While doing a weekly patient visit at a memory care facillity, an agitated resident was fighting a staff nurse and a family member. The resident was non verbal based on her significant cognitive impairment. The resident is a constant wanderer. Her gait is unstable and a privately hired caregiver walks with her as she ambulates through the facility. She walks from dawn to dusk and has lost substantial weight from this behavior. She had hurt her finger, it was bleeding and it required a dressing to stop the bleeding and protect the wound.
The staff nurse and family were trying to hold the resident down to put the dressing on the finger. The resident was fighting and attempting to push the individuals away. All she wanted to do is walk. They were exacerbating the behavior and agitation by restraining the senior.
Seeing the anxiety, fear and frustration on the senior's face, I aproached the scene. We pulled back and allowed the resident to walk. We applied the dressing while she was ambulating. She settled down and became less agiated. It was actaully less of a challenge to place the dressing without the physically aggression even though we were on the move. The non verbal manifestaion of the feelings of this cognitively impaired resident were clear to any observer.
As a family or friend visitng a senior in a facility, watch for the interactions between the residents and staff. The staff at a memory care faciity should know the resiients and their behaviors and be able to provide safe interventions. They are to use critical thinking skills to idenitify unique interventions to minimize the stress to each resident. Their abilty to manage seniors with dementa and congitive impairment should be well honed based on the single focus of their charges.