Long-Term Care

Common behavior problems for alert residents

LTC Nursing Assistant Trainer, December 16, 2010

There are many reasons for behavior that healthcare providers consider problematic or negative. If the resident is alert, behavior problems are often the result of unmet psychosocial needs. Of these, grieving over losses is the most common. Residents have lost their youth, health, income, security, and independence. They have often lost homes, pets, family, friends, and money. After admission to the long-term care facility, they lose control over the environment and their routines. This causes them to go through the grieving process. Fear of the unknown or the outcome of their disease, and anxiety, contribute to the problem.

Residents may begin to act out by yelling at staff members and other residents or using the call signal frequently for minor requests. The more out of control they feel, the more they act out. The resident may turn the anger inward. He or she may begin to neglect his or her appearance. The resident may refuse to eat. In this case, the resident’s loss of self-esteem and anger will become injurious to his or her health.

To reverse the downward trend, all staff members must consistently give the resident as much control as possible. Offer the resident choices in routines; allow him or her to select the time to get up and go to bed, food and beverages, and so forth. The behavior usually improves as the resident feels he or she is regaining control. Ask the social worker to assist in designing a plan to give the resident control.

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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