Aggression in NH

[SharonLyons]

My mum is now on a waiting list for a NH but I am very concerned about what will happen to her when she is there. She can be quite abusive and sarcastic and generally nasty to people (she can also be very happy, funny and chatty!). I just wondered how nursing homes deal with this sort of behaviour. I know it is a characteristic of dementia but what exactly do the NH staff do when they have one resident virtually fighting with another?
Sharon x

 

[Grannie G]

Sharon, be upfront with the NH and tell them your concerns.

Ask what their procedures are for dealing with challenging behaviours. It will be much better if you work with the NH rather than bottling up these concerns.

I imagine there are always challenging behaviours in NHs registered for care for those with dementia. I`m sure the home will be able to put your mind at rest.

Please post an update when you find out. It will be interesting to all of us.

 

[Canadian Joanne]

Sharon,
If your mother is only verbally abusive, I think the staff shouldn't have any problems. It is best to let them know the entire range of her emotions ahead of time so they aren't surprised. Certainly I have seen and heard a lot of squabbling and name calling in my mother's home and the staff just step and redirect.

 

[Mameeskye]

This was something I was used to seeing in Mum's home. The staff actualy used to joke about the effect of the full moon!

There are a number of techniques used in the homes.

Firstly if there are people not getting on they try to ensure that they are not seated together for a while.
If they see that a problem is arising a carer will generally step in to defuse the situation
If this appears to fail they will try and relocate a resident to another area, their bedroom, an office where someone is working and give them a cuppa etc.
Sometimes a resident will be taken to their room for some time out and their TV/radio etc. put on
Sometimes, if appropriate, a resident will be taken out for a walk.

The staff will learn to look for indicators of poor behaviours before they happen and also the times of days and situations upon which they happen.

Mum's staff were also aware that although Mum was mainly "sweet" she could be "feisty"!! They always tried to ensure that residents with similar abilities both physical and otherwise were grouped together. This tended to prevent the problems that could erupt if someone became aggressive while sitting next to someone extremely frail.

Yes, at sundowning time you could get walking sticks at 6pm. You learned when you visited regularly what happened.

It was not always easy for the staff, quite literally because without one to one cover there were always occasions that the whole palce could erupt (normally full moon hence the earlier comment) No one knew why, but I assume from having young kids that they feed off one another's emotions.

Let the staff know the situation. If the are forewarned then they are most likely to succeed with behavioural interventions at an early stage.

Mameeskye

 

[SharonLyons]

Thanks for your replies. Mameeskye, You made me laugh about walking sticks at 6pm!! I do believe it is true about full moon. I worked in a special needs school and we have noticed the same thing there!
Sharon x

 

[CraigC]

Hi Sharon,

In my experience homes seem very able to cope with different personalities and as Mameeskye pointed out a little bit of humour can help. A lot of us worry about this when someone goes into care, but in care homes they see it all and soon get to assess someone and get to know there personality. It is the nature of the illness that some people get agressive and any good home will be able to cope well.

Also think it very important to be very upfront about behaviour from day one as both you mum and the home need to be comfortable. The more the home know about your mum the better and the easier it will be for them to assess her needs. But this should all be made clear when they do and assesment before your mum goes to the home - in my experience they leave the assesment until a place becomes free.

Is it a dementia only home or mixed nursing home?

Kind Regards
Craig

 

[Alison K]

Full moon - the morning after

Hope this will make u laugh but one of our recp staff at the Drs where i work swears pts are always more grumpy, aagressive and down right impossible after a full moon. must bring out the werewolf in all of us!! Hope this makes you smile. Laughter is the best medicine love Ali

 

[Grannie G]

It`s true.

My husband is a Cancer birthday and has always been affected by a Full Moon.
If it can affect the tides, why shouldn`t it affect our moods.

 

[Skye]

Mortar board time!

The words lunacy, lunatic, etc, come from the Latin word luna, the moon!

So even the ancients knew about it!

 

[hendy]

Dear Sharon
When visitng Dad I've seen all sorts and it always amazes me how well trained staff are at dealing with issues! Its quite remarkable. Of course its a worry, but I had a chuckle a couple of weeks ago when there seemed to be a peculiar 'game' of musical chairs going on between patients(without the music though)various mobile ladies and gentleman were scuttling across the room and pinching each others chairs! I didn't spot any wielding walking sticks, I suppose its a good job really! Things can certainly get heated at times. Apparently my dad has an uneasy knack of moving toward hot spots. It occurred to me it might be because, in his professional life he often had to deal with difficult behaviour of patients himself! I think he might still be trying to assert his authority, although now he's not capable of doing this at all now. Sadly.
take care
hendy

 

[SharonLyons]

Thanks again everyone.
Craig, the home I am waiting for is a mixed nursing home but it will eventually be a dementia home only.
Hendy, my mum used to be in charge of an office with about 20 staff so she also tries to assert her authority and a couple of times when she has been in hospital, she walks around, very slowly, with her hands behind her back just keeping an eye on everyone!
Skye, how true, lunar!!!! How bizarre!
I just feel that with this aggression,(so far only ever verbal)as I have so much trouble coping with it, how is anyone else, who doesn't actually love her, going to be kind!
Thanks again all.
Sharon x

 

[helen.tomlinson]

Hello Sharon

who doesn't actually love her

I think it's because you love her that you find it difficult to deal with her aggression. The staff at the home are, or should be, trained to deal with it and it's different when it isn't personal - it doesn't hurt at all in the same way.

Love to you

Helen

 

[Skye]

I just feel that with this aggression,(so far only ever verbal)as I have so much trouble coping with it, how is anyone else, who doesn't actually love her, going to be kind!

Sharon, they do, believe me! Actually, they do love their patients, and especially enjoy the feisty ones.

My husband John is in an EMI unit, and there is a lady there who used to be a nursing sister. She's so tiny a breath of wind would blow her over, but she sits in her chair giving out orders to all and sundry! One day when I was standing beside John, she ordered me to sit down. I said I would in a moment, but I had to find a chair first. She said 'Sit down at once! You're not well enough to be standing yet. I'll tell you when you can stand up!' She's absolutely wonderful.

Another lady, equally tiny, pointed her finger at one of the carers and said,very threateningly, ' I'm watching you! You with the fat ****'! Of course, everyone collapsed in giggles, including the lady, and the carer (who is rather large!)

Another one, 96 next week, sticks her foot out to trip up any unwary carer who walks by!

These ladies are adored by the staff.

Don't worry about it, your mum will be fine.

 

[CraigC]

Craig, the home I am waiting for is a mixed nursing home but it will eventually be a dementia home only.

It sounds like they will be well versed in dealing with dementia issues and possible agression. I'd be a little more nervous if it was a nursing home that had just a few dementia residents. In my experience nursing homes that we've used (i.e. with just a few dementia places) struggled to understand and meet the needs of dementia. There is also the issue of security in some nursing homes.

I agree with Skye, best not to worry. This is exactly what the assesment is for, to put everyones mind at rest and makes sure needs can be met.

Kind Regards
Craig