Healthcare Training Institute - Quality Education since 1979

Section 21
Domineering Resident Technique #6
Three Proven Stress Management Techniques

Table of Contents | NCCAP/NCTRC CE Booklet

Stress Management Technique #1 – The Triple-A Approach
To effectively manage the stress which you may feel while working with your Domineering Residents, you may need a systematic way of viewing your stress and then determining how to go about reducing it. I have found that a three-step approach, or what I call the triple-A approach, to stress man­agement, is a useful and easy way to help plan a program of stress reduction.  It tells you where to begin and what to do after you have started.

Here’s what each of the three A’s in this stress management plan refer to:
    - Awareness: Awareness refers to knowing what your stress looks like and where it comes from.

     - Analysis: Analysis is the process of determining the best way or ways of managing your stressors. Your main option as mentioned earlier is changing yourself.  By “changing yourself” I mean changing the ways in which you react to a particular stress trigger.  Or is there something you can change about the situation?  Is there another activity staff member who might relate better to Hester?

     
     - Action: Action refers to what you do about your stress. Your action could be to take a few deep breaths,  create a visualization of a calm scene perhaps by the ocean and recall that, evaluating if that caffeinated drink is the best choice at this time. How about searching google.com for some herbal calmers.  My favorites are St. Johns Wart and  “Rescue Remedy” oral spray.  However, everyone’s body chemistry is different and what are my old stand-bys may not work for you at all.  So make a commitment to visit a health food stores.  In short after dealing with your Hester, what can you do to de-stress yourself?

Stress Management Technique #2 – Keeping a Stress Journal
To effectively manage your stress related to a Domineering Resident, you need to become aware of when you are feeling stressed and be able to identify the sources of that stress. A stress Journal can help you do just this. This Journal shows you, very specifically, when you experience stress and pinpoints the situations or circumstances that triggered those stresses. Your Journal acts as a cue or prompt, reminding you that you might need to take some action and make use of stress-management tools.

Make your Stress Management Journal small enough and compact enough so that you can carry it with you. Some people like a small notebook, with each day on a separate page. If you are a high-tech kind of person, you can work your stress Journal into your laptop or personal organizer. The form and format are less important than the fact that you use it on a regular basis.

Here is an example of what a portion of your stress Journal may look like.
Time                    My stress trigger                                                    My stress responses
7:45 a.m.              Couldn’t find my keys                                                  Annoyed, upset
9:30 a.m.             Domineering Resident greeted you at the time clock      Annoyed
11:30 a.m.           Husband called; big credit card bill                                Upset, worried
12:30 p.m.           Given a deadline for project by Administrator                Worried and anxious

Get started on your Stress Journal now.  Think back to your day today at the facility.  List the time of your stress Trigger, what the Trigger was, and what was your response.  You cannot change something that operates at an unconscious level for you.  Agree?  By bringing the stressor into your awareness, you can consciously take charge of your work day by making a decision to change.  Complete the following portion of a Stress Journal:

So now you have increased your self-awareness of your stressful times during the day.  Now what?  Use a stress reduction technique as an antidote, for example when the Domineering Resident stalked you as you walked to the time clock demanding attention.  There are hundreds of stress reducers.  Here is one of my favorites called "Finding the Funny Part."

Stress Management Technique #3 – Humor
Humor can be an excellent tool to help diffuse your frustration not only with domineering residents but in other situations as well. If you can find something about the negativity-triggering situation to make you laugh or at least bring a smile to your face, you can be assured your negativity will be lessened and possibly even eliminated. The following section offers two ways of creat­ing humor in a stressful situation.

Blow Things Up
Exaggeration is a great way of diffusing a potentially stressful situation, rob­bing it of much of its impact. Try using the blow-up technique. Here’s how it works in a situation outside of the facility.   Suppose, for example, you find yourself standing in line at the Bureau of Motor Vehicles waiting to renew your driver’s license. The line is moving slowly. Very slowly. You can feel your stress level creeping higher. Now, introducing a touch of exaggeration, you imagine that it will take forever before you reach the front window. You picture your family coming to visit you on Sunday afternoons, bringing many of your favorite snacks. You strike up strong friendships with others in the line. There is talk of taking vacations together. You start planning your first five-year reunion....  Funny huh?

Now let's apply the "Blow Things Up" technique to Hester as she stalks you to the time clock to punch-in in the morning, showering you with requests and complaints.  Instead of feeling your blood pressure rise, your stomach tense, and a headache coming on, envision this.  To trap you into an encounter, Hester pours tar on the floor so you are stuck to the spot and cannot get away… months… and years pass… you get gray hair, as your children and husband come to visit you stuck in the tar, continually listening to Hester.  J  Did you smile inwardly as you read this?  Your turn will come in the exercise below.

If exaggeration is a stress-reduction technique that resonates with you, write a page of exaggerations in your Journal.

Try Some Therapeutic Fantasy
A humorous fantasy can help you reduce and diffuse your anger, frustration, etc.  Here’s what I mean. Imagine that you are a passenger in a taxicab and you notice that the cab driver is driving much too fast for your liking. You also notice that your anger level is creeping skyward.  Before you yell at the cab driver or blow some internal gasket, imagine this improbable scenario:
You tell him that he is driving too fast and he immediately slows down, and, with a sheepish look on his face, turns to you and says, “You’re absolutely right! What could I have been thinking? I’ll slow down immedi­ately. In fact, I won’t charge you for this ride, to make up for my unsafe and insensitive behavior. I’m sorry. This will never happen again.”  Does this bring a smile to your face?

Imagine saying to your Domineering Resident, "The second Bingo game has been canceled because we need to provide a balanced Activity Program to meet all of the residents needs, and we have an increasing number of Low Functioning and Alzheimer's activities."  Hester, your Domineering Resident, replies, "Wow what a grand idea!  I feel you should cancel the Sing-a-Long too to give those poor unfortunate Alzheimer's and Stroke folks an opportunity to increase the quality of their life.  As a matter of fact, I heard of this idea called Success Therapy®.  I have a rather large trust fund, and I'd like to donate some money so the facility can buy all of their courses."  (Oops I guess I slipped into my own "Therapeutic Fantasy!"  What is yours?)

By imagining this or another unlikely outcome, do you see how this can create a different mindset that is less angry or negative and more accepting of the foibles, failings, and aggravations of others.

Consider devoting a whole page or several pages in your Journal to additional Therapeutic Fantasies