3 Tips for Dealing with Combative Residents

Melissa Mills
May 22, 2022
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You are about to receive shift report. You notice a new resident’s name on your assignment sheet. The CNA giving report tells you the resident is combative. They threw their lunch tray across the room and hit the nurse when she was trying to give medications. You think to yourself, “How am I supposed to handle this resident? I have no clue what to do with this assignment.” 

Not having experience with combative residents is okay. You’ll quickly learn how to deal with each person assigned to you in an individual way. Let’s start by exploring what it means to be combative.

What is Combative Behavior?

Combativeness shows up in many different ways. You might have a resident who yells or curses each time you enter their room. While another resident tries to hit, kick, bite or spit at you during care. All of these behaviors are considered combative and can pose a physical and emotional danger to you and others. 

Often, an underlying condition like Alzheimer’s or dementia causes the resident to act this way. However, it can be a sign of pain and other types of distress or even the resident’s way of dealing with the lack of control. 

No matter the reason for the behaviors, you can do a few things to provide the necessary care and keep yourself and the resident safe. 

Get to the Bottom of the Behavior

If the resident doesn’t have a condition that affects their thinking, the healthcare team must look at the behavior closely. If it’s new behavior and out of the norm, ask the resident what’s going on first. Then, be sure to notify the nurse right away. The nurse will probably do a quick assessment to check for pain, other new conditions, or a worsening of chronic health problems. 

Protect Your Safety

You won’t be able to help this resident or others if you get hurt. That’s why it’s vital to protect your safety at all times. Here are a few strategies you can use:

  • Stay at least an arm’s length away if you aren’t doing direct care.
  • Work in pairs when possible.
  • Keep a clear path between you and the exit, and never turn your back to them. 
  • Stay calm. 

Handle With Care

How you talk to and touch a combative resident can make or break the situation. You might typically be able to chat with this resident like you would anyone else, but when they’re agitated, it’s critical to change your approach. Try using these strategies:

  • Speak in a slow, calm voice and use a moderate volume. Talking loudly can cause more agitation. 
  • Choose your words carefully and use compassion, empathy, and kindness in all you say. 
  • Move slowly and naturally around the room.
  • Know that it’s okay if you feel frustrated. If you need to walk away, make sure the resident is safe before leaving the room. Then, ask the nurse or another CNA for help.

Final Thoughts

You must always separate these behaviors from the resident as a person. Unfortunately, many people can’t control these behaviors, and some don’t even realize they are happening. Use these tips and tricks to help you give the best care to residents displaying combative behaviors.  

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