Monday, April 28, 2008

Caregiving: "aggressive" episodes

Frustration through cerebral deterioration can trigger violent or, the politically correct, “aggressive” episodes.


As caregivers, we tend to ‘scrub’ incidents whether sharing with others or even remembering ourselves.


In earlier years, in episodes of Multiple Sclerosis emotional lability Patti slapped at and scratched at me. Experience taught me her range. <grin>


Patti’s cousin shared an anecdote from his employment at a care facility. Trying to comfort a tiny, elderly, and frail resident in a wheelchair he leaned close. She hit him so hard he could barely keep his feet with stars spinning around in his head.  


An autistic teenager has a sudden ‘aggressive episode’ and attacks their parent on a public sidewalk. Four strangers, unaware of dynamics of autism, become involved to restrain the youth before police and emergency personnel can arrive.


Violence is a spectrum from mild to at risk. It does and should change the caregiving equation.


Caregivers by nature are control freaks and control of the environment and stimuli makes it all work. Yet the power to control unravels as you expand your environment and the people involved in caring.


Violence toward a ‘contracted’ home care worker will pretty much end the home care era. Ironically, frustration is more apt to be higher with the variables of contracted workers. While hitting family is not right it has little legal consequence.


Violence contracts your world. Public episodes are out of a caregivers’ control. Strangers are random variables and exponentially increase the chance of someone getting hurt.


Frustration PLUS dependency on others is complicated, as is the caregiving involved.


Viewed through the introspection of “what could I as a caregiver have done different” to prevent the episode, right and wrong loose boundaries even definitions.


Knee jerk psychiatrists might raise battered something syndrome. Nor does codependency exactly fit as a label.


Caregiving, especially in this shadowy corner, is driven as always by the heart not definitions  … and a wise appreciation for range of reach.


Caregivingly Yours, J Patrick Leer 





(also available in Blogger edition, Caregiver Blog: "Caregivingly Yours")


  1.   I once got slugged so hard in the jaw I thought it was broken.  By a 90 something old man.  I have gotten choked, had a IV pole swung at me.  Scratched, bitten...fortunately her teeth weren't in.   None of this by people who would have done something like this deliberately.  You just learn to get quicker on your feet and always have a route of escape.


  2. I have learned not to over-react when I see something out in public that looks like abuse and have learned how to read people's body language a lot better and differently than I did before dealing with things with my daughter; it is a delicate situation though and always requires you to be on your toes and out of range as you so aptly said :)


  3. "Experts" are a dime a dozen. Violence is always expected in these types of situations and an 'expert' will always say, "If I were you, I would  ______. (blah blah blah... fill in the blank).


  4. I was overlooked for a job as a physical therapist (it was an intraining job at the time) as they were worried with my small stature I wouldn't be able to handle myself. At the time I was a mere 5'1 and 95lbs. It didn't matter that I had at one time worked as a bouncer (Yeah, I've had an interesting life). They wanted someone who was bigger yet didn't have to react to violence with violence to protect themselves. I thought that odd at the time (It was in a private facility for mentally challenged individuals) as I saw them as gentle and loving. Reading this it makes sense. (Hugs) Indigo

  5. ....thanks  for the warning.......that is why mom doesn't have a home health person, insurance to cover episodes of any kind isn't available..Tried workman's comp.  One person is too small a business to cover.  That is why I have this job alone.

  6. this is so true, when i worked a nursing home the sweetest little old ladies you had to watch out for. One man wanted to get up and use the restroom, but he couldn't docs orders. he got so angry that he tried to hit me and the other aid and the nurse. He kept trying to get out of bed.we hit the emergency light we had 10 people in the room and one shot to calm him down. He is the one who threw his urinal at me boy did that hurt. have a good hump day



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