Mental Stability of Elderly person

[KarynicaRN]

As a registered nurse, should I be obligated to report to social services an elderly lady who is so scattered brained and really in need of some type of services, perhaps help with a mental illness? I know of a woman who lives alone and seems to be unable to care for herself. She has family, but the family just say "she is old and crazy". I worry for her mental status since she has said several things in the past few weeks that make me think she isn't quite all there. When speaking with her, she can't seem to remember from one day to another things she previously stated. She says that people are lying to her. She thinks that people are watching her.

Any advice?

[TopazLover, BSN, RN]

I am glad you are concerned. She may well have some dementia going on and these symptoms may be early signs of Alz. Put perhaps she has a medical condition that can be addressed.

I wold suggest a call to Adult Protective Services. Ask if this could be checked out. You then would have done the mandated reporting, they would follow up and if she is in need of services, they can be the "bad guy". If you choose to become more closely involved, know you will be the one that the family thinks is interfering.

She may have an invisible support system such as church, neighbors, etc. You don't need to come up with the answer as to how to get services. Just know that there are services that might be paid through Medicare.

She may well be capable of staying where she is if she has some services provided.

[Grace Oz]

They say the whole village raises the children.

Same analogy I think for our elderly.

We all should be looking out for each other.

As health professionals, we are better able to pick up on the signs of something amiss than people with no training or knowledge.

It's our responsibility to be proactive, within boundaries of course, and alert the correct authorities of our concerns.

If this lady were me or one of my loved ones, I'd like to hope that someone was caring enough to put the wheels in motion to facilitate me/loved one, getting the help which might be needed.

Prevention is always better than trying to find a cure later.

Kudos to you for being an alert and concerned citizen!

[nerdtonurse?, BSN, RN]

On the floor, it would be a psych consult followed by a call to our social worker for possible APS intervention...

Just as a thought, could she have a UTI? I've seen elderly go stark raving crazy due to nothing more than a persistent UTI -- make the UTI go away, and they're back to themselves.

[morte, LPN, LVN]

from what i have seen mentioned here on the boards, APS isnt always very nice......she would probably be institutionalized BEFORE they made any ascertation and it is hard to get back out......if you know that she has a church affiliation i would start there

[bookwormom]

I would base my decision on whether or not to report on whether she is in actual danger. Being forgetful is one thing, leaving the stove burners on is another. If she is being abused or taken advantage of by her family, that is a concern too.

[leslie :-D]

Just as a thought, could she have a UTI? I've seen elderly go stark raving crazy due to nothing more than a persistent UTI -- make the UTI go away, and they're back to themselves.

exactly.

now, how to get this lady to the doctor?

somehow i'm sensing she may not be that cooperative.

from what i have seen mentioned here on the boards, APS isnt always very nice......she would probably be institutionalized BEFORE they made any ascertation and it is hard to get back out......if you know that she has a church affiliation i would start there

this is my fear too.

i hate to see anyone, but especially our elderly, removed from their homes.

devastating consequences.

I would base my decision on whether or not to report on whether she is in actual danger. Being forgetful is one thing, leaving the stove burners on is another. If she is being abused or taken advantage of by her family, that is a concern too.

agree.

if her home isn't in a shambles and she seems physically intact and clean, let her continue on with her eccentric ways.

but, i do wonder if she has a uti.

significant ms changes occur w/any infection.

leslie

[nightmare, RN]

Hey Leslie that star guide really suits you!

[CoffeeRTC, BSN, RN]

If the family wont interviene and she is still safe...not much you can do unless you go and talk with the lady yourself.

If she is unsafe...you can call the Adult services or Department of Aging. Good luck with that. In our area they are just as overworked as the Children and Youth Services and seem to "let" things go on and on and on.

I think adult children should be just as liable for caring for their parents as they would their children, especially when they benefit financially from their parents.

[TopazLover, BSN, RN]

In addition to the possible UTI I was thinking about something like Thyroid disease or even a brain tumor (we are seeing more and more of these in the elderly). I agree with the other posts about APS in some areas. Ours is really good to work with and would help get family involved, if possible and appropriate.

I view that early Alz. or cognitive decline as a spiral. For example, the more she worries about where she put her keys, the more she becomes convinced someone else must have taken them. Multiply this by the worry that if she mentions any problems the family will "shovel her off to the local NH". As one symptom appears it makes the spiral seem steeper, even if it really isn't. Our elders are not mediclly trained, they figure if they are losing it they are ready to be tossed away. Of course they try to cover this any way they can.

Getting old is only for the brave. I agree she needs help from all the sources available. I hope she can get what she needs. So many of our elders do not. Thanks to caring people like you, less need to suffer.