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!!
I agree that the online poster's approach is inappropriate. However, where is the professional nursing leadership? What plan has been developed for dealing with this patient's behavior? Surely the problem is evident to others in the facility.
Probably more like either embarrassment or fury at the overwhelming responses. I don't feel that he/she has likely had any training whatsoever in dealing with the elderly population and all of its presentations. Of coirse I can't know that from one post on the internet, but it seemed clear that OP did not feel that he/she was acting inappropriately.
Hopefully op is at least lurking but they've probably decided we're a bunch of meanies that don't know what we're talking about.
You wouldn't be this nasty (I hope at least) to a toddler that had an age-appropriate tantrum or wet their pants, so why do it to an elderly person? I know we're supposed to remember to treat them like the age they are, but sometimes it does make it easier to think of these issues as being sort of reverse development. Their id is at the helm again, so to speak.
I am trying to come up with a way to phrase what I want to say but still be tactful...
OP, I think you realize by now that your actions in responding to this patients behavior are incorrect. Other posters have described your actions as abusive and neglectful, and they are not wrong. As someone who always wants to believe the best of others, I interpreted your post as coming from someone who is ignorant and uneducated, not outright malicious.
I assume that you are a young person or at least someone with very little experience in healthcare. What you need to realize is that this mans behavior is explainable by his diagnosis, and is not something that he can control. People with dementia literally have a problem with their brain and the way that it functions. It's a disease. Their responses and actions are the result of a diseased mind. Dementia is a progressive disease that only gets worse, there is no cure. The patient has no control over this process. A patient may even LOOK healthy and mentally intact, but they are NOT.
I won't get too lengthy with my post-- I really encourage you to seek out education on these types of patients (dementia, brain injury).
This resident may not have control over his actions and behaviors, but YOU have control over the way YOU choose to REACT to them. You cannot take his behavior offensively or personally. This isn't about you. It's about this man and making sure that he receives the appropriate care. The resident that you are caring for is not the same person that he used to be before this disease started. That breaks my heart. You need to find some compassion for him.
I hope that you are still reading this thread. Please seek out educators at your facility and ask for more information on the ways to care for people with dementia. Approach the nurse if able and report this residents behavior. Perhaps he needs further nursing/medical interventions (such as a change in medication or a psych re-eval).
In the meantime I think you need to immediately separate yourself from his this mans care. You are taking him too personally to be able to provide the quality of care that he deserves/needs. Point blank, you aren't providing adequate care and are doing more harm than good.
I wish you good luck... I really do hope that with some education on dementia you will realize how your behavior/actions have been inappropriate...
OK, now that we all have discussed how inappropriate the "carer's" response was, lets talk about the stand lift versus the hoyer. I found a lot of patients liked the stand lift because of the way the hoyer slings fit them. They actually hurt the patients. The use of the stand lift requires that the pt is able to follow simple directions and usually PT has to evaluate their standing ability. The stand lift may be more comfortable for this pt, but he may not qualify for it because of his inability to follow directions or inability to stand. The lift just assists him, it does not do the standing for him. Maybe he should be a slide-board transfer, ask your nursing staff to consult PT to see what is the best way to transfer this pt!!! His dementia may prevent him from being able to participate in the lift.
OK, now that we all have discussed how inappropriate the "carer's" response was, lets talk about the stand lift versus the hoyer. I found a lot of patients liked the stand lift because of the way the hoyer slings fit them. They actually hurt the patients. The use of the stand lift requires that the pt is able to follow simple directions and usually PT has to evaluate their standing ability. The stand lift may be more comfortable for this pt, but he may not qualify for it because of his inability to follow directions or inability to stand. The lift just assists him, it does not do the standing for him. Maybe he should be a slide-board transfer, ask your nursing staff to consult PT to see what is the best way to transfer this pt!!! His dementia may prevent him from being able to participate in the lift.
I thought the OP said they were using a stand assist (I assumed stand lift like you described), and the patient requested a "hoist" (I imagined this as a full body hoyer lift). Not the other way around.
The OP doesn't seem to be from the US though, and I am, so maybe I'm reading that wrong.
Agree that a different form of transferring and PT/OT eval would appropriate though.
The lift is more passive, and the stand lift requires a whole lot more in the way of multi steps.
And I have to say that if I just wanted to get to the bathroom, the hoyer is perhaps the better, quicker option.
However, this is a brain injured patient who has little control. So this becomes a struggle for control. Not a remotely appropriate one on the part of the "carer" but never the less, the time to not have this issue come to light is when the patient needs to use the bathroom.
It is frightening how many CNA's/carers whatever you want to call them are NOT properly oriented to lift devices, proper body mechanics, or dealing with challenging disease process that causes behavioral issues. The educational focus seems to be on vitals, bed baths, walking patients to the bathroom...but little on hoyers/stand lifts or how not to wreck one's back while lifting. And most often, CNA's have to work alone--which is just nuts to me--
Because the OP stated that she was with someone else in this debacle I am surprised that the other "carer" didn't say "hey, this is not correct" or take charge of coordinating this patient's move. Because that did not seem to occur, one could assume that no support staff is really educated on what the heck they are doing. Not only dangerous, but sad for the patients.
bookwormom
358 Posts
I agree that the online poster's approach is inappropriate. However, where is the professional nursing leadership? What plan has been developed for dealing with this patient's behavior? Surely the problem is evident to others in the facility.