My patient and her abusive husband...advise please

  1. So today I am doing my rounds in my assisted living facility, and I hear a man not yelling but screaming at someone about his wife who had just recently moved to our side of the facility. (We have an independent apartment side, and a dependant side...the lady had a stroke and she was moved to our side, he lives on the other independent side and visits daily and is known for yelling at caregivers).

    So I ran to see what was going on, and my DON stopped me in the hall. "Don't get involved right now, we have it under control". I trust my DON, but it didn't sound in control! This man was screaming nonsense at a caregiver from what I saw, and I was furious! But my eye caught our administrator around the corner and then I knew that things were under control on a higher level (I mean, if Admin gets called...holy cow!).

    This poor woman talked to me last week, and told me of how her husband belittles her so much, always has in their 60-year-old marriage. That she took care of him till the stroke and now isn't allowed to move an inch without him screaming at her to get help from a caregiver (we are talking not even adjusting herself in her chair!). That he tells her how feeble she is, how worthless she is, and that he wished the stroke had done its job. Then he will love her up, take good care of her for a day...then back to the belittling and verbal/emotional abuse. She also startles easily and puts her hands to her face...and I know that he must have hit her in the past or still doing it behind closed doors (no physical evidence yet, but we have a hawks eye on her for anything!). She made my heart cry so hard, and despite many faxes and calls to the MD, the MD says there is nothing we can do medically that will help. That she needs to get away from her husband and that is something she or her family must do at this point.

    Still, here is this man screaming that "don't you guys care? Don't you know that a mind must be enhanced daily to grow, and you aren't making her sing! Why aren't you MAKING her sing...she use to sing! I make her sing to enhance her sick mind so she doesn't die! Are you trying to kill her?! You MAKE her get up, you make her sing at least an hour a day, you MAKE her do what I tell you to do or so help me GOD I will sue!" My admin tried to explain that we didn't know she sang, and we have a choir that would love to have her, but we just needed to know! He screamed at her about not knowing, she said...we were not told by anyone! Then he comes back with "well I knew so you should!" Oh yeah...I forget we are mindreaders right...OMGoodness I was furious...but left it be as my DON instructed so I didn't mess up a messed up situation! I also think he was drunk (we were warned by his family that he drinks all day and by noon is usually sloshed...would make sense after this scene!).

    I hate this situation to the core. Unless we have some S/Sx of physical abuse not much can be done. I believe they are going to try to get the family to move her out of the facility and away from him, but that too will be so hard on her!

    I will give my admin a week, then ask for a report on the situation (if they will even tell me, they usually tell me it is confidential and they are 'working on it'. But I am going to have to do something to help her. This is abuse, and it can't be tolerated!

    Any suggestions? (I asked for geri psych eval, but to no avail...MD won't cover, and the family refuses antidepressants or anti anxiety meds, even despite knowing it will help her emotionally...but they say "drugs can't cover the problem...she has to deal with it...hmmmmm think there is some family dynamic here of 'karma' towards their mother/father???). At this point she is saying "Yeah, maybe the stroke should have done its job" and that kills me!

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    About Antikigirl

    Joined: Oct '04; Posts: 2,757; Likes: 415
    Happily in Nursing Education!; from US
    Specialty: 13 year(s) of experience in Education, Acute, Med/Surg, Tele, etc

    10 Comments

  3. by   foxyhill21
    That is really sad, I hope and pray that the lady will overcome this situation. Her husband has a huge problem.
  4. by   rebel_red
    OK deep breath. I am so furious. She is not capable of "dealing with it" or she would have deep sixed this jerk of a husband years ago. It is not her responsibility to deal with it. IT IS HIS RESPONSIBILITY TO CONTROL HIS ANGER AND DRINKING. Since she is incapable of taking care of and or protecting herself, the responsibility falls to the nurse as advocate. I do not buy the powers that be explanation of "We are handling it." As her nurse you better d*mn well tell me how, or I will take steps of my own. Seems to me like the husband is being placated. And the rest of the family is in a life long habit of fear.

    Here in NJ that type of verbal abuse is considered battery. I would call your local women's shelter since they too have a responsibility for confidentiality and see what their on call counselor or attorney (we're lucky our shelter has an attorney) has to say about what steps can be taken. Adult protective services needs to be involved.

    Gee get the family to move her out of the facility......lets really screw with the victim instead of adressing the issue with the abuser......oh and gee that also works out real neat for the facility......What he isn't mobile and can't call her or go elsewhere to abuse her???? Lets just make sure its not our problem anymore......

    Sorry this is so inarticulate, but I am just ready to spit......

    Keep us posted.....
    Tres
  5. by   snowfreeze
    Victim vs advocate. Has this woman asked anyone to help her? If she has only shared her stories and not asked for help, maybe we cannot help her. Has she been given a psych consult to find what she wants? He is being verbally abusive and threatening to staff and her.. is this documented? If she claims an 'event', that should be written up and researched by the departments who need to be involved. He threatened me and I couldnt sleep..psych. He said he would hit me if I didnt do what he said...social services. Staff is uncomfortable with him, he is drunk...911 and arrest him unless he is already a psych patient. If he is showing he will hurt anyone, including himself then he might be a candidate for a 302 committment. Just remember the ominous rule...it is not against the law to be crazy, it is against the law to break the law.
  6. by   Antikigirl
    UPDATE...so my stupid administration (not nursing by the way!) has chosen to handle this situation by moving the husband in with the patient!!!!!!!

    Yesterday I had to console a crying caregiver from his verbal abuse (belittling her), and had to go in and give a TB test to his wife and he verbally abused me as well! Saying I was trying to kill her brain with 'pee pills'. (he ment lasix). I calmly explained the fluid overload and heart bit...but he insisted that I ordered the pee pills and again I tried to correct him, but no go...not going to happen, so I said "well, actually sir with the info I just gave you...you do remember about the heart being a pump with overflowed plumbing? Well, what will kill her brain faster is if the pump broke! We are going to avoid that...no sence breaking your fluid pump...in a car we can replace it...in humans...not so easy now."

    Then he started screaming at me about some glasses that were ordered, and I knew nothing about that because she is private pay and he ordered the glasses! I told him that since I was not involved in any of that, and was thrilled she is going to get new glasses and kudos to him for getting them, I still didn't have info to help...

    Then he screamed at me "well thanks for nothing you fake nurse! What else do you do besides wipe arses all day and say "I don't know"....".

    I smiled gently and said, help lovely people like your wife and yourself to find the answers you are looking for when I can...I have reasonable limitations, but do try my best sir, and would be happy to help if you have questions that pertain to my position and job here".

    He told me to go to hell, and I said..."thank you sir" and left.

    He later said this new nurse chastised him...and thankfully the admin knew I didn't (well helped to have a witness...I always take in a CNA in bad situations and we both had the exact same story!). And I reminded the admin that I have seen this man and talked to him at least 10 times, even that he was sexually verbally inappropritate with me the first time (I was fixing his wifes catheter and he said "I would love to see you pull that out with your teeth!"...I thought I heard him wrong and didn't react...then the CNA said she was suprised he didn't get decked...then I knew..yep he said it and I heard it right...and felt sick!).

    So great...he and her get to move in together and my admins excuse..."it may not be a very functional friendly enviroment, but it is a 60 year one, and we should cater to the continuity." BS! If you have someone raping their own child should you keep them together for continuity??? OH man I am livid..and waiting to make my move (along with 5 caregivers).

    The time will be right, and I will get the police involved this time...(my hubby who is paramedic and I have a new number code for emergencies with this man and he said he would do his best to show up if I was to call for 9-11 assistance...). I know our police, fire and paramedics..they won't stand by and let this happen once I report it! (I just need a bit more to go on).
  7. by   Antikigirl
    She has invertantly asked for help, but her MD said no go on geri psych and said there was nothing more to do for her and her family dynamics!

    I was thinking a bit of the 302 when appropriate, and another bit about being innapropriate to be making medical decisions for his wife. That is why hubby and I have that code, he is very good about assessing these two subjects, and will find a way to really prove it! (he gets more respect than an assisted living nurse, even though I have yet to be proven wrong!).

    I really think the wife should be in a progressive unit with more attention (fell 3 times yesterday, and increasing in dementia day by day), and him in an alcohol and anger management program! Too bad someone wants to do this now...should have happened long ago!!!!!

    Got to love my position in this...my clinical opinion means nothing till someone actually gets hurt! Then it is back in my lap with all sorts of questions...and yes YES I documented everything and so have my caregivers by my request daily!!!!!! They know what I am up to, and we are going to get it done, and documentation is our only hope!
    Last edit by Antikigirl on Apr 21, '05
  8. by   Antikigirl
    Today at 1200, I responded to a unconscious person down in a room in the other part of our facility. It was my little lady who was visiting her husband. I am pretty sure she vagaled out on the toliet, and I came in to see her husband doing an excellent job with CPR, and a caregiver and I took over for him.

    Very faint pulse, apnec...cpr started. Never got her back...by the time paramedics arrived she had been in asystole for over 3 minutes. A few more mins of CPR and all attempts were stopped.

    I comforted the husband for quite some time, he did try so very hard to help her! He kept crying out for his "little girl" to come back and appologized to the sky for his drinking and not loving her enough...he finally got it I guess...so now I had to turn to him and help and comforted him for as long as I could.

    I went into her room with his permission and was alowed to say goodbye. I brushed her hair from her face and said that I would miss her and I did my very best...and that her husband really did too... After I said goodbye the husband felt that it was his turn and since I was the last of the folks he alowed, he did...I left him alone with his wife....

    Family arrived shortly after...she was taken and a rose placed on her pillow. A lovely red rose for a precious soal...

    Now she can go on I guess...no more frustration and stress...and I guess her husband gets to go on too..after a time. I will help him through as long as he is in my facility...the switch was made by fate...I lost one to gain another....
  9. by   Jo Dirt
    Quote from TriageRN_34
    Then he screamed at me "well thanks for nothing you fake nurse! What else do you do besides wipe arses all day and say "I don't know"....".

    I smiled gently and said, help lovely people like your wife and yourself to find the answers you are looking for when I can...I have reasonable limitations, but do try my best sir, and would be happy to help if you have questions that pertain to my position and job here".

    He told me to go to hell, and I said..."thank you sir" and left.
    I would just laugh at this. I would kiss his arse when other people were around and when no one was looking I would curse him a blue streak. When he tells on you DENY THE WHOLE THING!...two can play at that game.
  10. by   CapeCodMermaid
    We have a very abusive resident on our subacute floor. He screamed at the CNAs, the nurses, the PT's and OT's..He calls his wife a "G-d damned stupid idiot. .the doc does nothing. The other day he said he was going to sign himself out AMA and go home. His wife came in to try to talk him out of it. She had shut the door to the room. When I came on the floor, I could hear him screaming at her. The doc was in the back room and said "Just let it play out and don't interrupt". I walked into the room anyway just in time to see him ball up his fist and try to hit her. I took her by the arm and took her out of the room. She went back later and he yelled again. I took her out of the room again.
    Finally his daughter came to see him. I don't know what she said to him, but he's been OK since then. How could anyone stand by and let someone be screamed at and threatened?!?! I grew up in a house where we weren't allowed to watch the Honeymooners because when Jackie Gleason waved his fist and said To the moon Alice, my father said that condoned violence against women so all this is enough to make me vomit.
  11. by   lizscott nurse
    Quote from TriageRN_34
    Today at 1200, I responded to a unconscious person down in a room in the other part of our facility. It was my little lady who was visiting her husband. I am pretty sure she vagaled out on the toliet, and I came in to see her husband doing an excellent job with CPR, and a caregiver and I took over for him.

    Very faint pulse, apnec...cpr started. Never got her back...by the time paramedics arrived she had been in asystole for over 3 minutes. A few more mins of CPR and all attempts were stopped.

    I comforted the husband for quite some time, he did try so very hard to help her! He kept crying out for his "little girl" to come back and appologized to the sky for his drinking and not loving her enough...he finally got it I guess...so now I had to turn to him and help and comforted him for as long as I could.

    I went into her room with his permission and was alowed to say goodbye. I brushed her hair from her face and said that I would miss her and I did my very best...and that her husband really did too... After I said goodbye the husband felt that it was his turn and since I was the last of the folks he alowed, he did...I left him alone with his wife....

    Family arrived shortly after...she was taken and a rose placed on her pillow. A lovely red rose for a precious soal...

    Now she can go on I guess...no more frustration and stress...and I guess her husband gets to go on too..after a time. I will help him through as long as he is in my facility...the switch was made by fate...I lost one to gain another....
    What a terribly sad situation. They both needed help, and I'm so sorry it
    ended this way. Poor dear women. But I am so proud of the way you handled things. Depsite you're feelings about this guy (and who could blame you) you saw past that, put it aside and were there for him when he needed you. This had to be so tough. My hat is off to you. : )
  12. by   lifesaverwv
    Quote from TriageRN_34
    So today I am doing my rounds in my assisted living facility, and I hear a man not yelling but screaming at someone about his wife who had just recently moved to our side of the facility. (We have an independent apartment side, and a dependant side...the lady had a stroke and she was moved to our side, he lives on the other independent side and visits daily and is known for yelling at caregivers).

    So I ran to see what was going on, and my DON stopped me in the hall. "Don't get involved right now, we have it under control". I trust my DON, but it didn't sound in control! This man was screaming nonsense at a caregiver from what I saw, and I was furious! But my eye caught our administrator around the corner and then I knew that things were under control on a higher level (I mean, if Admin gets called...holy cow!).

    This poor woman talked to me last week, and told me of how her husband belittles her so much, always has in their 60-year-old marriage. That she took care of him till the stroke and now isn't allowed to move an inch without him screaming at her to get help from a caregiver (we are talking not even adjusting herself in her chair!). That he tells her how feeble she is, how worthless she is, and that he wished the stroke had done its job. Then he will love her up, take good care of her for a day...then back to the belittling and verbal/emotional abuse. She also startles easily and puts her hands to her face...and I know that he must have hit her in the past or still doing it behind closed doors (no physical evidence yet, but we have a hawks eye on her for anything!). She made my heart cry so hard, and despite many faxes and calls to the MD, the MD says there is nothing we can do medically that will help. That she needs to get away from her husband and that is something she or her family must do at this point.

    Still, here is this man screaming that "don't you guys care? Don't you know that a mind must be enhanced daily to grow, and you aren't making her sing! Why aren't you MAKING her sing...she use to sing! I make her sing to enhance her sick mind so she doesn't die! Are you trying to kill her?! You MAKE her get up, you make her sing at least an hour a day, you MAKE her do what I tell you to do or so help me GOD I will sue!" My admin tried to explain that we didn't know she sang, and we have a choir that would love to have her, but we just needed to know! He screamed at her about not knowing, she said...we were not told by anyone! Then he comes back with "well I knew so you should!" Oh yeah...I forget we are mindreaders right...OMGoodness I was furious...but left it be as my DON instructed so I didn't mess up a messed up situation! I also think he was drunk (we were warned by his family that he drinks all day and by noon is usually sloshed...would make sense after this scene!).

    I hate this situation to the core. Unless we have some S/Sx of physical abuse not much can be done. I believe they are going to try to get the family to move her out of the facility and away from him, but that too will be so hard on her!

    I will give my admin a week, then ask for a report on the situation (if they will even tell me, they usually tell me it is confidential and they are 'working on it'. But I am going to have to do something to help her. This is abuse, and it can't be tolerated!

    Any suggestions? (I asked for geri psych eval, but to no avail...MD won't cover, and the family refuses antidepressants or anti anxiety meds, even despite knowing it will help her emotionally...but they say "drugs can't cover the problem...she has to deal with it...hmmmmm think there is some family dynamic here of 'karma' towards their mother/father???). At this point she is saying "Yeah, maybe the stroke should have done its job" and that kills me!

    My gosh! Do the authorities just stand by until he finally physically hurts her, or even kill her. This poor soul is verbally abused everyday! Someone from Adult Protection Services needs to be contacted to watch this abusive man in action. Besides abusing his wife he is creating a hostile work environment for the workers. I bet that some have quit your facility because of this man. Please don't stop trying to help this lady, who cannot help her self. Please let this thread be made aware of what happens about this poor lady's situation. God Bless you for being the pts advocate

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