You don't have to work in long term care for long before you encounter a difficult person. Sometimes it's a resident, other times a coworker, or even someone outside the facility like a resident's family member or doctor. Beyond the golden rule, what can you, as a health worker, do to improve these encounters? To simplify things, I'm going to address issues with residents here. A lot of these tips are universal and can help with any difficult person, but some are very specific to long term care residents.
First off, no matter how difficult it is, keep your temper in check. It's easy to get your hackles up when people are being belligerent - moreso when you know you're right and they're wrong - but nothing will
ruin the encounter faster than a lost temper. If you need to leave the room or turn away to regain your composure, do so. Taking a deep breath and letting it out slowly, or counting to ten in your head,
really does help.
Composed and ready to face the situation now? Great. It's important to remember that many residents are adjusting to many changes in their lives. It is very rarely about you, and almost always about something
else that's bothering the resident, so don't take outbursts personally. The loss of health and independence can be very hard to face. Fear, anger, sadness, and pain can pervade almost every aspect of a person's life when they first transition to assisted care. Keep in mind that any of these things might be behind a resident's rudeness or inappropriate behavior. Instead of scolding the resident, or getting your feathers ruffled, use your empathy skills to gently encourage a resident to share what is bothering him or her. A leading question like, "I hear a lot of tension in your voice. Is your pain worse today?" can give the resident the chance to tell his or her side of the story. Let your residents know that you're on their side
and will do everything in your power to help address their issues.
Now, with a belligerent resident, this might be an invitation to carry on about problems and pains, whether real or imagined. Do your best to get to the heart of their issues and offer solutions. Is Mr. Smith's wheelchair pad worn and causing discomfort? Is Ms. Jones' robe aggravating her skin condition? It's often the simple fix that can diffuse the litany of complaints. If fear is the root of the problem,
demonstrating empathy and sharing your knowledge might be all it takes to set a resident's mind at ease. Perhaps a resident is balking at taking medication because he or she doesn't fully understand why it is
necessary. Telling the resident to "take it because the doctor said so" won't help the situation. Use your knowledge to explain, as best you can, what a medication does or doesn't do, and set the resident's mind at ease. A resident might also lash out due to loneliness. Do whatever you can to be a friend to your residents. Sometimes all they need is someone to listen. Talk to your facility's Activity Director or Social Services representative and arrange for the resident to attend a group activity or have a volunteer stop by and visit with the resident.
First off, no matter how difficult it is, keep your temper in check. It's easy to get your hackles up when people are being belligerent - moreso when you know you're right and they're wrong - but nothing will
ruin the encounter faster than a lost temper. If you need to leave the room or turn away to regain your composure, do so. Taking a deep breath and letting it out slowly, or counting to ten in your head,
really does help.
Composed and ready to face the situation now? Great. It's important to remember that many residents are adjusting to many changes in their lives. It is very rarely about you, and almost always about something
else that's bothering the resident, so don't take outbursts personally. The loss of health and independence can be very hard to face. Fear, anger, sadness, and pain can pervade almost every aspect of a person's life when they first transition to assisted care. Keep in mind that any of these things might be behind a resident's rudeness or inappropriate behavior. Instead of scolding the resident, or getting your feathers ruffled, use your empathy skills to gently encourage a resident to share what is bothering him or her. A leading question like, "I hear a lot of tension in your voice. Is your pain worse today?" can give the resident the chance to tell his or her side of the story. Let your residents know that you're on their side
and will do everything in your power to help address their issues.
Now, with a belligerent resident, this might be an invitation to carry on about problems and pains, whether real or imagined. Do your best to get to the heart of their issues and offer solutions. Is Mr. Smith's wheelchair pad worn and causing discomfort? Is Ms. Jones' robe aggravating her skin condition? It's often the simple fix that can diffuse the litany of complaints. If fear is the root of the problem,
demonstrating empathy and sharing your knowledge might be all it takes to set a resident's mind at ease. Perhaps a resident is balking at taking medication because he or she doesn't fully understand why it is
necessary. Telling the resident to "take it because the doctor said so" won't help the situation. Use your knowledge to explain, as best you can, what a medication does or doesn't do, and set the resident's mind at ease. A resident might also lash out due to loneliness. Do whatever you can to be a friend to your residents. Sometimes all they need is someone to listen. Talk to your facility's Activity Director or Social Services representative and arrange for the resident to attend a group activity or have a volunteer stop by and visit with the resident.
Another issue that faces residents as they transition to a nursing facility is the feeling of a loss of responsibility. Many resent going from being parents and caretakers to being dependent on others. Refusing to take medicine, or not wanting to attend meals in the dining room can point to a deeper issue. Residents are going from being in control of their own schedules to being forced into a facility's schedule, and that can be tough. You can help by offering residents choices and allowing them to exercise independence and judgment on their own. Instead of offering water with pills, let the resident chose between water, milk and juice (according to the diet plan). Ask residents what time they like to eat meals, and if the time is different from your facility's dining hours, see if it would be possible to arrange for an
in-room meal at a time more fitting for the resident.
In all encounters, focus on the positive. If you need to get through an awkward or unpleasant activity (like a sponge bath) chat about a TV show coming on later that day, or about the facility-wide Bingo gamein-room meal at a time more fitting for the resident.
that evening. If a resident is fighting you as you try to change a wound dressing, remind them that the sooner you finish, the sooner the resident can go back to doing something he or she enjoys. Let them see that by sitting quietly and letting you do your work, they can move on to more pleasant things more quickly.
Finally, be on the lookout for residents who suffer in silence. Most people are taught to keep a stiff upper lip, or to remain stoic in the face of troubles, so it can be very hard for your residents to admit they are hurting and need help. Use your skill at reading body language to help see beyond the surface behavior to what might be going on under the surface. Stiff posture or fidgeting might indicate a person is in pain. Staring into space or frequent sighing can clue you in that your resident's mind is on something other than the here and now. It might be too embarrassing for residents to discuss medical problems with you at first, but if you demonstrate an air of trust and make your residents feel safe, you can help them to express what's really behind "bad" behavior.
Want to read more on this topic? Check out these articles.
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