Many of you were so terrific when I wrote asking advice and input for a resident of mine that yelled non-stop. As we all agreed, she did not belong in a health care facility for the elderly and she did not belong on our Alzheimer's unit, due to multiple psych. DX. Well about 6 days ago, she was sent to a local geriatric psych. facility. Yesterday they called our administrator, saying they were sending her back. She asked was the behavior any better? Their response was "No, and she is disrupting our building!" I was floored that they wanted to send her back after such a short time with no improvement at all. Thankfully our administrator took her daily dose of "back bone" and told them we would not accept her back unless some improvement was noticed because she was terrifying the residents at our facility. I am now even more concerned for her than ever. I have to wonder what will happen to her if no improvement is accomplished. Surely to goodness, there is an answer. I feel so very sad for her. To have lived her life, raising a family only to come to the point where no one wants you. My heart is truly hurting for her.
Apr 27, '01
Unfortunately, we see this everyday in the ER. Some poor patient being sent in, because they need to be medically cleared, before they can be placed to a psych hospital. Once in the ER and evaluated, it takes hours to get some placed. Unless it's a teenager, or fairly young, semi-normal person with potential....nobody wants anything to do with them. Sometimes it's an insurance issue...although there is no way to prove this, all i can say is, "Why does it take as long as 10 hours to place uninsured psych patients, and only 2-5 for most insured ones? Then on top of it, as you say Duckie, there are those that need help, and they keep coming back not any better. However, we cannot refuse a patient........so they pile up.
P.S. - sorry to hear about the situation.
Apr 27, '01
As usual, you guys are the greatest!!! Since what happens to her is really out of my hands now, I'm looking to the powers above me to take control. I believe there is help for her, and I'll just pray they find something that keeps her on a even level. I really doubt that she will come back to us, unless something drastic happens but I plan on trying to see what the outcome is. I'm leaving for Ohio for a few days to see my folks so if anything happens while I'm gone, I'll let you all know. Thanks for listening.
Apr 28, '01
We had a lady where i work, she went to where all of a sudden, she became disruptive, yelling constantly. Many meds tried, put on alzheimer's unit beause they felt she had dementia.
Her problem was pain from cancer. Undiagnosed cancer. the physician said something like probable cancer, but never bothered to help her. We tried to get something for pain, she had tried various things, just not the right stuff. died a few hours before being admitted to hospice
Apr 28, '01
Where is this patient's DOCTOR?!! Not having seen her, I'm willing to bet that a trial of a strong antipsychotic would be appropriate. She may even be having pain she can't describe. Maybe she has a brain tumor. (Just mouthing off here) The psych unit needs to do their job and evaluate her, get her under some kind of control, and develop a plan that everyone can follow. I take it Risperdal was as effective as it usually is. Okay, Duckie, I know it sounds harsh, but appropriate placement at this point may be a long term psychiatric facility. You may find that totally unacceptable, but sometimes we have to resort to that, otherwise she'll end up on the streets. The bottom line is we can't expect our other patients to have to endure this behavior in their golden years when all they want is peace and serenity. Sometimes psychiatric disorders manifest themselves strongly in the elderly because they have never been acknowledged and therefore never been treated. There is a strong stigma attached to seeing a psychiatrist amongst a large segment of our population even in this day and age. Families will make excuses and deny problems for decades and then society gets stuck with the results. We used to put Aunt Tilly in the attic with her laudanum; now we TURF her everywhere. If you get her again, petition for sitter. It would be cheaper in the long run. Let us know. Good luck, Honey.
May 1, '01
I seem to remember reading in a nursing journal about a man who had some unwelcome behaviour in a nursing home. They were at their wots end and finally a member of the maintenance staff attached rockers to the bottom of a geri chair. Apparently having a rocking chair allowed the mand to soothe himself and provided a distraction. He was able to rock to his hearts content and the behaviour did not annoy any of the other residents.
May 1, '01
it sounds like the maintance man had a great idea. It is so sad what happens to our elderly,especially if they start having psych problems. I saw so many when i worked in ER. In michigan so many have been turned out to half way houses or the street. I wonder is serzone would help this lady? serzone seems to be pretty effective on so many of the folks we have seen with this type of behavior problem. I have worked with some geropsych units and they at times really can make the problem worse instead of better. Thank god you had an administor with a back bone!!!
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