Expert Analysis

It is important to remember that the normal aging process can add to feelings of frustration, anxiety, sadness, confusion, and anger. Elderly adults often experience more pain, frailty, and emotions as they age. For some residents, living in a long-term care facility can be frustrating. For example, the routines around meals, bathing, and sleep hours can be irritating. Others will experience a deep sense of loss and loneliness as a result of moving from their home and family. Simple environmental conditions, such as changes in noise levels, odors, and lighting can be upsetting to some residents.

The care team should begin with an assessment of the resident to identify the aging processes that may be contributing to frustration and thus aggressive behavior. Data collection, including learning from a resident's family and medical team, is also crucial to determine behavior patterns. The key to a successful plan of care is that it needs to be designed for the individual resident, be team-based, and be consistently implemented by all who care for the resident.

Since there is a growing number of cognitively impaired patients in general, the issues brought up in this case study are relevant to nurses across all healthcare settings, not just long-term care for the elderly.