At times, your loved one may not want to take a bath or get dressed, or they may refuse to take medicine or just not cooperate. A person with Alzheimer’s disease might do this for many reasons. They may feel ashamed when they need help with things or stressed by not being in control. They may not understand what you’re asking them to do. This can be frustrating, but it’s important to remember that they’re not trying to make things harder for
you. It can help to think about what was happening right before the problem started: It could be that they think something’s happening that isn’t (a delusion). For example, do they accuse you of things that aren’t true? They could also be hungry, thirsty, hot, cold, tired, or in need of the bathroom. People with
Alzheimer’s disease may seem to be refusing help when they’re actually sick. They may seem to be weaker, less hungry, or more tired than usual. They won’t seem like their normal self. If you see these signs, talk with their doctor. Once you think you’ve figured out the cause, make a
plan and see if it helps. You can try a few simple things right away that might make a difference: You may need to try several of these things. If none of them seem to help, talk with a doctor. If your loved one thinks something’s happening that isn’t, don’t argue with them. You might: Sometimes when someone with Alzheimer’s disease doesn’t want help, they may do things like hit, push, curse, or scream. If you can’t calm your loved one down when they get upset, stop what you’re doing and back away. Keep dangerous things like guns, knives, glass, and sharp or heavy objects out of the house or locked away. Ask someone nearby, like a neighbor, to be ready to help if you need them. Tell the doctor if they’re often agitated or likely to lash out. As a CNA, you're on the front line of patient care, and you probably spend more one-on-one time with residents than any other professional in your facility. While your job provides the opportunity to make a difference in the lives of others and form close relationships with the people in your care, it's also challenging. Residents aren't always on their best behavior, and they may act out from time to time. Knowing how to deal with combative residents is essential for maintaining a positive and safe environment for everyone. Assess the SituationNo two residents are the same, and their reasons for acting out differ considerably. Anger is often a secondary emotion, and residents are typically combative because they're feeling something else, according to Connected Risk Solutions. Some patients may feel physically uncomfortable, while others could be disoriented or confused in their surroundings. Residents with dementia, Alzheimer's or another degenerative disease are particularly prone to agitation because they have difficulty identifying where they are, communicating with the people around them and carrying out tasks that were once easy for them. Assess what's causing the resident's behavior before you approach her. Identify what triggered her to act out so you can alleviate the stress that led to her outburst. Formulate a PlanWhen dealing with combative residents, think before you act if you want to help them return to a calm state. Once you've identified the trigger or cause of their agitation, remove it immediately. This could be as simple as turning down a television that disturbed them or taking them back to their rooms, where familiar items will make them feel comfortable and at home. Be empathetic, but retain your position of authority when interacting with residents. Don't feed into their outbursts by allowing your behavior to mirror theirs. Remain calm, collected and in control, says Minority Nurse. By setting an example of appropriate behavior, you can bring residents up to your level and gain control of the situation. If you can't calm a resident on your own or think your physical safety or the safety of other residents is at risk, call for another CNA, a nurse or a doctor immediately. Document the EventMost care facilities require CNAs to document all outbursts or otherwise out-of-the-ordinary encounters with residents. Take note of the time of the tantrum and report what happened from an unbiased point of view. Avoid inserting your opinion as well as exaggerating or downplaying the event. In order for the resident's doctor, case worker or family to make effective and educated decisions regarding the resident's care, they need the facts. Documenting the event will help identify patterns or regular triggers so you can keep stress to a minimum in the future. Prevention and Modifying the BehaviorIn order to keep your care facility a safe, nurturing place for residents and employees, try to prevent residents from becoming combative in the first place. If a resident has a reputation for hostility and you know what triggers it, keep her away from those triggers as soon as possible. Watch her behavior closely and intervene before she has the chance to become combative. For example, if you see her pacing and looking disoriented, don't wait for her to start yelling or crying before you act. Approach her immediately, remain calm and take her to a place where she feels safe and comfortable. In some instances, you can help residents learn to modify their behavior. For example, when a resident has calmed down after acting combative, tell her she can approach you when she feels uncomfortable and you'll help her deal with it. By being proactive and presenting yourself as a friend and mentor to residents, you become a person they can trust and go to when they feel agitated. What does resistive to care mean?The definition of "resistance-to-care" means physically and/or psychologically resistive behavior, for example "pulling away from staff, tightening limbs, stiffening the body, deliberately ceasing or refusing to weight bear during care, waving arms and legs and verbally objecting to care using words and/or sounds" (p.
How should the CNA respond to a resident who is exhibiting difficult behaviors?Approach her immediately, remain calm and take her to a place where she feels safe and comfortable. In some instances, you can help residents learn to modify their behavior.
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