I posted this in LTC but think it is a good general question for us all! Long one but you will understand why...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!