Behavior Problems in Aging Nursing Home Residents

Common Behavior Problems

Many nursing home residents display behavior problems, such as erratic, disruptive or difficult behavior. For instance, common behaviors might be to hit, bite or call out to get attention or to show displeasure.

One common behavior problem is a nursing home resident's refusal to cooperate with medical treatment or procedures. They may threaten those who try to administer health care services, or they may become physically abusive.

Occasionally, behavior problems are exhibited in order produce a certain result. For example, if a resident notices that nursing home staff members hug her when she cries, then she may cry frequently. Giving her hugs regularly likely will stop the behavior problems.

Behavior problems are among the most difficult for staff and family members to manage, but they can be managed. Indeed, many behavior problems must be managed because they endanger the health and welfare of the resident and others in the facility.

The Causes of Behavior Problems

The causes of behavior problems are many and varied. Many of the problems are caused by the resident's inability to communicate in any other manner.

The Symptoms of Behavior Problems

Every nursing home resident reacts to his or her surroundings differently. Likewise, each resident will handle negative feelings in unique ways. Behavior problems that are dangerous, disruptive, hostile or inappropriate should be taken seriously. Dramatic changes in behavior should be examined.

Correcting or Preventing Behavior Problems

As you visit a nursing home resident, you can often correct poor behavior, though doing so is usually a matter of trial and error. Eliminate the most likely cause of the behavior problem. For example, offer the resident a drink of water or something to eat. Take the resident to the bathroom. Try anything.

Be honest about your affect on the nursing home resident. Is the nursing home resident acting up because he or she knows that you will come to see the problem first-hand?

Involve a social worker, social services designee, mental health professional, or others who are trained to evaluate and treat the nursing home resident's problems.

Keep your own behavior log. Careful observation will likely lead to identifying the source of the nursing home resident's problem.

Nursing Homes and Behavior Problems

Attempt to identify and eliminate the underlying cause of the behavior problems. Keep a behavior log and document possible patterns. Take note of what time of day the outbursts occur and which staff members are on duty at the time. Keep track of which family members, friends or co-residents are nearby. Pay attention to the nursing home resident's personal comfort, such as body temperature, pain, discomfort or need to use the bathroom.

Determine whether the nursing home resident's behavior problems are a product of his or her medical condition. Evaluate and assess the nursing home resident's mental and cognitive skills, and the resident's ability to perform all or part of the activities of daily living.

Require nursing home staff to adjust their approaches to the resident's behavior problems.

Reward positive behavior. Avoid threatening the nursing home resident or punishing negative behavior.

Document approaches for behavior management in the nursing home resident's care plan. List the approaches to correcting bad behavior problems in order of their effectiveness. Document the results of behavioral interventions, whether effective or ineffective, on the medical record.

If the nursing home resident is refusing medical treatment, develop alternative measures to see that care is administered, such as reminders, praise and rewards for positive behavior.

Physical or chemical restraints should be used only as a last resort, only after alternative approaches in the care plan are exhausted.

Preventing Behavior Problems

Some poor behavior is rooted in the nursing home resident's annoyance with the immediate environment. That is, a hungry nursing home resident may misbehave until food is provided. Other environment-related behavior problems that can be corrected to stop behavior problems before they start include:

• hunger
• thirst
• pain
• boredom
• too much noise or confusion in the environment
• uncomfortable room temperature
• need to use the bathroom
• fear (may be fearful of many things, or of a single individual)
• feelings of anger, helplessness, loneliness and hopelessness
• loss of control (over one's own body, over the environment, over routines, etc.)

Nursing Home Neglect Can Lead to Behavior Problems

Nursing home neglect can be a root cause of sudden behavior problems or behavior changes. If you observe a loved one showing behavior problems, you shoud investigate further. If you feel your loved one has suffered from neglect during their stay in a nursing home, contact an experienced nursing home lawyer for help immediately.

Nursing home lawyer Jeff Rasansky is licensed to practice before all state courts in Texas, the United States District Courts in the Northern and Eastern Districts of Texas and the Fifth United States Circuit Court of Appeals.

Click here to contact The Law Offices of Jeff Rasansky.