How do you handle a demanding resident who is also very needy and wants all of your time when you have 18 or more residents to care for?

Have you kept a log during your shift to see how much of your time she is consuming? Collect and speak to your manager. You dont mention what place you work. If it is AL, then your manager needs to speak to family about z higher level of care. Is your team having meetings. Keep others informed and ask management for tips. I worked in a hospital and a manager would take up a few minutes of of report time to be aware of certain patients and families. In order to maintain privacy, only the room number and initial and a brief detail was written on a dry erase board. Also in hospitals, staff will try to deflect, but those facilities have intercoms and are able to remotly silence the alarm.
BTW what is the state patient to CNA ratio?

I wonder if she is one of those people that won’t respect you unless you stand your ground. Some people only respect the gruff side of human interaction. maybe she sees you as a plaything cause you keep running even though you know she is fine.

To get anything done or my “me” time I had to learn the word “no” and “I’ll get you when I get you. You are fine.” with needy hubby. He was raise in a gruff atmosphere and sometimes it’s the only thing he responds too.

Silence is terribly isolating, so I agree with putting on a radio for her.

Otherwise, this is toddler behavior that you're reinforcing with your response. Since she's got it all together mentally, be frank, kind, and honest with her that you cannot come in every few minutes when there are others who also require your attention. Then do not respond as you did when she puts on her call light. Stick an eye in there to make sure she's physically OK, then deal with the residents whose issues are a priority.

You do your level best and then say "I must attend to these calls, I'll be back later to make sure you're comfortable." You neither oppose nor comply, you just absent yourself.

Also, bear in mind at all times that you are doing your best to get this right because of what you are like, and not because of what she is like or because of what anybody else might choose to do.

We had a client like that, we got stuck with her for months because we are our county's provider of last resort and none of the private sector agencies "had capacity." In a pig's eye they didn't have capacity, they'd met her before was the problem. Her and her wicker baskets that you had to move out of the way before you could wheel her to bed and her crocheted shawl and the pillow pyramid and the flat one that went under her leg and the rolled blanket down the side and the nightly recital of how our local health service wouldn't fund a variable pressure air mattress for her and the glass of oat milk too full not enough and her lavender pillow spray and the white cardigan and the...

Anyway. All of us could probably recite that list. And one of us went through her rotten bathroom floor - not badly hurt, but not exactly in our job description - and she considered that her grievance.

I did her last call, and collected the paperwork and the satisfaction questionnaire. Not a good word to say about a single person. Not a word of thanks. I know how hard everybody worked for her and on their behalf I will not forgive her.

I've worked with seniors both with and without dementia for 25 years. I'm going to tell you honestly here. You need to put this resident in her place. It is not disrespectful to tell her that you will not cater to her nonsense and fussiness. That there are other residents who need your attention and assistance.
You have to refuse her. I have found in my many years of service that there has to be some ignoring. Trust me on this one. If you refuse to go running when she starts fussing about her bed and pillows you go in once. That's it. If everything is fine and she starts up again a little while later, you send another aide in. Do not cater to her because she'll never stop and will only get worse. There's no excuse for the other CNA's to give her 'lip' like you say. They need to learn how to ignore with kindness when it's appropriate to.
The resident is probably extremely bored and bothering you and the other aide is a kind of entertainment for her. Stop catering to her and you will see she'll stop fussing.

Actually Msnette, could you imagine this behaviour as a challenge? That you will overcome?

As Joann said, tell her "There are other residents that you must help too".
Again, it's the truth.

Of course she may reply "I don't care about THEM!"

This was the exact reply I got in a similar situation. 😖

It was yrs ago (but I still remember). The woman was demanding, calling out & seeking her nurses's attention despite being able to SEE her nurse attending to the other 3 people in the shared room. The nurse would say M. I'll be with you on a minute. Nurse..nurse..nurse..I need you.. nurse.. nurse..I need help now.. help! I'm falling.. I'm choking.. the Nurse would have a discreet look (yes she is safe, not falling etc) then give one short reply, finish her task then attend M. Professional at all times.

I was less experienced & this constant neediness ruffled my feathers. I kind of snapped one day. Told M it would help her to be patient. That others needed help too.
Her reply taught me much.
1. She did not care about others. Her pain, loneliness or broken brain overrode any empathy for others.
2. Nothing I did would change her behaviour.
3. I could only control my own behaviour.
4. I was not responsible to make her happy/content/relaxed - this was up to her.

When I let go of trying to 'fix' her mood, it was so much easier to be like the more distant & professional nurse.

Kind of a 'Grey Rock' approach I later found.

Each difficult person teaches us something!

" I know I have to keep cool because she treats me and another CNA like this, but the ones who go in and give her lip and treat her with a long handle spoon, she doesn't bother them."

So be like the ones who handle her with a long handled spoon. Seems to work for them. You don't have to give her lip but you need to be firm. Tell her you can't keep coming in all night. There are other residents that you must help too. I think its attention seeking and you should not play into it. Those lights should be "first come, first serve. You don't go back to her until you have answered all your call lights that came after her. If you haven't, bring it up to your DON telling her this one woman keeps you from seeing to others. How do you know she isn't intentionally fooling with her pillows. I think 30 min is too much time with one resident for just this. I like getting her comfortable and telling her you'll be back after you see to the other residents.

I am wondering if she’s having trouble settling because she’s in pain. I have a lot of back and hip issues and don’t sleep well because I can’t get comfortable at night. I do a lot of pillow shifting too! Maybe her family should mention it to her doctor to see if there’s anything that can be done to help her.

Attention seeking can stem from fear of being alone. (My guess).

Being alone, if hard of hearing, eyesight issues, not remembering the time, maybe not where you are, where your family is would be lonely & scary I'm sure.

Do what you can, within reasonable limits.
Be honest but polite.

As you say, being with one person, would neglect others. So fluff the pillows, tell her that's the best I can do, state the facts "I have to do my work now but I will check on you again later in the evening". Then DO check in - helps build trust. Offer to put the radio on for company. Ask is there anything else you need now? No? Ok, sleep well.
Leave.

Sometimes families hire a personal sitter when elders get like this. Report this behaviour to your Superior, especially if new. Sometimes the Doctor may prescribe something to help with the fear/anxiety.

Otherwise share around the staff if you can to avoid being drained. If this is your section often, experiment. See if spending a quality 5 mins lowers her anxiety or makes any change.

Sometimes nothing you do will help. Sundowners can be like fussy babies - they are tired from the day but not quiet tired enough to sleep.

Thank you for the care role you do!

I’m not a CNA but do provide 120 hrs a week of hands on care for my mom. She developed intense anxiety and fear of being alone before her dementia showed up. The pillow thing reminds me of a child who needs reassurance and asks for 90 glasses of water after being tucked in. Assuming the best about your lady, I wonder if she’s afraid or bored.

For Mom, when she acts out I ask her how she feels. In our case she’s losing language, so I can’t ask open-ended questions so I ask if she’s scared or mad. Then if she’s scared, I say that must not feel nice. Can you tell me more? I might be scared too. How can I help you not feel scared? If your lady can tell time, I might say how about if I come check on you in 10 min? And then do it, don’t forget, then over time expand that timeframe, and eventually she’ll likely be asleep before you come back. For Mom for whom time has no meaning, sometimes just knowing she’s not alone and someone sees her and understands makes her feel better. Seems like trying to discover the root of the issue is the key because as you already have seen the pillows aren’t the problem.

Also I slept on Mom’s hospital bed with air mattress a couple of times, and daaaang, those beds are uncomfy! Your lady might just be stiff and miserable. I sure was.

I know someone who was fussy at night because they were afraid they’d die in their sleep. Or maybe she’s going to bed too early for her sleep needs so she can’t settle.

She could also be a fussy, self-involved pain in the arse too! Is she self-centered during the day or only at night?

Maybe something in all that might help. I’m sorry for your troubles though. Caregiving is darn hard labour.

I have great respect for those working in nursing facilities. They are so understaffed. This resident is taking advantage of your kindness, just my opinion. Nicely tell her other people need assistance & you will return shortly.