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My dining experience

November 12, 2010
by Kathleen Mears
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Resident behaviors

Upon first moving into a long-term care facility, I felt I had entered

The Twilight Zone. The environment was noisy and the residents' voices bothered me. Since all the doors were locked and had alarms, I spent most of the first six weeks inside. I required assistance to get out and back in the front door. At times the nurses and aides would offer to take me outside on a nice day. I always felt afraid because I had no idea when someone would let me back in the building.

After a while I noticed residents getting upset-about smoking restrictions, perceived slights from staff, what they had for dinner. Sometimes these residents also got very loud. I was told that most of them were harmless but the sounds made me wonder. Then one day while a nurse was passing medicine, an angry male resident began to hit her with his walker. The nurse did everything she could to stop him. Soon two male aides assisted her and calmed the exhausted resident. For me this was eye opening.

When the weather got nicer some residents went for long walks off of the facility's grounds. Rather than try to talk them back in, the director of nursing and another nurse walked with the residents until they became tired and returned.

A short, pudgy male resident with Sundowner's Syndrome frequently wanted to leave after dinner. Sometimes he would calmly go back to his room but on other occasions he would get quite loud and walk off the grounds. The aides would follow him with a long-range cordless phone to keep in touch with the nurse. Unfortunately, at times this resident had to be calmed with an injection, which made me wince.

I was outside once when a very spry male resident walked determinedly out the front door, across the parking lot, and up the steep driveway. I alerted a couple of nurses who got in a car and followed him. With the resident almost out of sight, the administrator ran after him. A few minutes went by and the nurses returned with the resident, who calmly walked back into the building.

These negative resident behaviors are charted for frequency and also for possible triggering factors. But I always feel bad because I wonder if the residents think they are doing something perfectly normal, confused as to why the staff is so concerned.

Sometimes the male behaviors seem to make sense. Some men appear to want to head home at the end of a tiring work day. The women are less combative, and it will appear as if they are looking for their car or a familiar kitchen.

Behaviors can become problematic when a resident tries to hurt himself/herself or others. The result can be moving the resident to a different facility to see if it is a better fit. I have seen some of these occurrences and have been quite shaken by them. It must be difficult for the resident's family to uproot their loved one and thereby need to travel farther to visit them.

Maybe we will evolve into individuals who have better coping instincts. But for now I do not know how anyone can expect a nursing home resident to not get upset in the facility where they live. There are always things that anger and frustrate us in life. Most of us probably never think about staying calm at home. But if you live in a long-term care facility, staying calm may be required so you can keep your home.

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Kathleen Mears has been a nursing home resident in Southeastern Ohio for the past 14 years. Long-Term Living 2010 November;59(11):56

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