Problem Resident

[Susan 0]

I've been in the recreation/activity profession for almost 20 years now and have had my share of difficult residents (as I'm sure we all have had). I've never had a problem looking beyond the difficult behavior and continuing to work with them as I would anyone else... until now. We have a resident who is fairly young (60's), very cognitively intact who has had a very rough life which no doubt contributes to her behavior. She's also had a long history of addiction to prescription pain killers. This woman is just plain mean and very manipulative. The whole facility has jumped through hoops for her to make her happy and every time she stabs them in the back. My staff have gone so far out of the way to accomodate her, provide activities, oppportunities for her only to have her bad mouth them or make nasty remarks to surveyors about them. She makes negative comments about her care (and trust me - she's pampered) at every opportunity and tries to play one staff member against another. The team has confronted her on numerous occasions about her behavior but it doesn't help - it gives her even more attention which she enjoys. She's resident council president as well. I've given her projects like being in charge of decorating for holidays, "managing" monthly bake sales, running activities and with all of them (except the resident council position) she's dropped within a short time.... but then complains she has nothing to do. She attempts to "take over" every group my staff try to run and the other residents aren't liking it. No one can get a word in edge-wise with her around. God forgive me, but I don't like this woman at all and find it very hard to even speak to her. What's even sadder is, most of the staff (even administrative staff) feel the same way as I do. Has anyone else been in this kind of situation? Like I said, In almost 20 years I've never felt this way about a resident - I'm almost ashamed to admit that I do!

[Crysty 0]

We have a resident who is very manipulative and we have had to meet with him and his family on several occasions, Have you met with her family? We have went so far as to politely let him know that there are other nursing homes he might be better suited for. We made sure we document every interaction, The family of this resident doesn't even come because he is so hard to deal with. We have tried volunteers etc. I really do not have the answer, I wish I did, and don't feel bad for the way you feel, there are people in this world that no matter how hard you try you just can't please them. Her personality is common among abusers (drugs, alcohol) Just don't give up, you might find the one thing that does the trick, Just keep trying. I know it must be frustrating.

[StacieO 0]

Susan:

Has the Interdisciplinary Team explored the option that your facility is not the right place for her? That she may need some sort of mental health facility? How involved is her MD? When you have exhusted every avenue, it is very frustrating, but I would wonder if she is in the right environment. We have transferred residents to mental health units in other facitlies for many reasons, some have come back to use after meds are under control, etc. But it almost sounds to me like her mental health issues need to be addressed. Best of luck.

 

Stacie O.

[Diana 0]

Hi Susan, I understand your problem!

 

It sounds like your facility is doing everything right, and of course, I am sure you guys have documented till you don't have pens left in the facility.

 

For Stacie O's comment, the resident is probably competent enough to know that she can refuse, by resident's right, to go to any mental health facility. Which is unfortunate, because she needs psychiatric help.

 

But Susan, honestly, I just wish you guys the best! Be sure, also, to document your attemps at providing her activities.

 

Have you checked my postings reguarding "Asking Pres to Step Down." I had an issue where the other residents wanted the president to step down and you have to comply with their wishes - it is their right, also. Find out what the other residents feel reguarding this person - it might help your situation.

 

Good luck! Keep us posted!

[Susan 0]

Thanks for the responses, folks and you've addressed alot of the issues that we have addressed: To Crysty: There really isn't any family and the little there is (neice, nephew) rarely visit. She has a lady friend who has started to pull away from her because she is so demanding and this woman is elderly and has her own issues. The team actually came out and told her "if you don't stop the behavior we will help you find another facility where you will be happier". Even the MD was in on the meeing. It got that bad. This woman was actually faking seizures to get meds. To Stacie: You're absolutely right - this woman is not in the appropriate setting to address her needs. In fact, if the addiction wasn't an issue, she could live fairly independently. It's been addressed with her and as much as she complains about our place, she finds every reason not to leave (maybe we're not the snake pit she claims we are?). She needs to be in a more specialized facility. To Diana: I did read your post about the resident council president - with her in mind! Our residents won't say anything though. They'd rather just not attend. But who knows? Maybe the day will come when they do speak up. I can see many of the residents who used to socialize with her pulling away from her. You can bet her chart is bulging with volumes of documentation from all departments - which is what saves us during survey because she always is very vocal at the state run resident council meeting. I thank you all for your support - for now I just clench my teeth, smile and act as if her comments roll right off of my back (a reaction is what she thrives on). I'll tell ya - there's days I consider taking up drinking lol Thanks again

[Dixie 0]

oh how we all feel for you.......but a couple more options : have called in the obudsmen, ours here in central IL is wonderful help in addressing issues such as this. They explain what the extent of their rights are but also our's as caregivers. Another option give her, her own space. We hav one lady currently on public aid in private room since moving her I can honestly say live has been sweet. She previous fired several dr. disowned her daughter and grandchildren, refuse most any interaction with peers unless she was baiting the hook for you to bite. One day she got in a lady's face and said careful because there was huge pill of bm on floor under this other lady, she through her coffee in my face and went to administrator and told him I was not fit to give care after 19 years as aide. But now she is one of my biggest joys, I look forward to her daily. And most all pray for peace before you come in contact with her it took a year but it's working.....she says if want to get someone in a good mood give them chocolate.........you wouldn't beleive how much I gave her..................take courage, today one of most favorite ladies died of a stroke, I shall miss her so much she was like having a old high school friend that you could just talk to were blue in the face.........

[Susan 0]

Our facility is part of that volunteer ombudsman program. If you're not familiar with it, people from the community (ours is a college professor) take a short course to learn how to be "advocates" and come into the facility once per month to tell us what we're doing wrong or not doing. For us, it's awful. This woman continually goes to the chronic complainers, writes a report about all of their complaints and we have to write responses every time. She cannot go into resident charts and doesn't communicate with staff so she knows nothing about how much has already been addressed with the resident or that a resident has a history of chronic complaints. The residents of course see this as someone else to voice their complaints to so they're very vocal. I can't tell you how many times I've addressed the same problems to her in reports. We've tried talking to her, the Ombudsman's office and it doesn't do any good. I truly believe though, we haven't had any problems with the state with our "problem" resident because our documentation is very detailed and there's so much of it. As for a room change, she cannot afford a private room (she's medicaid) and there's no medical reason for her to have it. To be honest - I'm sure she'd find a problem with it eventually anyway. She'd be lonely would be one complaint for sure. She's just one of those people you can't please no matter what you do. My sympathies for the loss of your friend to a stroke

[Dixie 0]

what state are you in? We have never had a problem that they have not been of help with, ours even encouraged us to call her as we move towards the pioneer movement that she would support us in making changes that go against current regs if they of coarse we're truly in best interest of residents. At our facility she assisted in terminating a dietian that was like an army commander.

and thanks for note for the passing of my friend, tommorow I will have to lead a share-memory program with all the residents, hope I can do it without crying like baby. It so hard to not become attached even after 20 years......

[Susan 0]

I'm in NJ. There has been so much done at all levels with this woman and because it's such a complex issue I'm sure the ombudsman's office has been involved. I was complaining about this volunteer ombudsman program we're involved with. I'd like to think other facilities who participate in this program have had better experiences than we're having.