He feels that she is misbehaving and I feel that this isn’t acceptable
She is just old 95
- no dementia
- hard of hearing
- frail and not mobile
- recent trauma during an armed robbery where she was also held up
- this year has been really bad for her part of which she doesn’t recall
how will I know when a patient is misbehaving vs an underlying issue?
Spooning food out of the bowl & onto the tray is no big deal, first of all. Throwing food across the room into the wall or into your face IS a big deal.
Even if an elder is 'misbehaving', what are you going to do about it? It's not like this woman is a 4 year old child you'd put into a time out for being naughty! Being a passionate carer means you know that elders have issues, and act up and out from time to time, all of them. Especially a 95 year old elder who's recently had such a terribly traumatic experience such as being robbed at gunpoint!
Spooning food onto a try doesn't indicate an 'underlying issue'. Having odorous urine is; complaining of pain can be indicative of an underlying issue; a change in behavior where she's becoming aggressive or completely out of sorts; things like that indicate a possible underlying issue.
But if this woman has suffered SUCH a traumatic experience, she may need to see her doctor for calming medications and/or anti depressants if she seems withdrawn or exhibiting huge personality changes in general. I can't imagine going thru such a thing and NOT having issues afterward, quite honestly. I myself would have nightmares at the very least and sleep disturbances in general.
Whoever her POA is ought to get your client to the doctor for an exam, and to discuss this trauma (if that has not already happened). You need to be on the alert for other behavioral issues she's displaying that could be indicative of psychological issues. I wouldn't worry too much about the food incident, if it were me.
Good luck!
No matter what the age of your patient or client, there will be times when they cannot eat by themselves.
They may need to be spoon fed.
They may need to have someone sit with them.
They may need to be served food they like and enjoy.
They may not be able to verbalize their needs.
They may have a medical or dental condition preventing them from eating.
They may need a different caregiver that they like better. 🍕
And how do you know there is no dementia, did "he" tell you?
Re-write "my female patient is not cooperative" to 'my female patient is *communicating*'. .
What is she *telling* you?
She doesn't like it?
Not hungry?
I would say at 95, with a traumatic experience recently, there is some cognitive decline going on. If "he" is her husband he may be covering up her Dementia. A number of our posters have taken a parent in after another dies. The children lived far from the parents so did not visit often. They found after the parent started living with them that their care was 24/7. The other parent had never let on how much care the parent had become or that Dementia was involved.
If this is new behaviour, then a UTI can be involved and she needs antibiotics. If Dementia in involved, they do become like small children. Not that you treat them that way, but are aware of it. If you have never cared for someone with Dementia then u need to read up on it. Its very unpredictable. A person can seem OK one minute and paranoid the next. They can no longer be reasoned with. Short-term memory loss makes it impossible to learn anything. They process slower. Do not comprehend. You keep things very short. No big long explanations. And your dealing with deafness. If hard of hearing you have to stand right in front of her and look her straight in the eye. She maybe be able to read lips to a point. You talk slow and precisely with very few words.
If the answer is no, time to have your client checked for an Urinary Tract Infection [UTI] which can cause all types of strange actions plus will mimic dementia.
If there is no infection, this could be the start of dementia. If this turns out to be dementia, time for everyone involved, including "he" to learn all one can about this disease.