I heard the yelling long before I saw the resident and her Aide struggling their way to the dining room.
I was sitting in a small med room just off the dining room in the locked Memory Care unit of an Assisted Living Facility.
The Aide seemed to have everything under control, so I waited and listened.
The resident was agitated. The Aide spoke in a soothing voice.
The resident started ripping off her clothes. The Aide gently re-routed her to a bathroom for privacy.
The resident screamed profanities from the bathroom. The Aide waited patiently with her.
The resident tried to hit the Aide. The Aide stood at the door and asked her co-worker to “bring the tray.”
A breakfast tray was handed off to the bathroom.
I could hear the Aide calmly say through the resident’s shrieks and screams, “Here’s your bacon. You love bacon.” And, “Oooh, you have a biscuit this morning. Wanna try a bite?”
The cursing and shouting slowed, and then stopped.
A few minutes later, a quiet (and fully dressed) resident and her Aide emerged from the bathroom and sat down at a table to finish breakfast.
When the episode was over, I couldn’t help but think about this commercial!
In the old days, this type of resident behavior may have resulted in some sort of restraint. Today, most healthcare environments are restraint-free. That means we need to have more creative solutions!
In this case, the Aide used a method I call, “Drilling Down to Basics.” The idea is that when a resident becomes agitated or combative, there’s a good chance that one of his or her “basic needs” is not being met. The basic needs are hungry, thirsty, tired, lonely or in some sort of pain. So the caregiver identifies the basic need that is not being met and meets it!
In this case, the resident was hungry.
As the episode resolved, the mood in the room returned to normal and everyone went about their business.
But that’s when I started thinking about how this may relate to incivility and dealing with difficult co-workers or your own difficult behaviors.
The resident in this scenario had Alzheimer’s disease which made it nearly impossible for her to express her needs. People without AD can’t use that excuse! But it’s possible that the same dynamic is in play.
I can’t speak for other people, but I know for a fact:
- I’m grumpier when I’m hungry.
- I’m shorter-tempered when I’m tired.
- And I can be downright mean when I’m in pain.
And to make matters worse, it’s difficult be objective about yourself and connect these behaviors to your own basic needs that are not being met.
So here’s my challenge to you:
The next time someone is being rude, mean or raging-on irrationally, remember the Aide in the Memory Care unit. Stay calm. Speak kindly and gently. Remain patient. Then try to get to the root of the problem.
Offer to get the person a snack. Suggest they take a break, if possible. Ask her if she’s feeling okay. There’s a good chance one of these suggestions will hit her right where she needs it.
If you find yourself being rude or irrational, be your own Aide. Step back and assess your own basic needs. Take care of yourself.