Scenario: Answer call light ask her how can I assist her she states her pillows are not right (she has 6 or 7 mind you) now all this on air mattress the air mattress is suppose to have all those pillows and it defeats the purpose of the air mattress. We get them re-done and ask her if the pillows ok, are you comfortable, etc. Even hang around to make sure she's comfortable and get her ice water, plug in her phone, etc. Been her room now for 30 min or more. I have other call lights going off and while going to answer my other lights she put her's back on so I returned to room. She states I don't think my pillows are right so I just redo no words spoken from me. Then like 30minutes after that I go back and it's the pillows again. You guys I feel my 🤯 exploding 🤦🏾♀️🤦🏾♀️. I know I have to keep cool because she treats me and another CNA like this, but the ones who go in and give her lip and treat her with a long handle spoon. She doesn't bother them but the ones who respect her she runs us up and down that hall a number of times and says I am sorry to bother you 🤔. Help me! My mental health can't take this lady. She is too much and her mind is sharp. I will never refuse to help her nor will I disrespect her, but I am exhausted after 3hrs of being of work help any suggestions. I've got one more year to work and then I am 61. I am retiring early at 62 next year. Until then Lord give me the patience at this job. Just needed to get that off my chest and my brain.
As Joann said, tell her "There are other residents that you must help too".
Again, it's the truth.
Of course she may reply "I don't care about THEM!"
This was the exact reply I got in a similar situation. 😖
It was yrs ago (but I still remember). The woman was demanding, calling out & seeking her nurses's attention despite being able to SEE her nurse attending to the other 3 people in the shared room. The nurse would say M. I'll be with you on a minute. Nurse..nurse..nurse..I need you.. nurse.. nurse..I need help now.. help! I'm falling.. I'm choking.. the Nurse would have a discreet look (yes she is safe, not falling etc) then give one short reply, finish her task then attend M. Professional at all times.
I was less experienced & this constant neediness ruffled my feathers. I kind of snapped one day. Told M it would help her to be patient. That others needed help too.
Her reply taught me much.
1. She did not care about others. Her pain, loneliness or broken brain overrode any empathy for others.
2. Nothing I did would change her behaviour.
3. I could only control my own behaviour.
4. I was not responsible to make her happy/content/relaxed - this was up to her.
When I let go of trying to 'fix' her mood, it was so much easier to be like the more distant & professional nurse.
Kind of a 'Grey Rock' approach I later found.
Each difficult person teaches us something!
Being alone, if hard of hearing, eyesight issues, not remembering the time, maybe not where you are, where your family is would be lonely & scary I'm sure.
Do what you can, within reasonable limits.
Be honest but polite.
As you say, being with one person, would neglect others. So fluff the pillows, tell her that's the best I can do, state the facts "I have to do my work now but I will check on you again later in the evening". Then DO check in - helps build trust. Offer to put the radio on for company. Ask is there anything else you need now? No? Ok, sleep well.
Leave.
Sometimes families hire a personal sitter when elders get like this. Report this behaviour to your Superior, especially if new. Sometimes the Doctor may prescribe something to help with the fear/anxiety.
Otherwise share around the staff if you can to avoid being drained. If this is your section often, experiment. See if spending a quality 5 mins lowers her anxiety or makes any change.
Sometimes nothing you do will help. Sundowners can be like fussy babies - they are tired from the day but not quiet tired enough to sleep.
Thank you for the care role you do!
For Mom, when she acts out I ask her how she feels. In our case she’s losing language, so I can’t ask open-ended questions so I ask if she’s scared or mad. Then if she’s scared, I say that must not feel nice. Can you tell me more? I might be scared too. How can I help you not feel scared? If your lady can tell time, I might say how about if I come check on you in 10 min? And then do it, don’t forget, then over time expand that timeframe, and eventually she’ll likely be asleep before you come back. For Mom for whom time has no meaning, sometimes just knowing she’s not alone and someone sees her and understands makes her feel better. Seems like trying to discover the root of the issue is the key because as you already have seen the pillows aren’t the problem.
Also I slept on Mom’s hospital bed with air mattress a couple of times, and daaaang, those beds are uncomfy! Your lady might just be stiff and miserable. I sure was.
I know someone who was fussy at night because they were afraid they’d die in their sleep. Or maybe she’s going to bed too early for her sleep needs so she can’t settle.
She could also be a fussy, self-involved pain in the arse too! Is she self-centered during the day or only at night?
Maybe something in all that might help. I’m sorry for your troubles though. Caregiving is darn hard labour.
You're able to give hour after hour of your undivided attention to your mother and her fussing. A CNA in a managed care facility cannot.
It's fine to ignore a person a bit even when they have dementia (when safe to). It is like with a baby. If the parents go running in every time the baby squawks a little bit they never be able to go to sleep on their own.
I had a live-in position years ago for an elderly woman with dementia. I did three days on four days off. I went into the client's room twice a night to toilet her and that was it. I refused to allow her to develop a 'shadowing' habit with me.
The other caregiver ran into her room constantly every time she called. It got to the point where she had to move a couch into the client's bedroom and sleep there. It got to the point where the client had to be seated in the bathroom when she went to the toilet or took a shower. She was at her wit's end. One day she asked me how I cope with the client. I told her she should have abided by what I told her on day one and not allow a shadowing habit to form. That she has to ignore the client when there's nothing wrong and it's just fussiness. Otherwise you won't even be able to take a crap without the demented elder being seated in the bathroom with you.
So be like the ones who handle her with a long handled spoon. Seems to work for them. You don't have to give her lip but you need to be firm. Tell her you can't keep coming in all night. There are other residents that you must help too. I think its attention seeking and you should not play into it. Those lights should be "first come, first serve. You don't go back to her until you have answered all your call lights that came after her. If you haven't, bring it up to your DON telling her this one woman keeps you from seeing to others. How do you know she isn't intentionally fooling with her pillows. I think 30 min is too much time with one resident for just this. I like getting her comfortable and telling her you'll be back after you see to the other residents.
"Tell her you can't keep coming in all night".
It's the truth afterall.
Also, bear in mind at all times that you are doing your best to get this right because of what you are like, and not because of what she is like or because of what anybody else might choose to do.
We had a client like that, we got stuck with her for months because we are our county's provider of last resort and none of the private sector agencies "had capacity." In a pig's eye they didn't have capacity, they'd met her before was the problem. Her and her wicker baskets that you had to move out of the way before you could wheel her to bed and her crocheted shawl and the pillow pyramid and the flat one that went under her leg and the rolled blanket down the side and the nightly recital of how our local health service wouldn't fund a variable pressure air mattress for her and the glass of oat milk too full not enough and her lavender pillow spray and the white cardigan and the...
Anyway. All of us could probably recite that list. And one of us went through her rotten bathroom floor - not badly hurt, but not exactly in our job description - and she considered that her grievance.
I did her last call, and collected the paperwork and the satisfaction questionnaire. Not a good word to say about a single person. Not a word of thanks. I know how hard everybody worked for her and on their behalf I will not forgive her.
Otherwise, this is toddler behavior that you're reinforcing with your response. Since she's got it all together mentally, be frank, kind, and honest with her that you cannot come in every few minutes when there are others who also require your attention. Then do not respond as you did when she puts on her call light. Stick an eye in there to make sure she's physically OK, then deal with the residents whose issues are a priority.
To get anything done or my “me” time I had to learn the word “no” and “I’ll get you when I get you. You are fine.” with needy hubby. He was raise in a gruff atmosphere and sometimes it’s the only thing he responds too.
BTW what is the state patient to CNA ratio?
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