Dementia caring is like being a police negotiator

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Had to talk down an angry ‘almost naked’ male resident in the nursing home today, and I felt like a police negotiator. The resident had accidentally wet both himself and the floor in his room. With dementia the resident sometimes blames somebody else for the mess, and on this occasion he absolutely believed in his mind that an intruder had entered his room and left a puddle on the floor. He was threatening and bullying the nurse and care staff and wanted the person to be tracked down and found, and be punished for what they did. The care staff kept putting the resident back in his room, but this only reignited his anger when he saw the puddle.

I decided to step in and convinced the resident that I would help him.I felt that I needed to get him dressed first and realized very quickly that going back in his room (the scene of the crime) only enraged him further. I acknowledged his concerns, and told him that the perpetrator will be brought to justice 🙂

I remembered some negotiating tips from the movie ‘The Negotiator’ where you have to keep the person totally happy and never disagree with them. You have to stay positive and let the person think they are in control of the situation.  I looked him right in the eye and gained his trust and he began to calm down and thanked me for my help. I knew I had to remove him from the environment, but I had to make him decent first:).  I put some pants, socks and shoes on him then encouraged him to go for a walk with me.

It was really interesting to watch his demeanor change and his anger disappear. we sat in another area of the ward and I distracted him with conversation about good times in his past.

He had given himself a headache, so I offered to fetch him a glass of water and encouraged him to have a rest in the chair. He then fell asleep as he was so exhausted.

The next move was to get his room cleaned and tidied up ready for his return. Another carer was not happy that this resident had not had his shower. In my opinion he was not going to willingly have a shower in his aggressive state of mind anyway, so does it really matter that he misses one day?  He could be showered later on if need be was my thought.

I declared to management that I possibly breached a rule, and suspected I would be on report. I was so pleased that management agreed with my call and said the resident’s happiness and resulting behaviour is paramount. Phew!

What this incident taught me was that sometimes you need to bend the rules to make the right ‘person centred’ decision. If at the end of the day you have acted in a way that benefits the resident’s well being and retained their dignity (and made a safer environment for all) then I am happy to go on report!

hmmm….now where did I leave my bulletproof vest?

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