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Aggressive residents are a large source of staff frustration and burnout. In addition, these residents suffer too, as their hygiene, grooming, toileting, and nutritional needs are often not fully met because staff tend to avoid them out of fear or irritation.

You can not always control the aggressive behavior of your residents, but you can control how you react to it. Often, if you know how, you can prevent or diffuse difficult situations. Aggressive acts by residents toward staff often go unreported and are not documented because staff members feel like they can’t do anything about it anyway. You need to tell your supervisor when a resident is aggressive. This way the care team can develop preventative measures and interventions to deal with the problem resident.

Here are some tips for protecting yourself when dealing with an aggressive resident:

Physical stance

Maintain a non-confrontational stance: Don’t cross your arms in front of you, as this can be interpreted as menacing.
Put one foot forward toward the resident and the other foot a step back at a 45 degree angle. This will allow you to move forward or backward quickly, if needed.
Keep your hands and arms at your sides, in the resident’s sight. When a person can’t see your hands, he or she may feel threatened.

Eye contact

It is essential to maintain eye contact with an agitated resident.
Do not stare or scowl, as these expressions may be interpreted as a challenge.
Watch the resident’s eye movement. You may be given an advance warning that a resident is preparing to strike you. A blow is usually preceded by a glance to the area to be struck.

Release from a one-handed grip

The easiest way to pull out of an arm grip is to first make a fist.
Twist your arm toward the gripping thumb until the side of your wrist is between the resident’s thumb and fingers.
Back away from the resident as you pull your arm out of the grip.

Release from a hair pull

To release yourself from a hair pull, clasp your hands over your head.
Press down with your knuckles on your attacker’s hand. This relieves the pain cause by the grasp and provides leverage for the release of the hold.
While maintaining this pressure, when you feel the resident’s hold loosen, bend at the waist and turn away.

Release from a bite

If you are being bitten, try to avoid the urge to pull away. Pulling out of a bite can cause you increased pain and physical injury.
Instead, push toward the bite. Be careful not to apply too much pressure so you don’t hurt the resident.
Use your free hand to place your index finger in the pressure point just below the ear at the upper point of the jaw bone.
While pressing on the pressure point, extend the thumb of the same hand to the lower jaw.
The jaw will loosen and you can remove the injured area.
Note: Human bites need special medical attention. Report the bite immediately to a supervisor.

Always look for the causes of aggressive behavior and correct them if you can. Learn to recognize potentially dangerous situations and practice personal safety skills to protect yourself.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.