[Town & Country]

Just wondering if any of you all have experience with Granny-Dumping.
Evidently, there is quite alot of it.....it goes like this: understaffed nursing homes experience a resident who is "acting out" and having high-maintenance behaviors (requiring a 1:1 staffing) - they can't deal with it, so they "dump" Granny at the local ER. (Granny winds up on the psyche unit.)

Any thoughts?

[grannynurse FNP student]

Originally Posted by SunStreak

Just wondering if any of you all have experience with Granny-Dumping.
Evidently, there is quite alot of it.....it goes like this: understaffed nursing homes experience a resident who is "acting out" and having high-maintenance behaviors (requiring a 1:1 staffing) - they can't deal with it, so they "dump" Granny at the local ER. (Granny winds up on the psyche unit.)

Any thoughts?

Granny dumping has been around for years. Usually it was the children who dumped in the local ER.

Grannynurse

[Bird2]

Originally Posted by SunStreak

Just wondering if any of you all have experience with Granny-Dumping.
Evidently, there is quite alot of it.....it goes like this: understaffed nursing homes experience a resident who is "acting out" and having high-maintenance behaviors (requiring a 1:1 staffing) - they can't deal with it, so they "dump" Granny at the local ER. (Granny winds up on the psyche unit.)

Any thoughts?

Wow I have never heard that term before. I can tell you that from my experience on the LTC side that we have extreme difficulty getting help for these residents. We will send them out when the are are danger to self or others and the psych units send them back so quick it is doubtful they gave them more than a once over. Facilities have to protect the other residents. We always check before sending them that they do not have a UTI which we will notice increased behaviors and are in contact with the Psych Docs and are often trying new prn orders to calm them. Do you have any suggestions how to handle it differently? Any would be appreciated because believe it or not we do not like sending our residents out of the building. We work in their home and it is more upsetting to them to leave the enviroment they are familiar with and it is very time consuming to do the pre and post hospitalization paperwork. I will say that we often call the family to come in and sit with them and if we truly can no longer meet the needs of the resident we help the family find a more appropriate facility such as a Dementia unit.

[Angie O'Plasty, RN]

Originally Posted by SunStreak

Just wondering if any of you all have experience with Granny-Dumping.
Evidently, there is quite alot of it.....it goes like this: understaffed nursing homes experience a resident who is "acting out" and having high-maintenance behaviors (requiring a 1:1 staffing) - they can't deal with it, so they "dump" Granny at the local ER. (Granny winds up on the psyche unit.)

Any thoughts?

My understanding of "granny-dumping" involves the family leaving a Jane or John Doe aphasic or confused patient at the ER, so as not to be responsible for the cost of care.

IMHO, if a nursing home has a patient who is acting out so severely that the staff cannot handle it, the psych diagnosis is one of the possibile diagnoses, and as such, it is not "dumping," it is an appropriate placement.

[dekatn]

Originally Posted by SunStreak

Just wondering if any of you all have experience with Granny-Dumping.
Evidently, there is quite alot of it.....it goes like this: understaffed nursing homes experience a resident who is "acting out" and having high-maintenance behaviors (requiring a 1:1 staffing) - they can't deal with it, so they "dump" Granny at the local ER. (Granny winds up on the psyche unit.)

Any thoughts?

I work in an "understaffed" nursing home, understaffed according to the ones of us that work there, but not so according to state and fed regs. Until something is done to require owners of NH to increase staff it will remain this way, owners are not going to take money out of their own pockets to better the staffing on the floor until they absolutely have too. (which I don't see happening in my life time). If we have a resident, granny or grandpa, acting out and disrupting other residents, especially the A&O residents, they are the ones that complain and threaten to contact state. State comes in to check things out and want to know why we haven't done something to reverse the situation, they review the disruptive residents chart to see what kind of interventions we have implemented and the end results of interventions. Believe me, our staff goes above and beyond to alter behaviors, we have several staff members with psych backgrounds, but we have to protect our license and the integrity of our facility by doing whatever it takes to protect all our residents and see that they get the care that they pay for and desrve, if that means transferring a highly disruptive resident out of the facility for evaluation and treatment that we are unable to provide then so be it. At least we have done something to alter the situation. We don't mean to "dump" on anybody, I was under the assumption that we are all in this world together to make it the best place we can, all disciplines have to work together. Just remember, you have "granny" for a short time and then you can send her back where she came from. BTW, you should come and visit us sometimes at the NH and observe some of the "granny's and gramps" we get "dumped" on us! Those darn families just refuse to deal with them!

[lil'nurse]

I work on an acute psych unit in a hospital. We frequently get geriatric pts who have been acting out d/t alzheimers, demetia. We do "look them over" and do understand how difficult it is to deal with these patients. Unfortunately, we can't fix what's wrong with them except to give more meds which can have serious consequences to an elderly person. A lot of the time the nursing home won't accept them back into the facility d/t their assaultive behaviors, then it's up to the hospital and the county to work together to find a facility that is equipped to deal with them long term.

[motorcycle mama]

Originally Posted by SunStreak

Just wondering if any of you all have experience with Granny-Dumping.
Evidently, there is quite alot of it.....it goes like this: understaffed nursing homes experience a resident who is "acting out" and having high-maintenance behaviors (requiring a 1:1 staffing) - they can't deal with it, so they "dump" Granny at the local ER. (Granny winds up on the psyche unit.)

Any thoughts?

Yes, have had this experience as well. Who can you blame, really? Though they don't generally go through the ER, they are usually just sent straight to the psych ward. We have also had many instances of "gramps" dumping.

[CHATSDALE]

There are problems for which there are no solutions..fed guidelines toward restraints have resulted in more injuries to the resident and to those who must come in contact with him including other residients and the staff
we have had to call police to come and get residents in the thros of anger or frustration that they cannot be redirected...we have had emt who refuse to transport aggressive residents
and families sometimes you find them just like the resident but some are just overwhelmed with children at home, making a living, and trying to reason with a parent who thinks that they a stranger

[Blackcat99]

I use to work at an LTC facility. We had an alert angry patient with an extensive psych history. This patient warned us ahead of time that she was going to explode if we didn't send her somewhere else immediately. The LTC contacted every state agency available and they kept telling her week after week that they were going to find her a new place to go. After 3 weeks, the patient finally exploded and started breaking out a lot of windows out at the LTC. It was a "miracle" that no other residents were injured during her rampage. Of course, once she exploded and destroyed the facility she found an "instant new place to stay."

[Nurse Ratched]

We get a lot of "pop drops" around the holidays and spring breaks when families who are otherwise caring for a loved one are going on vacation - usually brought to us under the heading of mental status change (and btw, we'll be in Florida for the next week.)

The ECF's for the most part are doing the best they can with what they've got in terms of staffing. It's rare that we can fix behavioral issues in geriatric folks beyond medicating them. I can get almost any Alzheimer's patient to do anything I need them to with enough time and patience. Unfortunately, that is a luxury not afforded to staff who may have dozens of residents to get up and giong/to meals/showered.