MDS Alert

Resource:

Check Out These Slides to Increase Your Understanding of Personality Disorders

Care plan example:

Problem: Resident pushes the call light every few minutes to hear a voice.

  • Contributing factors: Personality disorder, fear of abandonment, need for control and reassurance.

Goal: Resident pushes call light only with genuine need.

Approaches:

  • CNA visits him every hour on a schedule to "check on him" and ask what he might need.
  • If resident has not pushed light in last hour, compliment him, tell him that now you have more time to spend with him and actually spend it with him in conversation.
  • When calls are frivolous, inform resident when you are coming for your rounds, and ask them to wait. When you do rounds, tell him, "Because your calls interrupted me, I don't have time to just talk with you; that's too bad, because I like that. Let's try not calling for the next hour and if you can do it, I can spend more time and we can talk about the baseball game."

Source: R.L. Ferrini, MD, MPH, CMD and R.M. Gibson, PhD, JD, from their presentation at the March 2012 AMDA Long Term Care Medicine conference.