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What to Do When a Senior Loved One Acts Inappropriately to Nursing Staff

Kimberley Fowler
By Kimberley FowlerAugust 15, 2018
What to Do When a Senior Loved One Acts Inappropriately to Nursing Staff

In recent years, there has been an abundance of research outlining the hidden dangers of nursing home care for seniors, specifically elder abuse and patient neglect. However, a topic that is often overlooked and under-reported is the abuse faced by care providers themselves from senior residents.

In the United States, healthcare workers are exposed to higher instances of assault than any other occupation – at a rate of 4 to 1 – and 53% of these incidents take place in nursing or residential care facilities. If you’re a concerned daughter, son or spouse, read more about what you can do if a parent or senior loved one acts inappropriately to nursing staff.

Issues in Nursing Home Care Settings

A report issued by Health Canada, Statistics Canada and the Canadian Institute for Health Information (CIHI), entitled “Findings from the 2005 National Survey of the Work and Health of Nurses” revealed that in long-term care homes, approximately 50% of nurses reported being physically and verbally abused by patients, over the course of one year.

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A 2017 paper entitled, “Enough is Enough: Putting a Stop to Violence in the Healthcare Sector” was published by The Canadian Federation of Nurses Unions (CFNU). It revealed further startling information regarding the violence and mistreatment that healthcare workers experience every day. The paper argues that not only is a violent workplace unsafe for care providers and residents, it also “erodes patient care” by reducing the number of staff due to “high turnover rates, lost-time injuries, fatigue and burnout.”

It is also a costly affair. Scientific American reports that in the U.S., attacks on health care workers account for about “70% of all non-fatal workplace assaults that lead to days off from work.” In order to address patient-driven abuse, we must first understand why patients are violent towards staff and how family members, health care providers and managers can play a role in mitigating this issue.

Reasons Why Seniors Act Inappropriately

According to an Aging Care article, there are a number of reasons why senior residents may act inappropriately towards staff, including:

  • Adult bullying behavior
  • Adverse reaction to medication
  • Desire for control
  • Loss of independence
  • Mental or physical health-related issues
  • Personality differences with staff

Residents with dementia pose a major predicament when it comes to resident aggression and violence against staff in long-term care homes and specialized facilities. A Maclean’s article states that, sometimes, there is no rhyme or reason why certain patients with dementia become violent: “aggression may be linked to the person’s personality and behavior before they developed dementia… however, people who have never been aggressive before may also develop this type of behavior.”

Ways Healthcare Providers Can Settle the Situation

According to a study published by the National Center for Biotechnology Information, there are four main environmental risk factors that may cause violence against healthcare workers:

  1. Containment practices
  2. Inadequate training
  3. Staffing patterns
  4. Time of day

Providing staff with comprehensive education and training – both upon hire and annually – that includes organizational policies, Occupational Health and Safety guidelines and practical procedures for dealing with violent residents will help to better prepare them for potentially dangerous situations.

As well, addressing staffing shortages and issues that plague long-term care facilities is necessary to protect healthcare workers on the job. According to the CFNU, “staffing has not kept pace with the number of residents, nor the rising levels of acuity, meaning there is often only one or two nurses caring for 60-100 residents, resulting in threats to everyone’s safety.”

Other measures staff can implement include:

  • Addressing a residents fears and concerns in a supportive manner
  • Getting to know aggravated residents’ and understanding their unique personalities
  • Identifying and eliminating triggers that may cause outbursts
  • Working in pairs

What Family Can Do When a Senior Loved One Acts Inappropriately

It is important for family members to be active in their senior loved one’s care. Aging Care states that, “patients are less likely to engage in objectionable behaviors when a family member is present.”

If there has been a problem with your loved one acting inappropriately towards staff, labeling their actions as “inappropriate” may come across as condescending or patronizing. Instead, try humanizing the care provider and talking about them outside of their care role. Discussing the healthcare worker in the context of their life as a mother and wife or father and husband etc. may soften your loved one and improve both of their experiences.

Practicing active listening and spending quality time with your parent or senior loved one will allow them to feel heard and respected. Moving to a long-term care community can be an enormous upheaval for your loved one and the loss of independence that comes with accepting care can bring with it feelings of anger, resentment and shame. These feelings may be misdirected at the healthcare provider, resulting in abusive or violent behavior.

Have you had a parent or senior loved one who acts inappropriately to staff? How did you resolve the situation? We’d like to hear your stories in the comments below.

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Kimberley Fowler
Kimberley Fowler

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