Dealing with Challenging Situations
In the last few weeks, I have received three reports from the nursing home where my dad lives, regarding his “aggressive behavior”. Each time, the nurse begins the call with “there was an incident with your dad this morning.” It almost always continues with “the staff person was trying to help him get dressed or was taking him to the shower, and he hit her.” When I ask for more information such as “What did she say?” or “How did she approach him?” the answer is “well, I don’t know, I just know that he hit her. I’m calling because I have to tell you about it and write up a report.”
The pattern of these phone calls is frustrating to me. I have never asked to read one of the reports. I probably don’t want to know what it says. I’m confused and dismayed with the lack of interest in wanting to do any type of reflection on what is causing my father to react to the staff in that manner. Why would you not want to change things for the better and improve the outcome of the interactions?
I always suggest that they look at the environment, their approach, their words, actions, and how they look. They should also pay attention to what my father says, and how he looks. The nurse last week did tell me that he said “no” to the staff person (who was new) but she continued to try anyway. Well, now we are getting places. I reminded her that no means no, and his reaction should not be ignored. Ignore it at your own risk.
I find the phone calls upsetting but I try to remain calm, take a deep breath, and think before I speak. I feel like I am being hauled into the principal’s office every time the phone rings. I’m not sure that staff understand the impact on family each time they have a conversation that centers around their loved one being “bad”. If they only knew my father as the sweet, kind and gentle person that he is.
I always remind them that there are two people involved in the incident and that it takes two to tangle. One young man has a bit of a knack for helping dad. He has said to me “if I enter the room and look friendly, and your dad is friendly in return, I know the interaction will likely go well. If he isn’t friendly than I leave and try again in another minute or two because I know that trying to help him dress or wash up, probably won’t go well.” Wow, what an insightful and observant care partner! I wish more people would pick up on visual cues and not continue to push their agenda when they are not welcome.
I heard Teepa say recently, “the person with dementia isn’t thinking health care when they see you.” Exactly! I love this statement because it helps us take a different perspective on things. The person with dementia likely doesn’t know where they live or who you are. I know my dad isn’t aware of the different roles of individuals. Yesterday, I observed a staff person encourage him to get out of bed for lunch. I walked with him in Hand-under-Hand and he said, “is mom coming?” referring to the staff person. I replied, “yes, she’s right behind us and she made you a delicious lunch!”
I put the following post on LinkedIn and received a lot of positive support and comments from people so thought I would share it with you:
"Writing an incident report on a person with dementia each time they do a “behaviour” that you don’t like is an unfair practice. The only person who gets to say what happened is the person writing the report. The person with dementia doesn’t get to tell their side of the story.
Less time should be spent on writing up a report, and more time should be spent looking at reasons why the person may have reacted in the way that they did. Look in the mirror. What did you possibly say or do that triggered the person to act a certain way? What could you change the next time to get a better outcome?
The person with dementia is living with brain changes and doing the best they can. They can’t change. You have a healthy brain and the only person in the interaction who can change. Unless a report is used as a tool to reflect on what went wrong and to take responsibility for your half, it only serves to blame and frame the person with dementia as “the bad guy.” That is unfair and should change."
At PAC, we are lucky to have resources available to help us with challenging situations. The Creative Solutions to Challenging Situations DVD/workbook combo is a great tool! Have you used it? If so, what happened and what changed?
