When a resident won't follow the rules

Specialties LTC Directors

Published

Specializes in Gerontology, Med surg, Home Health.

I have a resident who will not follow the rules about leaving the building. He says he can go whenever he wants. I am looking for another place for him to live but so far no luck. Do I have to keep him? If I had a place for him to go I'd pack his bags and drive him there myself. I'm thinking about calling the DPH for guidance. Any thoughts?

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We're having quite a time with elopement as the weather has gotten nice. "I just wanted to sit on the bench and drink my coffee."

Can residents legally leave alone in Mass? Would he be safe? Where is he going? Need more info to be of any use.

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Specializes in Gerontology, Med surg, Home Health.

They used to be allowed to leave and wander through town if they had an MD order. Lots of them still have permission to sit outside on the patio to smoke or do whatever they want. But they all know they are no longer allowed to leave the property. He goes off and then claims he has PTSD and thought he was in the jungle. Jeez....there are 4 trees in the whole town...nothing anywhere like a jungle. When DPH came for survey he tried to get me in trouble....the DPH told him that as the DNS I could make any rules about LOAs I wanted. The man is a creep and a liar and he needs to go away.

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They get to go sit on the patio and have a smoke? You have a nice place there. Seriously. We have ONE person allowed on the patio unsupervised. But my DON is paranoid and reactive.

I know in NY we can't just cut someone loose. Period. Even if they are glaringly inappropriately placed we must have another plan in place before they go.

Does he *need* skilled care? Can SS work with getting him into a subsidized apartment?

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Specializes in Gerontology, Med surg, Home Health.

He doesn't need skilled care. He somehow weasels out of going every time they set something up. He has met his match. I won't put up with him. Unfortunately we allow smoking on the patio and inside on the smoking porches. If they are well enough to go out alone and walk through town, they are well enough to live on their own.

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If they are well enough to go out alone and walk through town, they are well enough to live on their own.

Kick him to the curb. I would bet MA would help. He's costing a lot of Medicaid money. Call the DPH.

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Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.

Is he capable of living in senior citizen subsidized housing? Some provide 1 or 2 meals/day, with nursing care back-up if necessary. The city I live in has one, and it receives monies from the state and city. Tough to get in, though..

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Specializes in LTC, Hospice, Case Management.

Do you have an ombudsman available as support to you and your rules? Does the person have family that my be supportive of you?

I agree with your earlier post, if he is good enough to roam around town, he is good enough to be out on his own. In my state, we have to legally give them a 30 day notice of intent to discharge - do you have the same? If so, I would get that going ASAP and then see if you have any other options that could be carried out sooner.

Good luck!

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inre:PTSD, is he a vet? referral to VA if he is///

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Specializes in Gerontology, Med surg, Home Health.

In Massachusetts you can not give a 30 day notice without having an address to put on the form. He has to have some place to go...although I did work in a place where they discharged someone to a homeless shelter.

No family that wants anything to do with him.

Ombudsman is on our side but nothing they can do.

VA benefits are non existent for this guy. We are looking for another place but he has a reputation and many places won't take him.

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Specializes in Sub-Acute, SNF,ICU,AL,Triage, Cardiac.

Have you tried buying him a ticket to Hawaii? I've heard some stories :)

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Specializes in MDS/Office.

Do you have a facility psychiatrist/psychologist that you can ask for a referral to another facility? Are there any out of area/state facilities to contact? In my state, we can issue a 30 day notice & get rid of them, as long as we have found another facility to accept them in or out of state. Not too long ago, we had a resident that we refused to take back after a hospitalization. The hospital could not find placement for her & threatened to report our facility to the state....administrator told the hospital to go right ahead & report us. Next thing you know, the resident was fine enough to discharge home. Imagine that! :rolleyes:

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