Which is safer? Putting girders on place on the 22nd floor of a new Vancouver high-rise in your new work boots, or caring for senior citizens struggling with dementia? Worker injury claims for dementia caregivers are actually more expensive per capita than from the construction sector – and some days, you may feel like you need to wear a hard hat just to get through the day. The work environment of a care home may seem a lot safer to the eye. However, workplace violence from dementia patients can be an unwelcome surprise for an unwary nurse who just wants to help vulnerable people to live in dignity with a better quality of life.
Risk in the caregiver’s workplace can unfortunately be quite serious, as a BC nurse learned recently. As reported in Metro News, one nurse attacked by a patient needed stitches after being head-butted, elbowed and (while she was helpless on the floor) hit with a rock. Making matters worse, the paging system set up to help nurses remain secure wasn’t even working. Sadly, these kinds of incidents are not uncommon. As the CBC noted about a year before that attack, the BC Coroners’ office was already investigating horrendous attacks by dementia patients on other patients.
Eighty percent or more of seniors in residential care may have dementia – and among that pool, there is an enhanced chance that caregivers may be dealing with aggression. Of course, not every patient is a potential threat – but some, who may be dealing with undiagnosed challenges or unmet needs can lash out.
We also recommend an excellent series of videos by WorkSafe BC outlining how caregivers can reduce risk and protect themselves from harm. If you’re a caregiver, they’re definitely worth a few minutes of your time!
Ultimately, the advice they provide relates to responsive behavior. Part of the job of being a professional caregiver is being a kind of detective: finding out why there is an unmet need that is causing the patient anxiety. Speak slowly to make sure you are understood, listen carefully to what they are telling you, evaluate (because it may be that they are unable to truly communicate their needs – which could be a big part of the problem) and take your time – fostering trust on both sides.
Despite all of your precautions, there is no perfect recipe for preventing a sudden outburst or aggression that comes on with little or no warning. If a patient becomes agitated and violent, you need to remove yourself from the location immediately. Let them calm down – you can always try again later, but safety is your top priority. In the meantime, report the incident to make sure that any other caregivers, administrative staff or others are aware of what happened. Without diligent reporting, a pattern of violent behavior can go unnoticed – with very serious consequences down the line.
Remember, fending off violence isn’t ‘just part of the job’. Caregivers have a right to a safe work environment – and you also have a responsibility to do what you can to make that environment safer for yourself, your patient and your colleagues.