Dangerous and Demented: What Usually Happens?

[Ruby Vee]

when a dementia patient becomes abusive, what are the options? i'm just hearing now that my mother, who has alzheimer's and is in a memory care unit, has had four violent episodes in the last week, where she has attacked both staff and other patients. she's seen a psychiatrist who is tuning up her meds, but psych meds can often take weeks to achieve a therapuetic level. so what usually happens? i can't believe she'd be allowed to stay where she is a danger to staff and other patients. what happens? this is mostly an academic question on my part -- my sister has poa. in the icu, we can sedate them or restrain them. but what happens in ltc?

[SuzieeQ]

Quote from Ruby Vee

​What does "Form 1 the resident" mean? Is that something like an involuntary psych hold?

Yes, it is an involuntary psych evaluation BUT it is just for 72hrs in the hospital until they can find a reason for the onset of agitation/aggression. Once diagnosed and treated (e.g. UTI) they are sent back to the facility. If they are unable to find a solution and the aggression continues, the hospital will probably start nursing home/alternate facility placement. Sorry about my wording in my first post - I should have explained the Form 1.

[Ruby Vee, BSN]

Quote from Ruby Vee

​What does "Form 1 the resident" mean? Is that something like an involuntary psych hold?

Yes, it is an involuntary psych evaluation BUT it is just for 72hrs in the hospital until they can find a reason for the onset of agitation/aggression. Once diagnosed and treated (e.g. UTI) they are sent back to the facility. If they are unable to find a solution and the aggression continues, the hospital will probably start nursing home/alternate facility placement. Sorry about my wording in my first post - I should have explained the Form 1.

Thanks for the information.

[JZ_RN]

A horrible one that I quit. 5 stars my eye. They didn't care about the residents and certainly not about the nurses or other staff. Never happier than when I got to quit there. I miss some of those residents though!

[Anne36, LPN]

I wish violent/agitated behaviors were as easy to solve as being diagnosed with a UTI. Sorry, I get tired of hearing that one, especially when these people are already diagnosed with psych disorders and are on medication. I have not really seen changing medicaiton help, and I have only once seen a resident get sent out. I have had a Doctor recommend it in one case, but no way in heck are they going to send anyone out from our facility, not even after a resident has shown to be a danger to themselves or others. Many of these peolple do belong in geri-psych but they are now just getting mixed in with regular nursing home populations. I cant tell you how many times I have had a resident yelling to get so and so out of their room. With very limited options, all we can do is stand by and make sure they dont hurt themselves or someone else, (restraint free) too bad we are not staffed for that type of care.