Why does this man's personality change instantly

[Butterfly92xo]

I am a carer in a residential home, and we have set units what we work on. On this particular unit, there is a gentlemen who is such a pain in the backside! He loves his buzzer, and he loves it when young women come on the unit (hence why I dread it!) Anyway, yesterday, he wasn't too bad at all, he didn't press his buzzer very often and it was all dandy. Me and another carer was getting him onto a stand-aid, and he kept going ''I want to use the hoist'' (goodness knows how that came about!) I explained that he does not have a sling or is not assessed to use the hoist unless in genuine emergencies, and that he is quite capable of using a stand-aid as his wife has tried hard to get him assessed for it, then he went CRAZY! Going ''You have NO idea do you! Seriously if you do not get the hoist, I am going to hit you, and you (pointing to the other carer), we ignored this and just carried on because of this outburst, put him in the bathroom and left him. He only wanted it so that he can take more of mine and the other carers time.

He kept buzzing constantly, and every time we asked if he was finished, he says no. So we turn the buzzer off, and we emptied his bag, then he said he wants it emptying again (the bag was already emptied! Just emptied it there and then) and had ago at the carer, calling us a ******, etc. I said there was no need for him to be like that, and why has he got an appalling attitude. I said to him I am going home in 10 minutes as it was the end of my shift then he immediately said he is finished (he didn't need the toilet - he always does this!), we got him over to the bed, he tried forcefully to pull off his conveen, but I said if he does, I will not be changing it because I do not want to speak or go near him and he can lay in a pool of urine until the night staff come on. He continually buzzed that night before I went home... Literally, the minute I left the door he kept on buzzing. I went in one last time and he apologised (he always apologises! He does this to majority of the people), but I just said "you are always apologising, and you do not mean it. Anyway I am going now because you are a really rude man, and I do not want to be near you", and I just went home.

You must all think I was really rude but he really did annoy me with his horrid attitude and we tried helping him! He continues to buzz throughout the day, knowing you are toileting/showering/feeding people and it is so hard, if you leave it for too long, he will set the emergency off. He has a brain injury, and also vascular dementia. We have reported his violent outburst and continuous episodes of pressing the call bell and taking up our time - so many times but nothing is getting done about it. What else can I do? I am dreading working on that unit again because of his stinking attitude towards me and the other carer.

He was calling me names like thick, I cheated to get into uni, I am dumb, I don't know anything - can't I leave sooner, etc :/ Really sad!!

[VivaLaVespaGirl, BSN, MSN]

Is this a joke? Your treatment of a man who has dementia and a brain injury is what is appalling.

[JustBeachyNurse, LPN]

Perhaps you need to consult with your company trainer/educator to take some courses on Alzheimer's & dementia training and how to interact with clients. Additional coursework in working with dementia clients , the manifestation and progression of the disease and best practices is mandated by my state for all staff in LTC and assisted living. Your treatment of this man who's disease may be progressing is unprofessional and appalling. If this was witnessed in my state, you would be facing citations and job loss for what amounts to abusive behavior of a disabled senior citizen.

[ICURN3020]

I understand that patients with diagnoses such as brain injury, dementia and Alzheimer's can be challenging to care for. However, it is obvious from your post that you do not understand the processes or symptoms of these terrible diseases. As another poster mentioned, please educate yourself

[ICURN3020]

I understand that patients with diagnoses such as brain injury, dementia and Alzheimer's can be challenging to care for. However, it is obvious from your post that you do not understand the processes or symptoms of these terrible diseases. As another poster mentioned, please educate yourself. These patients cannot help or control their attitudes or behaviors like you and I can. You describe your role as a "carer"....what exactly is that? I'm hesitant to believe that you have had much professional education based on your post.

[roser13, ASN, RN]

Please find a new position. It does not appear that you are enjoying this one anyway, so why not?

At any facility in which I've worked, your actions and attitude simply would not be tolerated.

[blondy2061h, MSN, RN]

Do you have the same patient every shift, or is this man being rotated amongst employees? He sounds very challenging.

I suspect your treatment of him may be why he keeps buzzing and have g outbursts. If he feels well cared for, like you want to meet his needs, he will likely be calmer. Nonetheless, he has dementia. You're an employee. Don't sink to his level.

[Esme12, ASN, BSN, RN]

Your usage of the word carer...are you in the US? Is this a "project" for school?

It is not acceptable to speak to patients this way. You need to speak to the nurse in charge for a psych eval or perhaps medication to help modify this patient behavior. Under no circumstances can you threaten a patient to lie in urine because he is a rude person.

He has a brain injury, and also vascular dementia.

I think you need to speak with someone in charge to help you develop ways to deal with this patient.

[MissMoo25, BSN, MSN, RN, APRN, NP]

To address the topic of this post, the reason is because of his dementia. His disease process is what makes his behavior a bit challenging. I agree with the other posters about seeking professional workshops because I would like to believe that if you knew more about how the disease affected his behavior, your response would not have been the way it was. It is unprofessional to respond to him in the manner you did and you in a way threatened him. Please be wiser about the way you interact with patients, but if you really don't know how to seek assistance.

[Orangeman4]

Pre-Nursing Student?! I'd say you might be in the wrong field if you're already experiencing a burn-out aspect with this kind of care. Hang in there or find something new (not healthcare related)

[Everline]

he tried forcefully to pull off his conveen, but I said if he does, I will not be changing it because I do not want to speak or go near him and he can lay in a pool of urine until the night staff come on.

I am really trying to understand how you think this is ok to say or do.

This post scares me. I hope you educate yourself and remove yourself from that position, whatever it is, if you are unable to change how you interact with patients. I understand it is difficult but what you describe is not acceptable at all.

[LadyFree28, BSN, LPN, RN]

Because this "gentleman" is exhibiting these behaviors due to his progression of his Dementia, and add a TBI to it, you are going to take a step back and find a better way in communicating with this patient.

I highly recommend Googling a picture of a brain plagued with dementia; and then proceed to Google "how to deal with challenging behaviors" and get the information, and apply it to your interactions with all of your pts, and go from there.

Best wishes.