I hope to learn some tricks. I hope to share some insights, from my many weeks of nursing, on dealing with hard to care for patients and the problems their families bring into the mix.

Since I always worked at night we almost always had problems with new residents.Luckly most of them that were incorrent their families usually stayed a few nights to help with the transation.But those that were the families usually didn't stay at night so we would check on them often being careful not to scare them when we went into their rooms.A lot of times they just wanted a hand to hold or a friendly ear to listen to them voice their concerns and fears. I found it usually took about a week especially when they saw the same face often.

you made me so proud of being a nurse. we encounter a lot of problems but when we see that residents respond in a positive way----------we did what nurses should be. we sometimes wish that restriction is still allowed especially if the behavior is very disruptive or getting into our systems but i do feel bad when we forget that that they need compassion, understanding, love and care. am guilty of it a lot of times, and i do feel so sad because i resisted and didn't approach them in a caring manner. am not perfect but we should not use being stressed out at work for not giving our best in everything because we want to show them THE GOOD PART OF BEING THERE. Know why inspite of the loads of work, i am still in the facility? I love to be with the people that has been there. I see them as my grandmothers or grand fathers that i used to have. i also wish that if i got old, somebody will care and respect me as i am. the trust of most residents and families i care is another one that makes things easier to deal with. everything in life is hard but the thing that makes everything better, joyful is that DOING THINGS FOR THE GLORY OF GOD. try it and it will make a lot of difference.

Thanks fairyann912. Everyday I have the oppurtunity to learn and teach, I enjoy the learning the most. I can almost feel the lightblub go on in my head.

I loved working in the nursing home. I enjoyed when I had a little extra time to spend with my bosses (the residents). Weather it is just talking or holding there hand when they are feeling lonely. I know as well as any of us we are always busy that paperwork just keeps us busy, but when you take a little time out of the busy schedule it is rewarding all in it's own. Now with dealing with the familys thats a whole other ballgame. Put yourself in their shoes they put thre loved one in your care. I use to have a resident that had been in the home for 6 years I never knew she had a daughter until her mother got ill. Then it was on. She called at least 2ce a day on 1st and 2nd shift just to check and see how her mom was doing and how she ate. The other nurses would always be short with her. She came to visit one day when I was doing Dr rounds and her mom was on the list to see. We talked for a while and the I found out why she never came to visit before, and she was feeling very guilty for the feelings she had and about how she missed out on so much of her mothers life. She was trying to make amends, she even told me she prayed all the time for forgiveness. When she would call I they would always page me to the phone. Family just wants to make sure ther loved one gets what they need.

Aloha, great post. Thanx!

I have found that families that cause the most problems are the ones with the most guilt. I try and assure them that there love ones are being well taken care of. Residents are difficult when they feel scared, lonely or even homesick. I try to get them involved in activities are groups Talking to them about their life before coming to the facility helps to. In LTC they get a kick out of you asking them for advice from their profession. I had a lady who seemed depressed wouldn't talk or eat. I read in her chart that she worked in the same furniture shop for over 30 years. I began asking her questions about furniture ( how it's made and what are the best brands) she just lit up. Once I got her to open up I could talk to her about her care at the facility and what things would help her to be happier there.

I work the floor and do evaluations for admitting new residents, working with clients, esp those with dementia it helps to be extra sweet. if you have a patient who is more oriented they typically prefer a more goal directed approach to show competence. asking home health caregivers, floor nurses, and CNA's provide a great insight for knowing how a resident performs. Keep in mind it takes a resident two weeks to two months until they begin to show their typical behavior after a move (alot are anxious/frustrated/scared with a move). Certain residents i have even sung to while performing care (i sang the hokey pokey to one everytime we had to get her undressed.. except it would be to take the right arm out). Once a resident sees that you have empathy and compassion for them they tend to be more content with daily tasks., arual4 is right sometimes they just need someone to listen. It is appropriate to let a oriented patient or family member know if they are crossing the line by being aggressive or abusive.. i like to say, wow i see that this is upsetting you i will take a look at the problem... this must be hard for you. (there has been an instance where i had to ask a family member to leave the room so i could perform an assessment on her mother... i made sure to have a caregiver present as a witness to the verbal abuse towards her mom and staff, and wouldn't let my cna's go in that room by themselves with her present)(that family member was having several personal conflicts along with the declining health of her mother... it's alot for one person to deal with)

I do not work in an ecf, but  do at a hospital where we do get alot of confused pt's.I find they are more cooperative when you know a name of a family member they remember, such as a daughter or son  or brother.I ask them, (to try to redirect) has your daughter jan came by today? or so jan said she is going to stop by.Sometimes that helps them relax, that you know someone so close and dear to them.

Thank you NURSES! I APPRECIATE that very much! I feel good if my reports, my observations are being taken seriously because I know that the resident involve is getting what she/he deserve.

We have a resident in the Alzheimers Unit who would ask about her husband every after supper. "Is my husband coming?" Is my husband still in the barber shop? "Is my husband going to pick me up?" My answer would always be "he is not coming today, maybe tomorrow"., and  she will be okay with that. If she keeps on asking every now and then I would change the topic and redirect her to get busy on something and give her reassurance that she is fine and we have a room for her to stay for the night. After her medication she will then go to her room and prepare to go to bed.

My way of dealing with patients and their family's is to first be thankful that they have let me into their lives.  The patients and family's in a nursing home are the special ones for allowing us into their lives.  If you can remember this, you will have the love that you need to deal with the few pt. and family's that are difficult.  Talk to them and find out what they need from you and other staff.  Needy or guilty family's are usually the ones that are difficult and can be helped if they feel that they are a part of the care and not just observers.  Spend a few extra minutes with difficult pts. when you have the chance just talking and visiting, not doing care.