A resident, who I will call Bert, moved in a couple of years ago. Though he was in his 80s, he was robust. He was small in stature but authoritative in a way that showed his many years in the military. When he came, he walked a bit stiffly but could get around. He wanted to do things his way. He brought a razor and shaving cream and wanted to shave himself. The aides were instructed to allow him to do so.
Bert was in two different semiprivate rooms and had trouble remembering where each one was. When the nurses put a flower on the door, Bert could find his way back.
Bert would get feisty when one of the aides tried to get him to shower. He will not take a shower because the aides would have to observe him. So, for the two years he has been here, he just washes himself up in the bathroom.
Bert adopted the men who sat at his dining table. One of them, Buford, an older man, had been here a couple of years. Most days, Bert pushed Buford back to his room. But Bert's mind told him he and Buford owned the facility. Bert frequently reminded the aides of that, who would look at each other and smile.
For the first year or so, he went on outings with his granddaughter. She took him to family gatherings, get his haircut and out to eat. She also frequently visited and brought him goodies.
Bert took on the role of manager in the dining room. If a resident acted up or had his elbows on the table, Bert had something to say. He did not like it if dietary told him he could not have a second bowl of cereal. If an aide told him that, he would likely chase or kick at her.
One morning, Bert was upset because the ceiling fans were on in the dining room. He had a point. The fans in the dining room blew down. I suggested they could reverse the fans, so they would not cool the food. However, an aide said Bert wanted them turned off because they made the room too cool. Bert believed as owner he could make management decisions any time.
The aides and nurses told Bert he could not turn off the fans. He was told it was summer, and the fans were necessary to keep the dining room comfortable for residents. Bert was upset and refused to eat. The nurse manager intervened to bring him a tray. On several occasions, Bert had to be escorted from the dining room.
Bert experienced skin infections in the past and was always treated for them. However, over the last several months, he has refused treatment and will no longer take any medicine. His granddaughter no longer visits because of his worsening infections and attitude.
Bert is experiencing pain that is affecting his behavior. Sadly, since he will not cooperate with treatment, the nurses can do little to rid him of these infections.