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LTC Or Mental Hosp

Geriatric   (1,246 Views 7 Comments)
by dorrybnursing dorrybnursing (Member)

2,995 Visitors; 76 Posts

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Is your long term care facility turning into a mental hospital? Our residents are coming to us younger and younger, and with all types of mental illnesses. Many are former drug abusers. Not only do I feel I don't have the training to deal with this population. I don't think the traditional LTC resident is being served best by this environment. :twocents:

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CapeCodMermaid has 30+ years experience and works as a DNS.

1 Follower; 59,493 Visitors; 6,035 Posts

Most states have closed the 'mental hospitals' and most residents can't afford the few private ones that are still open. NO ONE is well served by mixing these 2 populations but young people with psychiatric problems need care, too. The real problem comes when we try to manage them using the regulations imposed by long term care...and yes, the DPH surveyors agree.

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Bella'sMyBaby works as a MDS Coordinator.

9,497 Visitors; 340 Posts

Yeah, my Boss & I discuss this exact issue all the time. We get all the "Behavior" Residents in town!! Our LTC facility has become a Behavior Unit & yes, many of them are younger & have sucked off the System their entire lives! And since they are in a Nursing Home they have their "Rights" don't you know.....We can't do anything with them.....like give them the Discipline they need. We've had a few "Residents" recently who were on the State's "Most Wanted List." A significant number of the Residents in our facility are there due to their "Chosen Lifestyle." Talk about "Abuse of the System." :madface:

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CapeCodMermaid has 30+ years experience and works as a DNS.

1 Follower; 59,493 Visitors; 6,035 Posts

Until I started working in my current facility, I felt like you did....their bad choices...their fault. But, we have many residents with schizophrenia...not their fault any more than diabetes or alzheimer's dementia is the resident's fault. Many of my residents had productive lives with high paying, important jobs. Mental illness is horrible. The regs will have to change so we will be able to have true behavior units with negative consequences for negative behaviors.

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VivaLasViejas has 20 years experience as a ASN, RN and works as a Retired/Disabled Nurse and Blogger.

8 Followers; 142 Articles; 247,693 Visitors; 9,600 Posts

I"m afraid that this is only the beginning........my new LTC houses a number of residents in their 50s and 60s who are there mainly because of lifestyle choices that have contributed to early-onset dementia, brittle diabetes, psychiatric issues, amputations, CVAs and more. It's downright SCARY for us Baby Boomer nurses, because these are our age-mates and we can easily see ourselves in their position.

We can also see a need for the kind of care facilities that, unfortunately, don't yet exist in large enough numbers. A typical LTC that caters to the needs of a geriatric population just isn't appropriate for

the fifty- and sixty-something resident with perhaps a touch of dementia and/or a psychiatric illness, or a 600-pounder who's just had bariatric surgery, or an alert and oriented CABG patient who needs help figuring out how to live the rest of his or her life without becoming a 'cardiac cripple'.

Given the state of health care and the economy, I don't see such facilities becoming a reality anytime soon either, but it's certainly worth thinking about because there are some 76 million of us and we're getting nothing but older.

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Nascar nurse has 25+ years experience and works as a Hospice Nurse.

31,764 Visitors; 2,213 Posts

I"m afraid that this is only the beginning........my new LTC houses a number of residents in their 50s and 60s who are there mainly because of lifestyle choices that have contributed to early-onset dementia, brittle diabetes, psychiatric issues, amputations, CVAs and more. It's downright SCARY for us Baby Boomer nurses, because these are our age-mates and we can easily see ourselves in their position..

In my facility I would guess we have had at least 10 referrals within the past 6 weeks of 30's & 40 year olds..even one 24 year old with alcohol poisoning that lead to a CVA/non responsive, trach, etc. Most of the 10 have had something to do with chronic alcoholism. While I realize they need care too, there are a lot of behavioral concerns with these folks and they tend to scare the beejesus out of my sweet little old ladies. I try to refuse them but either the marketing person or the administrator trumps the decision. Of course the nursing staff is banging on our door daily complaining about all this change.

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Magaly63 works as a crc.

948 Visitors; 30 Posts

The typical LTC facility does not exist anymore, unless it's a stand alone privately owned one that doesn't have to answer to a corporation.

CENSUS is of primary importance.

When census drop then we HAVE to take anything that knocks on the door.

Yes, we also have been told by surveyors "you can't handle this many psych issues", even been cited for some issues and have been told by a surveyor " We are trying to send a message to your corporation, you are doing a wonderfull job, considering your resources"

So, it becomes a vicious circle.....If anybody tours the building they get scared a nd go somewhere else, census drops and the next behavior adm comes in.

Yes, some can't help it, and deserve all our help and support, but when you get someone that has never worked, lived on welfare, comes in and the first thing you do is to give them a bath because you can only hold your breath for so long, purely of their own making, and they complain " I don't like this meal" "Channel 6 is fuzzy" , it becomes REALLY hard to be understanding and control ourselves.

There is nowhere for them to go, not changing anytime soon. Involve your Ombudsman and remember, their rights end when they infringe on someone else's.

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