Aggressive Dementia Patients

[lpnpasta]

I'm an LPN at an assisted living facility on a locked down dementia unit.

I'm curious what other facilities do when a patient is aggressive. I don't mean, "Mrs. Jones stepped on my foot when transferring tonight."

I mean, a patient running around a unit, trying to hurt anyone they can, including staff, other patient, administration, and visitors, unable to be redirected, family on the unit, all PRN's given, staff just trying to keep other patients from getting hurt and themselves.

The psychiatrist has already quadrupled the doses of the two antipsychotics they're getting and the antianxiety medications.

I read up on some of the posts here that EMS and the police are called.

I'm just wondering what exactly is done at other places. I chart everything that happens. Bu what else should be done, as far as my license is concerned?

I am genuinely worried that one of these times the staff may not be able to move a patient away from them and another resident could get very badly hurt.

What exactly is done at other places in similar situations?

Thank you so much for your time.

[NOADLS]

Call the cops. They will have the patient transferred to an acute psych facility. Be sure to state that other people are at immediate risk for harm and you will receive a faster response.

As far as violence is concerned, don't try to move the aggressive patient. Moving everyone else to a safer place is the easier route (and path of least resistance).

[loriangel14, RN]

Where I work if meds don't help then they are restrained. Usually IM Haldol and Ativan together does the trick. Then the Geri chair with a seat belt. Then a posey vest.

[wowohwow]

Where I work if meds don't help then they are restrained. Usually IM Haldol and Ativan together does the trick. Then the Geri chair with a seat belt. Then a posey vest.

Doesn't the family or guardian have to approve such measures?

I ask this because I have seen numerous aggressive dementia patients at the locked facility a family member was in and they did nothing when one was hitting other residents and another used her walking canes on others just because she felt like it.

[loriangel14, RN]

Yes they do have to consent. We will sometimes restrain and ask for consent later in extreme cases. We will tell families that refuse to consent that they will be getting a call to come in a babysit if there are issues. Even in the middle of the night. Most families consent. And yes we have called people to come in and keep them out of trouble.