Negative Emotions

By Barbara Karnes, RN

May 26, 2015

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Author Barbara Karnes, RN

QUESTION: How do you handle feelings of anger, fear that is being projected onto the caregiver by the patient?

It is hard to be caring for someone (which is generally a challenging task at its best) and have that person be rude, demanding, irritable, or just down right nasty to you.

My first recommendation is to not take it personally. The behavior has nothing to do with you. As you stated above “feelings of anger and fear” are being projected onto you, the caregiver. This is how, unpleasant as it is, the patient is dealing with their fears of debilitation, needing a caregiver and most of all the fear of illness and dying.

We tend to want to fix other’s challenges so we often want to discuss why the anger is not appropriate and or defend ourselves. I think that just tends to inflame the situation. I’m for giving no response as in no response is a good response. Not engaging tends to diffuse a situation. If there is nothing to rail against we tend to stop.

Even though you know intellectually the negativity is not about you I think setting boundaries is necessary. I had a gentleman who kept threatening me with his cane and loud, verbally abusive words. I told him to be more selective with the wording of his displeasure and that I would not stay if he continued to threaten to hit me with his cane.

As a person enters the dying process their personality doesn’t change. It intensifies. A grouchy, irritable person can become downright mean. An easy going person becomes even more laid back and quiet. Look at the person’s personality. Has it intensified or actually changed. If there is a personality change consider the possibility of medical issues and drug reactions before deciding the person is just being unpleasant.

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Hospice fears

Hospice fears often begin with this “H” word – Hospice. The discussion of help often begins and ends with a single word – “hospice”. It is as if the word itself was a “cause” of the terminal illness instead of the “care” for a someone with a terminal illness. In my many years of working in hospice care, I have been amazed at how many times- even some who works in and believe in hospice- would avoid using the word when someone they were close to clearly needed the care. Over the years we have attempted to find many alternatives to better address this problem. The following two blogs do an excellent job in addressing this challenge. Please check them out and let me know your thoughts.

Hearing the word hospice

Hearing Hospice

Fear of the “H” Word…Hospice, Walking on Sacred Ground website, Marygrace Lomboy, MSN, CRNP, ACHPN, CWCN, is a nurse practitioner with Palliative Medicine Consultants and Hospice and Community Care

Marygrace Lomboy, CRNP –

“I had worked in hospice for approx 8 years and when my father was physically declining, it was extremely difficult for me to bring up the “H” word to my own family.  My mother whispered it around my dad and the rest of the family. I knew it was time to get hospice involved, but there was so much fear and misconceptions around the “H” word, that it was difficult to get the entire family on board as well as my dad’s physician. When was the right time?  I even doubted myself at times in suggesting it…”

Uncomfortable Using the Word Hospice,, Barbara Karnes, RN: Award Winning End of Life Educator and Award Winning Nurse

“The dilemma of not wanting the word ‘hospice’ associated with materials and/or care is unfortunately  a common one. I think that is the basis for the creation of the word and idea of ‘palliative care,’ to deal with approaching end of life situations but not actually dealing with the eventual end of life.”

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