Caring for a Difficult Nursing Home Resident

Subject: Nursing
Pages: 3
Words: 821
Reading time:
4 min
Study level: College


Working in an elderly care facility as a nurse aide, I am assigned a 75-year-old male patient who had recently lost his wife. Mr. James is labeled a difficult resident and constantly clashes with the nurses and other patients. He is also an insulin dependent diabetic with severe hypertension who has recently suffered a heart attack and, thus, cannot take care for himself at home alone. This paper will examine Mr. James’ medical problems along with his emotional and physical needs and will consider patient’s safety issues and best ways to dealing with his problems as a nurse aide.

Identifying Mr. James’s Medical Problems

As previously mentioned, Mr. James has a long history of diabetes. Diabetes is often defined as “complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycaemic control” and takes place in the top ten causes of death in the U.S.A. (as sited in Kutz et al., 2018, p. 1). In turn, Mr. James’s hypertension, which is a common name for high blood pressure condition, can be equally the cause and the direct consequence of his diabetes. Regardless the origin of his blood pressure condition, Mr. James has suffered a heart attack which was likely caused by a combination of factors including hypertension as well as his declining mental health. Mr. James’s wife had suddenly passed away about three months ago, leaving him in an acute state of grief and bereavement. Furthermore, Mr. James seems to be experiencing the stage of grief often associated with anger, projecting his frustration onto the medical personnel and other patients of the elderly care facility. In conclusion, considering the current state of Mr. James, he requires close supervision, a complex of a healthy diet and physical activities and, above all, empathetic therapeutic help.

Identifying Mr. James’s Emotional and Physical Needs

As far as Mr. James’s needs as a patient are concerned, there is a lot to be done with regard to his physical and mental health in order to improve his wellbeing. First of all, Mr. James, as far as possible, should be in a stress-free environment as high levels of stress can affect both the blood pressure and sugar of the patient (Kutz et al., 2018). Furthermore, he is expected to stick to a strict diet developed by the facility which would limit fat processed products as well as high-glucose food and sugar drinks to lower the chance of another heart attack (Nguyen, 2011). The food should ideally be served within the same time periods during the day, followed by wholesome snacks in between the meals, in order to ensure steady blood sugar levels (Peri, 2020). Moreover, healthy diet must be reinforced by daily sport activities and physical therapy in order to help him recover from the heart attack as well as to prevent such in the first place (Adams and Wright, 2020). Finally, therapeutic supervision and counseling is required to help Mr. James to overcome his grief and get out of his toxic depressive state (Cacciatore, 2021). Taking all these factors into consideration, the next section will discuss dealing with Mr. James’s specific issues.

Dealing with Mr. James’s Problems

With regard to Mr. James’s AM care, there are several things that need to be addressed in his morning routine. First, one has to be particularly cautious when shaving facial hair and clipping nails of diabetic patients in order to prevent any cuts and, hence, those procedures would ideally be performed by the nurse aide (Peri, 2020). Furthermore, baths can be taken as long as there is a tub bath in the facility and the water is not too hot. Moving on to the Mr. James’s mental wellbeing, the recent aggressive behaviour and mischievousness can be attributed to the state of shock and grief experienced by the patient due to the loss of his wife. In turn, Cerit et al. suggest that one should “earn difficult patients’ trust by showing consistent behaviors towards them, empathize with difficult patients and to support them to take part in their own treatment and care” (2020, p. 9). Moreover, Cacciatore et al. mentions that “emotional support in grief can be defined as being present and holding space for the griever, more specifically distilled to listening and allowing grief without judgment, platitudes, or an agenda” (2021, p. 9).


To conclude, Mr. James’s path to physical recovery depends on a combination of a healthy diet and daily physical activities. Furthermore, in order to get rid of the status of a difficult patient, Mr. James need counseling along with strong emotional support from the facility’s personnel and, in particular, his nurse aide. By winning over the patient’s trust, addressing his mental problems and unjudgementally empathizing with his thoughts and grief, nurse aid can significantly improve Mr. James’s wellbeing. In turn, the return to stable mental state will help him to find other like-minded patients in the facility along with some peace of mind.


Adams, J. M. and Wright, J.S. (2020). A national commitment to improve the care of patients with hypertension in the U.S. JAMA, 324(18), 1825–1826.

Cacciatore, J., Thieleman, K., Fretts, R. and Jackson, L. B. (2021). What is good grief support? Exploring the actors and actions in social support after traumatic grief. PloS ONE, 16(5).

Cerit, K., Karatas, T. and Ekici, D. (2020). Behaviors of healthcare professionals towards difficult patients: A structural equation modelling study. Nursing Ethics, 27(2), 1-13.

Kutz, T. L., Roszhart, J. M., Hale, M., Dolan, V., Suchomski, G. and Jaeger, C. (2018). Improving comprehensive care for patients with diabetes. BMJ Open Quality, 7(4), 1-6.

Nguyen, A. (2011). Caring for someone with heart disease. WebMD. Web.

Peri, C. (2020). Diabetes: A caregiver’s checklist for daily care. WebMD. Web.