[withasmilelpn]

On our sub-acute unit, we had a gentleman drag his mattress down the hall, threaten to kill the nurses, and punched a cna for good measure. He was very big and could walk well, and did in and out of the other patient's rooms etc. , all the while saying very colorful, abusive things to the staff and residents. The nurses could not get near him to give him anything, and called the police and 911 for help. It was the end of my shift when I was leaving from another floor when this was happening, so I stopped to see if I could help. When I arrived, he was in a bathroom (not his own), yelling at the mirror and punching at his reflection. When the staff got near him, he would grab his recently placed suprapubic catheter and swing the bag at them like a rodeo cowboy.
Sometimes I have a knack for people like this. I talked to him very gently ( I have no idea what the heck I said now!) and eventually persuaded him to calm down. I was feeling pretty good about that until 911 and the police arrived and treated us like dirt and like we were 'wasting' their time. They made it very clear that we were bothering them. The fact that this man had no dx of dementia or any psych hx and was a new admit for the sp tube placement warrented sending him out anyway. (I heard he did get a dx of schizophrenia.) But I"ll never forget how we were treated by the 'rescuers'.

[TalldiNY]

Yes, except grandma ends up on a medical unit because there is no psych unit or the psych unit says it's dementia not a psychotic break. Either way equally fun.

[softstorms]

I am thinking that as a nurse, I have never "dumped" a pt. I do know that in long term care we are very restricted in the way we can treat pts. that get out of hand. No we can't give them meds to stop the behavior (chemical restraints) we can't take them to their room (isolation) and we can,t restrain them px. To get treatment for those pts. we usally have to send them out to be evaluated and let those who know more about it adjust the medications they are on. So don't look at it as dumping, look at it as asking for help in managing a pt. who needs more help than we can give.

[bigjim]

Originally Posted by withasmilelpn

When I arrived, he was in a bathroom (not his own), yelling at the mirror and punching at his reflection. When the staff got near him, he would grab his recently placed suprapubic catheter and swing the bag at them like a rodeo cowboy.

Thank you for the insane mental picture of a crazed patient yelling YEEEEEEHHHHHHHHHHHHHHHHAAAAAAAAAAAAAAAAAAAAAA!!!! and swinging his pee bag like a lasso!

[withasmilelpn]

I'll never forget it! I have too tell you though, that when crazy cowboy calmly got on the stretcher, and the 911 crew was looking at us like we were crazy, I got an insane urge to pinch him just to rile him up again.

[bigjim]

Originally Posted by withasmilelpn

I'll never forget it! I have too tell you though, that when crazy cowboy calmly got on the stretcher, and the 911 crew was looking at us like we were crazy, I got an insane urge to pinch him just to rile him up again.

Awesome!

Withasmilepn: (Tiptoes up to patient)
Patient: Yow!!!!!
Police Officer: Why did that man just howl in pain?
Withasmilepn: No reason

[Cecilea]

My father is in a dementia unit in the UK. He has reacted badly when at home to Cipramil..stomach bleed. Quetiapine ..in two weeks off feet not swallowing . Trazadone upset his heart.. etc. He had a gastectomy at 15 yrs old so I guess his b12 intake has been compromised all his life as he did not supplement.He was at home with us and prostatism disturbed his nights and the confusion from the drugs combined with dementia made nights very tiring for us but we maintained his continence. We refused to continue drugs that didnt suit him even though gp wanted us too saying it was the process of the disease not the drugs making dad ill . We stopped the drugs dad began to walk talk and swallow safely but continued to be up alot at night in an agitated state. We asked for night care but were told nothing was available . So after many tears and the start of lorazepam to which he reacted with paradoxical agitation our social worker eventually found us a place in a care home (no nurses)close by.After two days i think he fell down and was in a lot of back pain plus he had another bleed from his ulcer .( I could smell meleana on his breath but he did not vomit any blood) they treated him again with omeparazole successfully and then began to teat the back pain with paracetomol but changed to co co damol. After this he has slept nearly all day with some periods of being agitated which i think is still paradoxical agitation from the lorazepam 1mg bd.I think that the coccodamol is potentiating the effects of the lorazepam and making him so sleepy. While this gives him respite from his anxiety due to his skill loss from the dementia and sadness from missing us I am concerned that the staff insist dad is still in pain from his back but he "aint its bettter" we got in a massuse who did a great job on his back and he is upright instead of bent over following the fall .The gp says the codiene content of the cocodamol is too small to do this to him but i disagree having seen him at home six months ago without drugs.While I can see that this sleepy state is better than an agitated one i wish they would just say he aint in pain and they are using the meds to sedate him. THE MANAGER SAYS DAD WOULD HAVE TO LEAVE THE HOME IF THE COCODAMOL IS STOPPED!!!! This is a dementia unit! I DONT WANNA STOP IT BUT THINK THEY SHOULD GIVE HIM SOME SPACE WHEN HE CAN BE HIMSELF AND NOT SLEEP. hIS DAY NIGHT IS REVERSED NOW. HE IS INCONTINENT . wE KEPT HIM CONTINENT AT HOME . wHAT DO YOU GUYS THINK. DO RECKON THAT THE COCCODAMOL AND LORAZ TOGETHER ARE DOING THIS ..
I AM A GENERAL AND PSYCHE NURSE AND WORK IN A DEMENTIA UNIT .IF FOR ANY REASON THEY HAVE TO STOP THE COCODAMOL IE ANOTHER BLEED DAD WILL GET "GRANNY DUMPED " and have to be sedated til he is better in a hospital ward or psyche unit. ( HE MUST BE ADDICTED TO THE LORAZEPAM NOW) Or just be treated at the home............Any thoughts out there.
I miss my dad he is still a great dad and i wanna care for him so bad i hate other people doing it. Every time i visit he manages to let me know he wants to come home and says he hates it. But i am grateful for the good basic care its the other end of the scale i,m no sure of and i am getting tired of advocating for the rest of the family. I am the baddie who has to ask the awkward questions and it is getting too much now .
TEARS IN BUCKETS . Cecilea.

[Blackcat99]

If you possibly can it would be best for you to take your Dad home. I am taking care of my mother with alzheimer's at home. When you have your loved one at home you can do what is best for them period. When Mom goes to the hospital from time to time I have to go along with what the hospital wants for Mom not what is actually best for Mom. You know your father the best. You know what is best for him. Follow your heart. Do the right thing. Best of luck.