preferably male, speak to him. Maybe some sort of schedule will let him feel he has some control over his life if not his toileting schedule.
And, thank goodness for the Ombudsman in my area. She can spot an unreasonable resident a mile away and does not always 'side' with the resident.
Thanks for all the input, I appreciate the help , I will try some of the suggestions I have read. I agree that the resident should be able to use the commode when he wants as I myself would not want to sit and wait for to relieve my self. But he has been evaluated and has no physical problems that the doctors can see that would make him need to go so frequently also the majority of the time he doesnt do anything. He is very mean and demanding. We don't have a standing lift at my job as of yet.
Thanks again everyone!
Pumpkin92356
Which doctor? Gastroenterologist? Psychiatrist? He needs to see a specialist. Keep the food diary.
Residents have the right to be toileted when they need to but not necessarily when they want to....some demented residents think they have to go every 15 minutes. It is not normal to 'go' this frequently. Since the poster says there is no medical reason...think behaviors. He is rude and sexually aggressive. He has no right to be that way. Have someone, preferably male, speak to him. Maybe some sort of schedule will let him feel he has some control over his life if not his toileting schedule.
And, thank goodness for the Ombudsman in my area. She can spot an unreasonable resident a mile away and does not always 'side' with the resident.
No, it's not normal. Exactly my point in saying that there could well be some medical and/or mental problem, something that the GP or FamPrac or Gerontologist hasn't thought of or ruled out. Specialist eval is needed. Psych med might be needed. Schedule is a great idea AFTER the above are done. And talking with him, in a courteous, non-threatening way, is great, too. First, rule out the physical. And again, it is totally important to remember that residents have been forced into a living situation that most sane people would never choose. They have had to give up so very, very much. We need to be ever aware of their loss and their grief and treat them with respect and dignity and have a true heart of caring for them.
Another thought - has anyone tried some recreational therapy with the OP's patient? Some volunteers, some doggie visits, something to do? Boredom might be a factor.
Is he capable of using a urinal? If so, I would definitely drop one on his bedside table. It wouldn't be right to be doing things he can do for himself. And maybe try a 1 hour toileting schedule for his bowels?
As for how heavy he is; Isn't there a limit as to how much weight you guys should be bearing? Have PT look at him, if he is over this limit, there should be another way to transfer him. I realize that a mechanical lift so often may be a challenge, so what bout a slide board to his bedside commode?
Specializes in LTC, assisted living, med-surg, psych.
Definitely, a PT/OT consult is in order, as is a urology eval. He could have an infection; he could have stones; he could have an enlarged prostate; he could have all three. And frankly, if he has any of these conditions I can understand why he might be mean and nasty---he is probably UNCOMFORTABLE!
If all these conditions are ruled out, he might benefit from a medication such as Ditropan or Detrol to help reduce the sensation of urgency, as well as a urinal to use in between toiletings. If all else fails, THEN request a psych eval........we should never assume that undesireable 'behaviors' are due to psych issues.
Residents have the right to be toileted when they need to but not necessarily when they want to....some demented residents think they have to go every 15 minutes. It is not normal to 'go' this frequently. Since the poster says there is no medical reason...think behaviors. He is rude and sexually aggressive. He has no right to be that way. Have someone, preferably male, speak to him. Maybe some sort of schedule will let him feel he has some control over his life if not his toileting schedule.
And, thank goodness for the Ombudsman in my area. She can spot an unreasonable resident a mile away and does not always 'side' with the resident.
Why would they want to be toileted when they didn't need to go? Or be willing to toilet when they don't want to?
I would call his Dr. to see if you can get an appoitment with a GI Dr. Have pt evaluate him. May be he needs to be seen by psych. You know your patient best, sometimes it could be that there is something wrong with him and that needs to be addressed
Specializes in Gerontology, Med surg, Home Health.
Why would they want to be toileted when they didn't need to go? Or be willing to toilet when they don't want to?
Because some people have attention seeking behaviors and any attention they get, they perceive as good. If he is being sexually inappropriate, what better time for him to be so than when he is being toileted?
Believe me some residents that are A+OX3 love some attention, and they will go a zillion times to the bathroom for attention, if that is the only way they will get attention that way!
CapeCodMermaid, RN
6,092 Posts
Residents have the right to be toileted when they need to but not necessarily when they want to....some demented residents think they have to go every 15 minutes. It is not normal to 'go' this frequently. Since the poster says there is no medical reason...think behaviors. He is rude and sexually aggressive. He has no right to be that way. Have someone, preferably male, speak to him. Maybe some sort of schedule will let him feel he has some control over his life if not his toileting schedule.
And, thank goodness for the Ombudsman in my area. She can spot an unreasonable resident a mile away and does not always 'side' with the resident.