Preventing AggressiveResident Injuries

Facility Name

Introduction to Aggressive Behavior

Half of staff injuries caused by aggression Injuries may be severe Stressful and confusing to caregiver Can be frightening

Types Of Aggressive Behavior

Verbal

Physical

Emotional

Causes Of Aggressive Behavior

Pleasantly confused; can’t understand Fear: of us, their environment, their future Difficulty communicating: feel anxious and

frustrated Underlying medical problems such as pain or

infection Toilet-related problems Damage to the brain, Alzheimer's, etc. (con’t)

Causes Of Aggressive Behavior (con’t)

Approach and attitude of caregivers Changes resulting in loss of control of their

lives Over-reaction to simple things such as noise,

glare, commotion, routine, rushing Social and moral values Losses resulting from aging

Some Characteristics of Aggressive Behavior

Aggressive behavior is usually progressive Can usually predict behavior Most likely times for aggression:

Bathing and toileting ADL care Passing meds

There are good days and bad days

Avoiding & Preventing Aggression

Avoid:Avoid: Reality orientation or reasoning Approaching from the rear Calling out after the resident Talking too loudly Shouting at or among staff members Using slang (“take a hike”) Arguing, scolding, or being negative Talking about other residents

Avoiding & Preventing Aggression

Evaluate as you approach, looking for clues Stay out of their space until sure of your safety Approach from the front; smile Establish eye contact Give resident time to respond or “warm up” Use touch if appropriate

Avoiding & Preventing Aggression

Your face should match your words Watch your body language: they will tend to

mirror your moods and actions Keep your voice at normal tone Remove distractions before communicating Don’t rush Watch for warning signs

Avoiding & Preventing Aggression

Validation matches your mood to your message Redirection distracts them from frustration Remember: concentration is difficult for them

Limit choices to two (2) Break tasks into small steps Demonstrate what you want One short instruction at a time Give them time to do the tasks

Be A STAR

Stop

Think

Assess

Respond

Responding To Aggressive Behavior

Warning Signs Changes in normal patterns Body language:

Gestures Clenched fists Grating teeth Rapid breathing Red face or eyes

Responding To Aggressive Behavior

Do not take it personally May help to stay close to them, to reduce force Remain calm; stop the care briefly Use a gentle approach Redirect If necessary, leave and get help

Gentle Responses To Aggressive Behavior

Yell their name, or clap to divert their attention Tell them they are hurting you Sing something calming, like “You Are My

Sunshine” or “Jesus Loves Me” Never turn your back Keep an exit available

Specific, Gentle Defenses For Aggressive Behavior

Hair pulling: Push their hands into your scalp

Biting: Gently pinch their nose shut Gently push your hand into their mouth Wear a towel or jacket

Grabbing: Gently pull their thumb loose Turn and pull away

Other Preventive Measures

Delay activity if appropriate Evaluate ABC’s

Antecedents Behaviors Consequences

Document and evaluate problems Communicate, but don’t label or condemn

TIPS FOR CAREGIVERS

1. Singing softly sometimes calms the patient

2. Safeguard the environment: remove dangerous objects their from reach

3. Ask permission for all tasks that require you to approach them

4. Communicate non-verbally in a reassuring manner: use eye contact, or a non-threatening physical position

5. Join the patient in their world (their reality)

6. Walk away from verbal assaults (con’t))

7. Recognize and heed the warning signs

8. Keep the patient covered and warm while undressing and/or bathing them

9. Don’t force them into doing tasks

1. Avoid abrupt approaches

11. Approach slowly; approach calmly Gain their trust, don’t demand it

12. Create a comfortable, fun atmosphere as much as possible

Questions?

Thank you for your time!