Elderly Mental Health Issue

bargainhound, RN · May 21, 2004

Call nearest geriatric psych hospital unit. They will evaluate the patient. They will also contact next of kin or APS as needed. Doctor also has to be aware....

chris_at_lucas_RN, RN · May 21, 2004

I recall that the elderly can get to looking like AMS if they have an infection, such as a UTI that is otherwise asymptomatic.

Anybody check this fellow's CRP or sed rate?

Nurse Ratched, RN · May 21, 2004

If he is a danger to himself, others, or gravely disabled, he can be placed on a 72 hour hold in most states (involuntary admission.) In my state, this involves getting a petitioner (can be anyone) to request the hold, then getting a doctor to sign off on it, and executing the hold through the police, who will take the gentleman in. Try calling to psych dept again and tell them you have a person who needs to be admitted involuntarily, and ask for guidance on the paperwork and if the psych doc is willing to assist.

They can rule our co-morbidities that might be aggravating the man's paranoia and delusions.

Good luck!

adrienurse, LPN · May 21, 2004

The man needs a medical evaluation asap. Especially if this is an acute episode. He needs to be checked for infection as well as his B12, folate and TSH level.

jrenae · May 21, 2004

Thanks! I have spoken with his physician and they are in process now.

Blackcat99 · May 22, 2004

I worked at a nursing home where a psych patient wanted to leave the facility. She said she was ready to "explode" and would "explode" if they didn't find her a different facility. They called everyone crisis centers,adult protective services etc. etc. etc. and they promised her they were doing all that they could to find her a new place. After 10 days she finally "exploded" and ran into other patients rooms about 3 or 4 different rooms and broke out all the windows. The police were called and we never saw her again. If he hits staff call the police and have him arrested. Good luck

jyoung1950 · May 22, 2004

Is this true, that if a nursing home resident hits you (nurse/CNA, employee), you can call the police? I work at a nursing home and, to tell you the truth, nobody has ever really addressed violence by the residents to the employees.

We usually experience the rough stuff from Alzheimer's/dementia residents.

One evening I stayed over to help the 11-7 staff. They assigned me to the skilled unit. Me and another aid went in to bed check this one man. I came within an inch of getting a full punch to my face. Had he succeeded, what steps would I as the employee and the company been required to take? Can they refuse to take extremely violent people who are strong enough to inflict serious injury?

Should they refuse to take these type of residents? Do they legally have more obligation to protect the staff from this? Seems like the place I work at turns a blind eye to the abuse we employees are exposed to. Another aid on skilled was repeatedly punched, slapped and had her hair pulled by a male resident up there.

I worked at a nursing home where a psych patient wanted to leave the facility. She said she was ready to "explode" and would "explode" if they didn't find her a different facility. They called everyone crisis centers,adult protective services etc. etc. etc. and they promised her they were doing all that they could to find her a new place. After 10 days she finally "exploded" and ran into other patients rooms about 3 or 4 different rooms and broke out all the windows. The police were called and we never saw her again. If he hits staff call the police and have him arrested. Good luck

Blackcat99 · May 22, 2004

Nursing homes can refuse to admit violent Alzheimer patients to their home. If that female patient at my nursing home would have hit me I would have called the police. Yes she was a psych patient. However, she was alert enough to know the difference between right and wrong. Now If I got hit by an Alzheimers patient who was totally out of it I probably wouldn't call the police. It's a personal decision. I don't think nursing homes should allow violent people in with the general elderly population. Not only is it dangerous to staff just think what would happen if one of these violent patients got hold of a frail elderly person and hurt them. I think violent Alzheimers patients should be on a locked unit away from the rest of the elderly.

I would contact the "ombudsmen" and tell them you are worried that the violent person is going to attack another patient. No one ever seems to care if staff are hurt or injured :angryfire Tell them how these patients attached you and how you are worried that they might hurt other residents. Good luck