1. Nursing Assistant Monthly February 2007 When a resident resists care When a resident resists care The challenge of dementia

2. Nursing Assistant Monthly February 2007 When a resident resists care Why residents with dementia may resist care Confusion may result in Fear Misinterpreting the environment or the caregiver’s intentions Pain Physical need (such as hunger, need to use the bathroom) Painful memories (for example, of a sexual assault)

3. Nursing Assistant Monthly February 2007 When a resident resists care Signs of distress Remember to report these to the nurse so resident can be evaluated Crying Pacing Agitation Angry outbursts Combativeness Withdrawn behavior

4. Nursing Assistant Monthly February 2007 When a resident resists care Bathing Bathing is especially frightening to some residents Fear of running water is common Resident may associate bathing with discomfort (cold, pain) Caregiver’s actions may be misinterpreted as an attack

5. Nursing Assistant Monthly February 2007 When a resident resists care Helping residents feel calm Prepare environment (room temperature, low lighting, supplies handy) Prepare resident (toileting, simple explanation) Use gentle, caring approach Speak slowly, calmly Keep resident comfortable and protect dignity

6. Nursing Assistant Monthly February 2007 When a resident resists care If resident still resists care He/she is sending a message: “I cannot tolerate this. Please stop!” Never argue or insist Stay calm and try to reassure resident Another caregiver may be able to get cooperation this time Try again later when resident is calmer

7. Nursing Assistant Monthly February 2007 When a resident resists care Brainstorm Listen to the messages the resident is sending What is the unmet need? Get to know the resident and his/her likes/dislikes Brainstorm with other staff to find a better way, alternatives to current approach Take a deep breath- be patient Be creative! Be flexible!