At a recent care plan meeting at a memory care faciity, I was told that my interventions to protect residents who were in crisis was inappropriate. The response by the Executive Director was that I should have called her and she would have intervened. This was her directive even though she was gone from the building for day.
The scenario was as follows. While walking with a patient, we came to a unit in the building where more confused residents reside. There was verbal altercation occuring as one of the residents was yelling out for assistance. His yelling was agiating two other residents who were yelling back for him to "shut up". Two staff members were sitting at the dining room tables and allowing this behavior to escalate. When I suggested that they do something to calm the situation, they told me it was almost evening meal time and they were not to leave the dining room. Based on their responses and the fact that they did not recognize the pending severity of the issue, I directed them to remove the resident who was verbally aggressive. Next, I wanted them to go to the other two residents who were increasing agitated to calm them. Immediately on removal of the verally aggressive resident, he quieted. Once the yeling stopped the other two residents calmed down. They were redirected and a crisis was averted.
The executive director was demeaning and curt with me for having intervened. I suggested that the staff had not recognized the severity of the episode and that they would have allowed the situation to explode into a potential physical altercation. The verbal altercation was in full swing when I arrived. She told me that I should have called her and not taken the situation into my own hands. She informed me that my intervention was totally inappropriate. When I asked her what she would have done from afar from a phone call, she did not respond further. Her attitude was one of displeasure, dismissal and disgruntlement. She did not see this as a proactive intervention to keep the residents safe and an opportunity for improvement and training for the staff of the building.
The daughter of the care plan resident was most upset with the exchange and concerned with the response of the Executive Director. Her comment was that the Executive Director sat there and was totally disconnected and acted like she was superior to the family and care manager. Her closed attitude was concerning for the family member. The family member's question was whether her mother was safe in this building.
Use care plan meetings for what they are. They are the opportunity for the family to advocate for their oved one and for the facility to listen for opportunites for improvement in customer service and quality of care.