Coping in the wake of the North Carolina nursing home shooting

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Eleanor Feldman Barbera
Eleanor Feldman Barbera
The shocking news of an assault on nursing home residents and staff is likely to cause fear and anxiety in members of our nursing home community.  As a nursing home psychologist who was working in New York City in the aftermath of 9/11, I'd like to offer some suggestions regarding ways in which we can help our community members cope with this tragedy.

* Be aware of our own feelings:  If we're anxious ourselves, it's unlikely we're going to be of much assistance.  We should take time to calm ourselves, or let others take on the task of reassuring residents, staff, and family members until we're ready to do so.

* Allow community members to express their concerns:  We don't need to fix things, but can act as a sounding board.  Often if we listen long enough, the speaker can get through the frightened feelings on his or her own.

* Acknowledge feelings:  It's not uncommon to be fearful or anxious, which will diminish over time.  Knowing this is normal can be comforting.

* Emphasize safety procedures:  Reviewing the safety procedures in the nursing home, such as a security guard, observant staff, alarms, and security cameras, can increase the sense of safety and control.  If it seems necessary, separate group discussions can be offered for residents, staff, and family members.

* Utilize spiritual supports:  Tragedies such as this reinforce the capriciousness of fate, and, for some people, may lead to questions of how this could have happened.  Help them to understand it in terms of their spiritual beliefs.

* Anticipate increased efforts at control:  For a brief period, we might expect to see our community members striving for control in other areas of their lives.  For example, residents who usually feel some anxiety using the lift to get out of bed might find it more distressing and need increased reassurance.  Staff members who are normally flexible about their work assignments might be less so, and family members might be more vocal about concerns for their loved ones.  We need to be gentle with ourselves right now.

* Be prepared for denial:  Many people won't mention the attack, or won't feel it has any relation to them at all.  Let them be. They'll bring it up if and when they need to.

* Observe for symptoms:  You might notice increased depression or anxiety, rumination (repeatedly discussing the event), tearfulness, nightmares, insomnia, symptoms of Post Traumatic Stress Disorder such as exaggerated startle response, etc.

* Use your mental health team members:  If a resident is having difficulty in the aftermath of this attack, consider a referral to the psychologist and/or psychiatrist.  Staff and family members who are distressed might be gently directed toward using their mental health benefits.

* Provide the opportunity to be of assistance:  Sending cards or taking up a collection for Pinelake Health and Rehab <http://www.peakresourcesinc.com/nursing/pinelake.html> is a positive way to channel the energy of our community and show the power of human kindness in the face of tragedy.

Eleanor Feldman Barbera, PhD, the author of The Savvy Resident's Guide, is an accomplished speaker and consultant with over 16 years of experience as a psychologist in long-term care. This blog complements her award-winning website, MyBetterNursingHome.com, which has more on how to create long-term care where EVERYBODY thrives.
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