Nursing Assistant Monthly February 2007 When a resident resists care

When a resident resists care

The challenge of dementia

Nursing Assistant Monthly February 2007 When a resident resists care

Why residents with dementia may resist care

Confusion may result in

•Fear

•Misinterpreting the environment or the caregiver’s

intentions

•Pain

•Physical need (such as hunger, need to use the

bathroom)

•Painful memories (for example, of a sexual assault)

Nursing Assistant Monthly February 2007 When a resident resists care

Signs of distress

Remember to report these to the nurse so resident can be evaluated

• Crying

• Pacing

• Agitation

• Angry outbursts

• Combativeness

• Withdrawn behavior

Nursing Assistant Monthly February 2007 When a resident resists care

Bathing

• Bathing is especially frightening to some residents

• Fear of running water is common

• Resident may associate bathing with discomfort

(cold, pain)

• Caregiver’s actions may be misinterpreted as an

attack

Nursing Assistant Monthly February 2007 When a resident resists care

Helping residents feel calm

• Prepare environment (room temperature, low lighting, supplies

handy)

• Prepare resident (toileting, simple explanation)

• Use gentle, caring approach

• Speak slowly, calmly

• Keep resident comfortable and protect dignity

Nursing Assistant Monthly February 2007 When a resident resists care

If resident still resists care

• He/she is sending a message: “I cannot

tolerate this. Please stop!”

• Never argue or insist

• Stay calm and try to reassure resident

• Another caregiver may be able to get

cooperation this time

• Try again later when resident is calmer

Nursing Assistant Monthly February 2007 When a resident resists care

Brainstorm

• Listen to the messages the resident is sending

• What is the unmet need?• Get to know the resident and his/her

likes/dislikes• Brainstorm with other staff to find a better

way, alternatives to current approach• Take a deep breath- be patient• Be creative! Be flexible!