Wo「king With Diffi⊂u音t & Combative Peop漢e

Working with Diffi⊂u漢t Peop漢e

HeaIth care is a peopIe-O「iented

business. Every health care

WOrker spends a lot oftime every

day with people: COWOrkers,

⊂=ents, famiIy members, Visitors

and soon.

Getting aiong with peopIe is part

Ofyourjob. And, iet’s face

it…SOmetimes, it’s the hardest

Part Of yourjob=t’s natural to

get aIong better with some

PeOPIe than with others. For

example, Certain peopie rub you

the wrong way. Others seem

unhappy with you no matter

What you do. And, Sti= others

Seem tO take pleasure ln gIVing

you a hard time. ln retum,yOumay fee=ike these peopIe are

being di解ult. Butwhat do we

mean exactIy when we saythat

someone is 〃difflcuIt’’?

Peopie are d櫛cuItwhen they get

in the way ofwhatwey±型吐Or

凸eedto do. Forexample:

. Tomv坦口壁totake his Iunch

breakjust when his coworker,

Sharon, aSks for his heIp

transferring a cIient. Tom has

transferred that particuiar ⊂lient

by himseifmanytimes and is

irritated with Sharon for

needing heIp. Hedelays his

!unch break long enough to

繭冶heIp Sharon, but he’s mad at

herfor being d櫛cult.

● Susan畦to Ieaveworkon

timetodayto pickup her

daughteratschooI. But her

CIient, Mr.」ones, is moving

more sIowlythan usuaI and

Susan is afraid she’s going to be

late. She wished that Mr.」ones

WOuId stop being so d櫛cult!

Are Sharon and Mr. 」ones reaily

d櫛cuIt people? Maybe...and

maybe not. Remember, it’s onIy

丁om’s opinion that Sharon is

being d櫛cult. MaybeTom

WOuId change his mind ifhe

knew that Sharon is pregnant and

herdoctortoId hernotto l肺

dients.

And, it’s Susan’s opinion that Mr.

」ones is a di怖cuItclient. Would

Susan think differently ifshe

knew that Mr. 」ones hadjust

found outthat his wife is dying?

Remember...

CALしtNG SOMEONE ′′DIFFl⊂UL丁〃

lS A MATTER OF OP/N/ON NOT「AC丁!

棚ink obou書書he

竹iHi`u/書〃 peop/e in

y〇㌦′〃俺. In請細事pのでら

wife down a〃書he worくね

yo岬でan think ofto

de5`高めe fhe什behのVior;

Des⊂ribing Di怖くuit Peop看e

Did you come upwith anyofthefoIIowing

WOrds to describe the ’‘d櫛cult’’peopIe you

. Demanding　　. Sa「castic

. lrritabIe　　　　　.　Hostile

・ Nasty　　　　　. Uncooperative

. Rude　　　　　. Angry

・ Aggressive　　. Complaining

. CriticaI　　　　・ Ungratefui

. Depressed　　　. Pushy

.　Abusive　　　　　　.　Mean

・ S⊂ary　　　　　. Argumentative

Why A看e Some Peop看e Diffi⊂u音t?

We are a旧ndividuals...with our own

PerSOnalities, likes and dislikes, PerSOnal habitsand ways ofcommunicating. But′ SOmeOfus

Seem tO have trouble getting aIong with other

PeOPle. There are many reasons forthis.

Rememberthat ’‘d櫛cuIt’’peopIe may be:

. Recovering f「om stress o「 tragedy in their

看ives.

・ Su什eringf「om an川ness.

know?

Now, think about clients and coworke「s who a「e

皇旦SytO get aIong with.

How manywords can you

thinkofto des⊂ribe them?

lfyou’re Iike most people,

this listw川bemuch

5horterthan your first list.

Whyis itso much easiertothinkofthethingswe

don’t Iike about peopIe

than it istothinkabout

the g♀Q立things? T「yto

think po5itively about a=

Rem em ber…

/=ake5 mOre energy tO be

neg。tive rh。n /t doe5 rO be

poj諦ive!

your clients and cowo「kers!

Dealing with a disab冊y.

ExperIenCIng Pain-alI

day, eVery day.

Fee=ng lonely or

depressed.

丁aking medications that

make them act

d肝erentIythan normaI.

Hint: Be Carefu8 Who Ybu CaI音〃Diffi⊂u看t〃!

lmagine thi5: You’ve been assigned to work with

a new client, Mr. TayIor. Your coworker, Mary,

teiis you that she worked with M「. TayIor

yesterday and he was ‘‘diHlcuIf’’, ’’rude’’and‘‘grouchy’’.

So, nOWWhat? You haven’teven metMr.

丁aylo「, but you’「e al「eady prepared for him to

give you troubie. You probabIy wish you didn’t

havetoworkwith him ataiI. Howw川thisaffect

the way you t「eat Mr.Taylo「 when you first

meet him?

◎2OO「 lntheKnow, In⊂.

Write down rhree quaIities

you have that make you

銭型to get aIong with:

1.

sca「ed o「 in pain yesterday. /fyouthinkthof叩erso而

o「,Marymayhavebeen ,r。窃盤霊箆嵩th。

having a bad day herse-f!　Wqy捜behoveoroundhim!

Page 2

Remember…rePOrting

incidents ofvioIence or abuse

from ciients (Or COWOrkers) is

ImPO「tant, but it’s best td

avoid spreading ’’rumors’’

about peopIe. After alI, Mr.

丁ayIor may have been

What Are Agg「essive Persona看ities?

PeopIe wfth aggressive persona/棚es may

be;

●　」oud.

●　Rude.

・ Bos5y.

. lntimidating.

. Argumentative.

. lmpatient.

Aggressive people tend ro:

・ Interruptothe「s instead o川stening.

・ Makesa「castic remarks about otherpeopie.

Stand too cIose to others.

Stare or gIare at othe「

PeOPIe.

Point o「 shake theirfingers.

Raise thei「 voices.

Make decisions for others.

Complain a Iot.

THE BOTTOMし1NE:　　　　　　　　　　　　'

Aggressive peopIe seem to be Aggres5ivepeopIe

請書書と藍霊薯:諾驚惹about others.

What Makes Agg「essive People Diffi⊂u8t?

Wbrking wifh peop/e who are aggressJve

`an be di鮒i`ul書be`ause they fend fo;

. Demanda Iotofyourtimeandattention.

・ Blameyou (andeve「yoneeIse)forthings

that aren’t your fault.

. T「yto control your behavior.

・ Saythings like, 〃you。Iwoy5…〃or “you

neVer.

. Putyoudowntomake

themselves feel more

POWerfu l.

. Trytostartarguments

by saying hu「tfuI

things o「 by raising

their voices.

.　Bestubbomabout

their schedule and

activities.

Write down fhree quaIities

you have that make you

d櫛cuit to get aiong with:

1.

How Should Ybu Communi⊂ate With Agg営essive Peop看e?

・ Most importantly,trytOStayCalm.

Aggressive peopie want to upset you. So, if

you let yourseifget angry, then you′ve given

them what they want-COntrOI overyou!

(Remember, nOOne ⊂an makeyou feel bad

unIess you let them!)

・ Don’t beaf「aid to stand upforyourseIf…but

do it in a respectful manne「. Continueto

Show care and concem for the othe「 person.

@2001 inthe Know,inc.

丁ryto也垂旦tO Whatthe

PerSOn is reaily saying.

For exampie, ifM「. Smith

isye冊ng about his lunch

being coid, maybe he’s

t「ying to teii you that he

needs heIp feeding

himseIf.

SmiIe and stay reiaxed.

lfyou odd均塾生anger rO fhe

Onger Of。n 。ggreS5iv叩erson,

Whot doyou hove?

An expIosion!

Page 3

What A看e Passive Personalities?

People wifh passive persona/ifies may be;

.　Quiet.

・ Ag「eeablea=thetime.

・ ApoIogeticforthingsthataren′ttheirfauIt.

. Intimidated byothers.

・ 5hy.

●　Scared.

Passive peopIe tend ro;

・ Avoid speaking upforthemselves.

.　Letothers makedecisionsforthem.

.　GetoverwheImed.

・ Beafraidtosay’‘no’’.

.　Ashamed ofthemse看ves.

・ Avoideyecontact.

● ‘′Beataroundthebush’’.

●　A=owotherstoberude.

THE BOTTOM LINE:Passive peopIe seem to be

COnCemed with other

peopIet needs andWantS...but don’t try to

meet their own needs.

What Makes Passive People Diffi⊂u音t?

書〃brking w肋peop/e who are passIVe `an

be d朋i`ulf be`ause they rend ro;

. Blame themselves for eve「ything…but never

do anything to change the situation.

. Wastetime by’’beating around the bush’’.

(丁hey don’t come out and tell you what they

need.)

・ Expectyouto readtheirminds-and

become unhappy when you can’t.

Get quietIy aggressive

When they feeI

OVerWhelmed.

Have troubie making

decisions...even littIe

TaIk negativeIy about

PeOPie behind their

backs.

How Shou音d Ybu Communi⊂ate With Passive People?

Ask questions to try to get passive peopIe to

OPen uP. (But, aVOid questionsthatcan be

answered with just ‘γes’’or ′’no’’.)

Don’t stand over passive people whiie you

taIktothem. it makesthem feeI scared and

Shy. Sitdown soyou are on the same ievei.

Praise passive peopIe when they stand up

for themselves or express their needs.

@2OO「 lntheKnow, Inc.

PeopIe with po55ive

personcl/ities don’t take

re5POnSibi/rty for rheir

OWn /ive∫.

Remember!

80% ofthe problemsin your work day will

⊂Ome f営om 2堕塑Ofthe

peopie you workwith.

771ink abour /t…

Don’t most ofyour

PrOblems ⊂Ome from

the samefew clients or

coworke rs?

Heip them make decisions by

giving them a couple ofChoices and then offe「ing

information about the best

WaytOgO. ForexampIe, aSk

Mrs. Ke=y ifshe wants to

wear her blue sweater o「 her

green blouse. Then,te= her

that it’s a bit cool today.

Hopefu=y, She’II pickthe

SWeater!

P。SSive peop/e are

in5eCure about

th emse/ves… 0nd

about eveIy de`i5ion

thγ mOke.

Page4

丁ips For Wo「king With Diffi⊂uit People

Sinceyou spend so much timewith your

Clients, thei「 negative behavior is often

directed atyou. But,try hard nottotake

their comments o「 behaviors pe「sona=y!

Remember, it’s onIy your opinion that

SOmeOne atWO「kis d櫛⊂uIt. A person who

SeemS d櫛cult to you may get aIong fine

With everyone eIse. Or, yOu may get along

greatwith a ciientthat noone eIsewantsto

work with!

Try ha「d not to overreact when deaIing with

a d櫛cuIt pe「son. AskyourseIf, ‘‘ls this issue

rea=y worth making a fuss about?’’

When you wo「kwith peopIe who have given

you trouble in the past, trytO Startfreshevery day. Forget about what happened

yesterday, Iast week or last month.

Te看i yourcIientswhatyou are goingto do

before you do it. This decreases the chance

that they w川react negativeiy.

Ifsomeone is yelling at you, Crying or

COmPIaining ioudIy, try Standing sti=,

iooking directIy at the person…and waiting.

This givesthe person a chancetogetaII

their anger out.

You might aIso try saying, γwantfohear

everything you h。Ve fo 5。男but not here where

it might d厨urb other5. Lett go somewhere

privo te. 〃

Time fora Laugh!

De0r Lord

5o f。r tod。y God /’ve done 。lright. /h。Ven’t

gos5ゆed /o5t my rempe′ been greedy grump男n。5ty

Or Se侮h・・・ 。nd /ho very rh。nkfuI for thor.

But/n a few minute5, God /tn going ro getou書ofbed

。ndわ′Om then on, lTh going to need。 /ot more he佃!

Amen.

◎2001 inthe Know, Inc.

Consider thatthere may be

other reasons for a cIient’s

behavio「 (besides just

Wanting to make your life

d櫛cuIt). Fo「 exampIe, Mr.

」efferson a⊂tS grOuChy to

Sa=y everytime she comes

into his room. He saysthings

Iike, 〃you 。Iways ⊂Ome /n here

。ndmumble rhing5 。tme. /

don’t Iikeyou!〃 SaIIy’s

feeiings are hurt unt旧he

doctor discovers that M「.

」e什erson has Iost most ofhis

【ザ

覇peopIe you workWirh-eVen when

勅ey 。re “diHicuIt∵

hea「ing. Now, Sa=y understands that Mr.

」efferson wasjust feeiing scared and upset

about his hearing. (And, 「ather than admit it,

he was taking his frustration out on Sa=y.)

Since hegot his hearing aid,things have

been better.

Be patient with your coworkers, tOO. 1t′s

human natu「e to thinkthat ifyou「 coworker

IS grumPy With you, it must be something

you’ve done. But, ⊂hances are, it has

nothing to do with you. So′ don’ttake

everything pe「son訓y. For exampie, What

happens ifyou say hitoTim and hedoesn’t

SPeakto you? You mightthinkto yourseIf,“77m h。te5 me.〃 But, What’s the reaI truth?

Timjustgotsome bad newsfrom homeand

didn’t hea「you say hi.

Remember that oId ‘′ruIe’′ about counting to

ten? It rea看lydoeswork. The nexttimeyou

feeI angry or upset with a client or coworker,

b「eathe sIowiy and count to ten-before

you speak. You’= feeI bette「 aboutthe way

you handIe the situation.

Don’t a=ow other peopie to control your

moods. ifyou do,yOu are giving them

tremendous power over you. So, ifyou’re in

a good mood, don’t iet someone else’s

g「ouchiness b「ing you down.

Page5

㌔浮圏

塑旦坦丁ips Fo「 Working With Diffi⊂ult Peop音e

Rememberthatwhen peopIe

are being d櫛⊂uit, it′s usua=y

because they:

. Wantyourattention.

●　Areafraid.

.　FeeIinsecure.

●　Lackconfidence.

.　Fee川ketheirlivesareout

of control.

圏DiHlcuIr peop/e

Ore frying to grob

your power from

you...be`auSe tryfeeI po werIe55.

・ Whendeaiingwitha d櫛cuItpe「son,focus

On the particuiar behaviors you don’t

like...ratherthanjust Iabe=ng the pe「son.

For example, instead ofsaying to a

COWOrker, 〃youte 。lways rude fo me〃 try

Saying, γ feeI hurt when you don’t 5ay gOOd

moming, pIe。5e Or thonkyou fo me.〃

. Thenexttimeyou havetoworkwitha

d櫛cult cIient, give you「selfa Iittie ’’pep

talk’’.丁eii yourseif, γm re。dyfor fhis. /c。n

h。ndIe wh。teVer h。ppen5 rOd。y. / will not get

upset no m。tterwh。t.〃 it may seem silly, but

ifyou start outwith a positive attitude

(rathe「 than te旧ng yourseIf, “77]i5 /s going fo

be。Wんl.’’), yOu「time with the clientw川be

. ⊂on5iderthis: lfyou sawa videotapeof

yourseIffrom a confrontation with a d櫛cuIt

PerSOn, WOuld you be embarrassed byyourOWn behavior? ifso, howwouId you iiketo

See yOu「Self behave?

・ Besureto praisepeoplewhentheybehave

in a positive manner. (ln otherwo「ds,

reward the behavior you want to see them

repeat.) For exampIe, ifMrs. Simpson says,

写Ie。5e he佃me ro the b。throom now" instead

Ofthe grumpy way she usua=y says it, yOu

might say, “771。nkyou for。5king 5O nice小lH

be happy to he佃you.〃 Hopefui看y, She’=

③ 200=n the Know, Inc.

COntinue to ask nicely in the future.

・ It’saIwaysgood notto makepromisesthat

you can’t keep…but especiaIly with ’’d櫛cult’’

PeOPie. Ifyou teli them you’regoing todo

SOmething,then do it. And, ifyou haveto

breakyour promise for some reason, be sure

to apoiogize.

. 1fyouworkwithaduItclients,besureto

treat them like aduIts. Ifyou treatthem Iike

ChiIdren, they may behave that way!

・ WatchyourbodyIanguage. 1fyouteII

PeOPle that you’「e listening to them, but

you’re standing with you「 hands on your

hips, taPPing yourfoot and staring at a

Ciipboard...they’= know you aren’t reaIIy

=stening.

・ Keepin mindthatwe訓havece「tain ’‘pet

PeeVeS’’, mOSt Ofwhich deveIoped during

Our Chiidhoods. For exampIe, maybe you「

mother aIways nagged you to keep your hair

OutOfyoureyes. Oneday, a CIientsaysto

you,佑ow can you 5ee With your h。ir /n your

eyes?〃 it’s an innocent question, but it sets

you offbecause you’re sensitive to it. (And,

you’re not rea=y mad at the ciient, yOu’re

mad atyou「 mother!) So,thinkaboutthe

Iittle things that tend to bother you and try

not to overreact when a client or coworker

does them.

丁hinkofyourmost

‘‘di冊cult’′ciient…

●

Wouldyouwantto

誓書豊豊　d ノヽ

Page 6

What About Confused CIients?

一　Doesthissoundfam掴ar? Ma「y’scIient,Mr.

Brown, has good daysand bad days. On the

good days, he’s not ‘’d櫛cult’’at a=. Mary

reaiiyenjoyswo「king with him. But, On bad

days, hetriestociimb outofbed, Pu=s out

his urinary catheter, undresses himseifand

Waiksaround naked. MaryfeeIs Iike puiling

her hairouton those days!

'　ObviousIyMr. Brown has periodsof

COnfusion. These might be a sign of

dementia, deIirium or a medication reaction.

Whatever the cause, it’s important to

rememberthat M「. Brown is凸Q! being

d櫛cult on purpose.

ittakesa lotof

patience to work with

COnfused ciients. Your

number one goa=s to

keep confused ⊂Iients

Safe, butyou have to

keep their dignity and

COmfort in mind, tOO.

1t′sa b0didea to use

restraints to tie

COnfused clients to a

bedora ⊂hair. (And,

ln many StateS, itis

山室g重し)

弼tempora/y. For other5,耀o

perm。nent `Ondition.

What七the Diffe「en⊂e Between Dementia and De8i「ium?

Dep「ived of sIeep.

丁aking seve「aI kinds of

medications.

Dementia is a `hroniccondition which causes　. on bed rest.

常盤書書誌豊豊豊島・霊霊t.Delirium isan 。CuteShort-term mentai probIem . Recoveringfrom a

諾禁書嵩詳言詰: :嵩reCentOIder peopie who are:

. Suffe「ing from an infection orfever.

Try uns`rambiing the

foiiowing words.

HIN青Eo`h word re/ate5 tO

COm m uni`O tion!

NITLSE

EM5i」

CEOVi

丁ESQOUIN

How ⊂an Ybu He漢p Confused C音ients?

. Remain verycaim when you speakwith　　. Rememberthatagitated clients often

COnfused cIients. SpeaksIowIyin a caring respond toquiet music. IfpossibIe,tum On a

tone ofvoice. (Remember that theywouid radio ortape pIayer. Keep the music

never choo5e tO be confused.)　　　　　　　SOOthing-nO ‘’rock ’n ro=’’! And keep the

・薫嵩諾鵠濃鵜〃　黒岩豊嵩霊丁hatwouId probabIyupsether. lnstead,aSk . Te=yoursupe「visorrightawayaboutany

herto teil you more about he「 mother.　　　neW ePisodes ofconfusion and/Or COnCemS

you have about a confused client’s safety.

⑥ 200=n the Know, inc. NOI⊥S]nO ′]⊃IO∧ ′!「問S ′N]⊥Sl「 :S」eMSu∀ Page 7

What About Combative &Vio8ent C音ients?

Some ofyour ciients may be d櫛cuit because

they tend to be combative or violent. So,

WOrking with d櫛cuIt peopie can be more than

a communication issue-it can be a safety issue!

The govemment agency ca=ed OSHA

(OccupationaI Safety & HeaIth Administ「ation) is

COnCemed with empioyee safety. They work

hard to make sure that every workpIace is safe

for eve「y empIoyee.

Did you know that more assauits take place in

the heaIth care indust「ythan in anyother?

About 2/3 ofaIi wo「kpiace assauits take piace in

nursing homes, hospitaIs and other residentiaI

What音s Wo看kpla⊂e Vio漢en⊂e?

VioIence atwork is morethanjustthe kind of

things you hear reported on the evening news・

Workplace vioience inciudes incidents such as:

・ Verbai abuse,includingcursingand

SCreaming.

.　Th「eats.

.　Unwanted sexualadvances.

・ PhysicaI assault, incIuding hitting, SCratChing

and biting.

Patient Rights vs.Ybur Safety

. You’veprobabIyheardthattheneedsand

「ights ofyour clients come first. And fheydo!

However, yOu have rights, tOO. That incIudes

the rightto a safe and heaIthywork

envIrOnment.

・ It’sgoodtobepreparedforthepossib冊y

that some ofyour cIients may be combative

Or Vioient. But that doesn’t mean thatyou

haveto put upwith being abused,dayafter

day.

⑥ 200=n the Know, Inc.

丁o heIp prevent workpIace vioience, OSHA has

deveIoped guideIines such as:

・ Everywo「kpIacemusthave

a zero-tOler。nCe POIicy for

any violence o「th「eats of

VioIence against

empIoyees.

・ EmpIoyeescan′tbe

Punished fo「 reporting

incidents-Whether they

invoIve a cIientora

COWOrker. In fact,

empioyees shouId be

encour。ged to report aiI

incidents.

Remember...the majority

Ofyour clients w川not

exhibit vioIent behavior.

And most ofyour

COWOrkers are peacefuI

PeOPIe,tOO! Keep in mind

that peopIe are more

IikeIy to be violentwhen

they are scared,

OVerWhelmed or have

their ‘′personaI space’’

invaded.

園30% ofnuI5es repOrted

th。t fhey h。Ve been

Victims of workpIa`e

vioIen ⊂e.

Time for aしaugh!

Finding oneofher

Students making faces

at others on the

PIayground, Ms. SmithStOPPed to taikto the

Child. Sm紺ng sweetiy,

the teacher said,

侮obby when / w。S 。

`hiId / wa5 foId fh。t /fl

m。de ugly fa⊂e5, my

face wou/d freeze 0nd

5tγ thot way.〃

Bobby looked up at

her and repIied, “We//

M5. 5mith, yOu C。n’t

SOy yOu Weren ’t

Wam ed!〃

Be sure to report any incidents ofabuse to

your supervisor. (You’lI probably have to f川

Out an incident report.) Remember…ifyou

don’t report the p「obiem, it may happen

again to someone else in the future.

Te= your supe「visor ifthe stress ofwo「king

With a particuIar client is getting to you. 1t’s

betterto switch your assignmentthan to risk

taking yourfrust「ation out on the c=ent.

Page 8

Tips for Wo看kp獲a⊂e Safety

・ RememberthatworkpIace safety is an

lmPOrtant Part Ofyourjob. The mo「e

attention you and you「 coworkers payto

maintaining a safe environment, the better

Offyou’= aIi be. (And,yOurClientsw川

bene価, tOO!)

・ AskyoursupervisorifanyofyourcIients

have a history ofbeing physica=y orverb訓y

abusive. Knowing your ciient’s hi§tOry Wii看

heip you be prepa「ed to handle combative

Or Vioient situations.

●　Take th「eats seriousIv. ⊂on5iderthis rrue

5tOry: in a Coiorado hospitai, a Patient was

recovering from su「ge「y. During the night,

hetoId the nu「sethat he wouId k川the next

Pe「SOn Who cameto get him outofbed.

丁he night nurse didn’t te= anybody what the

Patient had said. The next moming,the

Patient stabbed two physicaI the「apists with

fo「ks.

・ Remembe「…it’s betterto reporta threatand

have it tum out to be ′’nothing’’than to

lgnOre a threatand wind upwith someone

ge両ng hurt.

・ Besureto shareyourobservations about

your clients with other staff members. ForexampIe, te= you「 coworkers ifMrs. Grady

gets agitated and hostiie every time

SOmeOne mentions her son.

・ Consider using a ‘’buddysystem’’when

Caring for c=ents who have a history ofbeing

COmbative. This isn’tsoyou can ′’gang up’’

On the ciient, butsothatyou can remain safe

as you perform cIient care.

・ lfyouworkina hospitalorafac掴ty,there

may be a spe⊂iai ala「m ortelephonecode

used when an empIoyee is in troubie. Be

Sure yOu know your workplace procedure.

@2001 lnthe Know,Inc.

. Keep in mind thatthefo=owing conditions

may cause or contribute to vioIent behavior:

・ ⊂OPD. This Iung disease may preventthe

brain from getting enough oxygen. This

Can make people anxious and agitated.

. St「oke. Afte「a stroke,there may be some

damagetothe brain thatcauses a change

ln yOur Client’s personaiity二

・ Urina「yTraくt lnfe⊂tion. Believe it or not,

an infection in or nearthe bladdercan

CauSe COnfusion and agitation.

・ Pain. When clientsa「ein a iotofpain,they

may become frustrated ve「y easiiy and

may lash out atthose around them.

●　Dementia &A音zheimer′s Disease. WhiIe

Vioience is not a frequent symptom, if it

does deveiop, it’s usu訓y in the middIe

StageS Ofthe disease. (And, this middIe

Stage Can last for years.)

. B「aintumor. Whenthereisan abno「mal

growth in the brain, itcan cause

PerSOnaiity changes.

. Substan⊂eabuse. 1fciientsare underthe

influence ofdrugs or alcohol, they may be

combative or violent.

. Depression. When peopie are depressed,

they may not be thinking straight and may

get frustrated easiIy.

Be supportive ofany

COWOrker who experiences

WOrkpIace vioience. Any

Vioient incident can be scary

and can have a iasting effect

On SOmeOne’s emotions.

Some peopie have even quit

WO「king in heaIth care

because ofthe st「ess caused de。/w肋theemorion5

by workp看ace violence.　th翌諾霊鳥葉柄

Page 9

Tips Fo「Wo「king With Combative PeopIe

ifyour client is combative,

Iookfor a pattem to the

behavior. Your observations

W川heIpthe nursesand

doctors figure out and/or

manage your cIients’

behavior. For exampIe, do

your clients usua=y become

aggressive:

・ Whenthey’re hungry?

.　Aftermeals?

・ Ata particulartimeofday?

. Whenthey’recoid?

. Whenthey’「ehot?

・ Afte「taking medications?

・ Whenthey’rewith agroupofpeopIe?

. Whenthey’releftaione?

. Aftergetting some exercise?

. OnIywithyou?

・ With anyonedressed inwhite?

Pay attention to things thatyour clients

enjoydoing. Then, ifyou see a vioIent

episode coming, try tO distract your client

With a favorite activity.

Ifyou encounter cIients who a「e combative

Or Violent, try tO:

. SpeaksIowiyand caimIy.

. Listentowhattheyaresaying. Don’t

tease or igno「e them.

.　Don′tcrowdthem. Givethem roomto

breathe.

・ Don′tletthem crowdyou…Orbackyou

into a come「.

. Avoid touching ang「yciients uniessyou

know from past experien⊂e that

touching them is safe.

◎2OO「 inthe Know, In⊂.

Sometimes, yOu Can get the attention ofa

hostile, uPSet Pe「SOn byca冊ng out his or her

name-IoudIy and cIeariy. (But don’t

COntinue to shout atthe person.)

Try to get a hostiIe, COmbative person to sit

down, if possibie. (Most people are less

aggressive when they are seated.) But, ifthe

PerSOn refuses to sit, yOu ShouId remain

Standing, tOO.

Ifa cIient becomes vioIent around other

Clients, do your best to protect the other

C=ents (and yourself) f「om harm.

Keep in mind thatall cIients havethe rightto

refuse treatment. For exampie, ifa ciient

becomes aggressive when you arrive to give

a bath, Iet your superviso「 know thatthe

Client has refused your ca「e.

Be a good role model. Ifyou getangryo「

aggressive because ofa ciient’s vioience, it

W川oniy make the situation worse.

Make sure you knowyour workplace policy

for getting heIp ifa c=ent becomes violent.

Rememberthat a= episodes ofcombative or

VioIent behavior shouId be reported to a

Physician. There may be a way to treat the

aggressive behavior.

Remembe「…

You have唾main goaIs:

1. Keep yourclients safe-eVen if

they are being combative.

2. Guard yourown safetyand peace

Ofmind.

Page 「O