help! Harriet Houdini lives

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Specializes in Gerontology, Med surg, Home Health.

Here's the problem. 96 year old demented woman fell and fractured her wrist. Off she goes to the ER. Comes back with a 1/2 cast wrapped with an ace bandage. That lasted less than 2 hours and off it went. (Yes, we all ducked when she threw it at us!) SO back she went to the ER ..got a full cast put on. That lasted 2 days. She pulled the cast off in one piece. Did the same with the second full cast. We have tried ace wraps, gerisleeves, long sleeved shirts, jackets (no, not straight ones!) and she manages to take off everything. Aside from restraining her 'good' hand, does anyone have any thoughts? She has pain meds, Ativan, Trazodone....what else could we do?

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She is 96 yo, physically active, & you want to medicate her to oblivion? Let her be...

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She sounds pretty tough!! Like the ones who won't let you take a b/p. Ha! Ha! Gotta love that spirit.

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Specializes in LTC, geriatric, psych, rehab.

Oh, I so needed a good laugh tonite, and this did it!!! My nursing home is full of folks like "Harriet", and I love them. I vote for leaving her alone. Apparently it doesn't hurt her too bad or she'd leave it alone. She is 96, so if it doesn't heal right, how damaging is that really going to be for her. I work in a nursing home, so know all about all that paperwork you'll have to do over this, but I still say to leave her alone.

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Specializes in LTC, Hospice, Case Management.

I would probably have to agree with travel50. What else CAN you do! I would certainly think if it was at all bothersome to her, she would not be slinking out of full hard casts. Once she is out of the cast, what does she do with the arm? Put weight on it.. still must not hurt to bad if she is doing that?!?

You will definately want family consent and Dr. order if you all decide this is the best option & careplan well.

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Specializes in acute care and geriatric.

We had a similar situation, we ended up keeping her in an ace bandage till the orthopedist d/c'ed it, What can you do?

Glad you ducked!!

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Specializes in school nursing, ortho, trauma.

since the other posters have noted that it must not be hurting her so badly, you might want to consider cutting back pain meds if she is still getting any. If it hurts her to mess with it, she's less likely to do so.

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Capecod already knows the answer, but was just looking for some extra help.

If you been in ltc for a while, we see these types all the time, but still it is hard to just give up on them..it is our nature as nurses to continue to try to help and prevent further injury or illness.

In this case..you know...document everything, try to provide diversions, medicate for pain and just hold your breath and cross your fingers...say a prayer too.

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Specializes in Gerontology, Med surg, Home Health.

thanks for the replies..no obvious pain...doesn't get most of the meds she's got ordered. I'm thinking her PCP can write an order to ace wrap PRN and leave it at that.

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Specializes in acute care and geriatric.
thanks for the replies..no obvious pain...doesn't get most of the meds she's got ordered. I'm thinking her PCP can write an order to ace wrap PRN and leave it at that.

Exactly!!!

Question is : Doc, will she be able to play the piano after it heals?

BTW we have a 85 yo pt who still plays the piano- she used to be a concert pianist and it is so heartwarming to see her tickle the ivories.

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Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

oh funny.... I can just see this!

like others I would get MD orders for no cast due to the behaviors, update family, careplan it and document in prog notes

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