Elderly Mental Health Issue

  1. In an independent living facility I am contracted (through another company) with clients for medication assistance. We have a man who had a psych eval done 3-30-04 and he was diagnosed with delusions and paranoia. He attempted to hit a staff member yesterday and I have called everyone I can think of to help and I am Not getting any assistance. He has a nephew several hours away and he doesn't want to help because he was POA in the past and it was dissolved by the court. The patient has a history of physical violence from a nursing home stay when he had a psychotic episode several years ago. He has a home but I am told it is condemeable, due to rats and holes in the floor etc. Any advice is appreciated. I have contacted Adult Protective Services, local psych hospitals, our local crisis teams etc without success.
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  2. 8 Comments

  3. by   bargainhound
    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....
  4. by   chris_at_lucas_RN
    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?
  5. by   Nurse Ratched
    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!
  6. by   adrienurse
    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.
  7. by   jrenae
    Thanks! I have spoken with his physician and they are in process now.
  8. by   Blackcat99
    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
  9. by   jyoung1950
    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.



    Quote from Blackcat99
    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
  10. by   Blackcat99
    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

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