Aged Care Duty of care question

[Huwscor]

Note: I am not a nurse but I am posting this because my gf who is a nurse has had this experience and the issue has annoyed me.

hi everyone

my gf works in an aged/palliative care and they have recently had a new resident arrive with dementia. About a week ago my gf was taking care of him when he violently attacked her. She pressed the emergency button, no one came for a while and when they did they were apparently less than useful or sympathetic to the situation. My gf was later told that the resident used to be a woman abuser and alcoholic etc. this was her first "attack" situation so she was pretty traumatised about it. She is okay now but was told to work a different part of the home for a while.

so a week later now, my gf has been told this man has been luring other women with dementia in the home to his room and kissing them and molesting them. My gf was upset and said to the managing RN nurse what should they do to which the managing RN replied "there is nothing we can do because he has dementia, the best we can do is keep an eye on him"

so my my question is - is this true? Can nothing really be done because this man (using the term loosely) has dementia? Doesn't the nursing home also have a duty of care to tell families of these other women with dementia that their loved ones are being repeatedly sexually assaulted and nothing is being done? And can my gf do anything to address this situation?

thanks for your time if you're reading this.

[NurseCard, ADN]

Yes, the nursing home very much has a duty to protect the residents!

This is a horrible situation. That resident needs to be moved to a more

appropriate placement/facility. The families should have been notified

about what happened and incident reports filed. This is bad.

[Huwscor]

This is exactly what I have thought! The RN also told my gf (and I quote) " it's not rape if he just has his hand down their pants and not touching their genitals".

i almost lost it at this point. But more specifically... If my gf has already discussed with the managing RN what can be done and nothing is being done, what else can she do?

shes only been working there about one year.

[Davey Do]

On the geriatric psych unit where I work, we often admit patients from LTC facilities who manifest behaviors such as what you're describing, Huwscor. Until stabilized, patients manifesting such behaviors are placed on a 1:1 status.

I also wish to welcome you to AN.com. Perhaps it would be to your girlfriend's advantage to check out this website and maybe become a member. She could then discuss the situation and get feedback from professionals who have experienced similar situations.

You could also check out Geriatric/Long Term Care listed under "Specialties" at the top of the page.

It is good that you're seeking information on behalf of your girlfriend. You are taking an initiative and obviously care a great deal for her.

The best to you, Huwscor!

[NurseCard, ADN]

Go above whomever she talked to.

[Huwscor]

Thanks for that Davey Do, I wasn't sure where to actually post the message as I know absolutely nothing about nursing.

i care very much about what's happening with my gf and things like this make me angry (and they are probably quite common which makes me more annoyed)

i will certainly get my gf on here to start discussing and looking at others feedback. Honestly when it comes to doing something my gf doesn't want to be someone who "rocks the boat" and she's not a very proactive person when it comes to sensitive issues like this which is completely fine. Me on the other-hand can't stand injustices of it all hence why I'm here.

ill try to get her to discuss with a higher manager.

[Davey Do]

Nursecard is giving good, timely advice. Something needs to be done now.

Clients or patients are not to touch others. Especially in a sexual way. One of our precautions, such as suicide, assault, etc. is "sexually acting out". All are illegal. No person can legally commit suicide, assault another individual, or sexually force themselves on another without having to deal with the ramifications, once the behavior is reported to the appropriate professionals.

Without going into great detail, the sexually acting out individual can be involuntarily admitted to an inpatient psych program and diagnosed with Psychosis nos. The criteria for admission is an altered mental status, which can be treated with medication and other therapies.

[Davey Do]

You did fine posting here, Huwscor- this is an appropriate forum. I suggested the Geriatric forum just because you may be able to gain more information, and it's specialized.

You have every right to be angry and I commend you for your actions, Huwscor- gaining information without charging headlong into an emotional situation is truly noteworthy.

If unsatisfactory results come from the higher manager, outside entities need to be informed. But first, follow the chain of command up the highest administrator.

Keep us apprised and we'll suggest appropriate actions.

The best to you.

[Avid reader]

Many variables here. Dementia levels, secondary DX, ruling out medical, chemical complications and fallout from management re embarrassment, etc. My advice would be to chart, chart and more charting re incidents. Mention at handovers, report to a Dr, Nurse manager and chart that you did and whom you reported to. CYA is my maxim! Resulting fallout if you have charted and followed protocol should extricate you from any lawsuits etc. Not only should you advocate for patients but also for yourself because this looks like a potentially developing situation and you want to avoid the fallout. Best advice, find an experienced, considerate nurse at the facility and seek their advice because their experience always comes with knowing the ropes!

[Davey Do]

My advice would be to chart, chart and more charting re incidents.

Excellent advice, Avid reader!

[heron, ASN, RN]

I strongly suspect this is a mandated report situation. The sexual abuse of residents is abuse and licensed nurses are required by law to report it. The consequences for not doing so vary from state to state. That the abuser is also a resident with dementia only means that the perpetrator won't be criminally charged. It does not mean nothing can be done. More likely, the facility does not want to get the state involved. I know in my state, such abuse is a reportable event.

OP, if your gf has already notified facility management of the problem and they blew her off, she has a legal obligation to take it to the state regulators. She could lose her license if she knows and does nothing.

[Davey Do]

I strongly suspect this is a mandated report situation. The sexual abuse of residents is abuse and licensed nurses are required by law to report it.

Yes!

Thanks for cutting to the quick and for the wake up call reality orientation, heron!