Case Study 4: Long-Term Care

A LPN and CNA working in a long-term care facility are verbally and physically abused by a cognitively impaired resident. They meet with their nurse manager and a consulting clinical nurse specialist to discuss courses of action.

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A Resident Strikes Out at Staff

Mr. Otis is 79 years old and suffering from Alzheimer's disease and other impairments. He has been striking out at nursing staff with both verbal insults and personal threats as well as physical attacks including slapping, punching, digging in fingernails, and kicking.

Raising Concerns to the Manager

One of the CNAs assigned to Mr. Otis reported repeated incidents of abuse to an LPN, who had himself experienced similar incidents with Mr. Otis. At a loss for solutions to this problem, they approached their nurse manager with their concerns. Together they tried several different ideas, none of which seemed to resolve the problem.

Seeking an Objective Opinion

At a loss for ideas, the nurse manager called in a clinical nurse specialist (CNS) in gerontological psychiatry to help problem-solve. The nurse manager called a team meeting with the CNS, LPN and the CNA. In the following video, the team meets for the first time.

Page last reviewed: February 7, 2020