The very anxious resident: A team approach (McKnight’s LTC News)

Posted by Dr. El - May 15, 2014 - Depression/Mental illness/Substance Abuse, Medication issues - No Comments

Here’s my latest article on McKnight’s Long-Term Care News:

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The very anxious resident: A team approach

“My mother was kicked out of her nursing home again,” my cousin told me. “They said they couldn’t handle her.” I phoned Cousin Belle’s new number in the afternoon.

“They didn’t give me my pain medication,” she said angrily. “They took away my walker and I need to use the bathroom. CAN SOMEBODY GET ME MY WALKER – I NEED TO USE THE BATHROOM!” She began sobbing. I heard another voice. “Did you hear what the man next to me just said?…You’re not a man?.. .I’m sorry, I can’t see…” Belle lost her vision several years ago, just like her father before her. “I helped people all my life,” she told her companion. Belle is a retired nurse.

She shouted again and I heard a staff member say, “Have some respect for the other residents.” Belle responded immediately, “Have some respect for me!”

“Let’s say the ‘Serenity Prayer,’” I suggested. “OK, let’s,” Belle agreed immediately. When we finished, she asked to say it again. She sounded calmer. “The woman next to me said it with me,” she remarked.

That story is about Cousin Belle, but it’s also the story of Gerry, Anna and a host of other residents I’ve seen over the years. Below are some suggestions for handling these challenging residents, coming from my perspective as a psychologist. I know there are many educated, experienced and compassionate people from other disciplines who will read this. If you have any additional tips, please add them in the comments section.

  • Start afresh: If the current staff members are burned out and no longer responding well to the resident, it can be helpful to move the resident to a new unit or facility with a clean slate and fresh expectations. Notify the new team in advance so that they can prepare for the anxious resident and avoid repeating the same situation.
  • Keep in close contact with the psychiatrist: The very anxious resident is likely to need medication for anxiety or depression, or at least to know that something is available if necessary. The early, frequent and regular attendance of the psychiatrist can reassure the resident and the team that an expert presence is guiding care.
  • Give meds quickly: If residents are in pain or on a medication upon which they’ve become dependent, give the medication as soon as possible. Waiting will only increase their agitation and disturb other residents.
  • Mollycoddle: A loud and anxious resident is likely to become louder and more anxious the longer they have to wait for their demands to be met. Just like with the medication, attend to their needs as soon as possible. Anxious people tend to be anxious because they feel out of control. Meeting their needs helps them feel more in control.
  • Assign your most patient and compassionate aides: Satisfying a very anxious resident’s demands can be a never-ending task. Try to assign the type of person who will approach each call for assistance with a pleasant demeanor and not those who will let their displeasure be known with an unkind word or expression.

For the entire article, visit:

The very anxious resident: A team approach

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