Looking for, Managing Personality Disorders in “Difficult” Residents

​Some residents who behave in ways that challenge staff may have personality disorders, states an article in the November 2012 issue of Annals of Long Term Care. The article presents signs to watch for and strategies for managing residents with personality disorders in long-term care. Cognitive assessment tools (e.g., Mini-Mental Status Examination) may help identify medical problems that could be contributing to the behavior. If a personality disorder is still suspected, physicians may wish to consult with a mental health professional to aid diagnosis. Personality disorders are defined partly as "an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture" that is "inflexible and pervasive." Their estimated prevalence among U.S. adults ranges from 9% to 15%. When a staff member has a "consistent, strong, or uncharacteristic" emotional reaction related to the care of a specific resident, the resident may have a personality disorder. Unfortunately, the benefit of psychotherapy may be limited in long-term care residents.