Very disturbing...one of our frequent psych patients (d/c'd) was picked up by the police. For what, I don't know. But I've never known the guy to assaultive. Agitated at times, yes. Assaultive, no.
Police apparently had him and he got agitated. He was Taser'd a few times and died when he got to our hospital.
This is the fourth time *this year* that police in our area have ended up killing a psych patient. Mostly from Tasering, once from being 'restrained' according to the news.
I just think police need some training on dealing with mentally ill people. This is a crying shame. Mentally ill and agitated is not the same as criminal!
I'm sorry but, at the very least, this patient has to be prosecuted and placed in a criminal psych facility.
:typing
How can you prosecute someone who is mentally incapable of assisting in their own defense (as a man with dementia would no doubt be)? Doesn't the constitution say something about that?
It is possible to protect the staff from him without prosecuting him. That's what security is for.
How can you prosecute someone who is mentally incapable of assisting in their own defense (as a man with dementia would no doubt be)? Doesn't the constitution say something about that?
It is possible to protect the staff from him without prosecuting him. That's what security is for.
Dangerous patients who are incompetent to stand trial are placed in criminal psych facilities all the time. Nothing new about that, it's done all the time under legal commitment procedures ... when a court determines that they are a danger to society. They still receive treatment, but in a more secure environment.
I'm sorry but, at the very least, this patient has to be prosecuted and placed in a criminal psych facility. At a criminal psych facility he will receive treatment but, hopefully, he will also be prevented from harming others. At least the opportunity to harm others will be much more limited.
:typing
Wow, harsh.
Let's paint the picture of the normal combative dementia patient. We'll say he's 79. His family had him placed in a LTC or Assisted Living dementia unit due to unsafe wandering a year and a half ago. During this time he declined from the grandchildren loving, car fixing, fishing every weekend, would give the shirt off his back to a stranger if they asked for it grandpa to someone who was became combative with cares and sexual inappropriate. This is a man who could be anyone's lovable Grandfather who was made this way by a disease!
When he was found on top of the CNA chances are he had no ability to comprehend the significance of his actions. For all we know in his mind he was making love to his wife of 20 years and she was a willing participant!
In honesty we don't know HOW exactly dangerous this person is. This could have just been his response to the chaos of being on a general hospital floor! Those with dementia need organization, routines, and lessened stimulus. Where he was probably didn't provide this as they don't specialize in dementia or behaviors related to dementia. There are ways to deflect these behaviors and prevent them from occurring, but he wasn't in a facility that had the training or resources to do so.
Speaking as a person who remembers huge state-operated campuses of 'mental hospitals' that were the sometimes life-long home of most of societies psych pts, I have to point out that 'freeing' psych pts into the general society was a political/ethical/financial decision.
There were many abuses of that system. Unfortunate persons were 'committed' to the state hospitals as a result of bad family dynamics or similar problems that would never result in medical/psych diagnoses today. (I specifically recall one newspaper story of an elderly woman who's records revealed that she had been committed by her parents as a result of being pregnant & unmarried and who lived in the hospital for 40-odd years. One is left wondering how many gay persons were judged to be 'crazy'.)
Modern behavior drugs were supposed to make psych pts' behavior compatible with general society. A system of clinics and subsidies/supports for group homes etc was going to make this transition successful.
Probably it was the best decision. But the reality for lots of our psych pts is that follow-up doesn't meet their needs and many of their lives have long periods of homelessness and that the police end up dealing with them.
Obviously, there are difficult issues involving civil liberties and social responsibility here. But the ultimate 'freedom' in the US is that we all have the 'right' to sleep under bridges and eat out of dumpsters, to reject all social supports and treat society as if it were some sort of 'wilderness'.
But the degree of 'choosing' for lots of psych pts is problematical. Should they be given the same 'choice' to descend to the bottom and behave disruptively as I have?
I don't know the answers. But the results wehave today are the result of essentially political decisions. And if American society should change it's mind--we could keep psych pts safer but less free.
Scratching my troubled, bald head
Papaw John
This was a very thought provoking post. I don't have any answers either, but I know that this issue will not die, as long as the people who were "liberated" from the state hospitals in the 80's and 90's who now are walking the city streets with no safety net, and no one to claim them. As Papaw John said, these people floundered in the state system for decades, and not always for good reasons. The local state hospital in my area was torn down recently to make way for a Wal-Mart. It was closed 20-some years ago. I remember my psych clinical rotation there. The orderlys showed us the tunnels where the rich families on the river would bring their family members in through them under the cover of darkness, lest someone find out. The library at the hospital kept the old record books from the early 1800's with lists of patients and conditions that brought them in to the system. Diagnosis' like "spirits" and "fits" were common conditions that would bring a pt in to a life time committment to the state hospital. So sad.
In honesty we don't know HOW exactly dangerous this person is.
True. That would be for a court to decide. The circumstances of this particular case notwithstanding, it's not unusual for patients with dementia to be placed in criminal psych facilities because in those cases, they are very dangerous.
I wonder: if any of you were that CNA who was pinned down against your will, and the patient was pulling down your pants about to rape you ... how would you feel? Perhaps you would view it differently if you were the one who was attacked. Why is the healthcare worker expected to take this kind of abuse because of illness ... and then expected to be potentially exposed to that trauma all over again?
I do draw the line at that point. I'm sorry about the patient and the family but, when I've been attacked by patients, I've never felt more horrible or more violated in my life. I do care more about my safety at that point. Why that's considered "harsh" .... because I don't want to be beaten, raped or even worse ... is beyond me.
Hospital security? I don't know what it's like where you work, but where I work it's a joke. Yeah ... they get there eventually, but you can't count on them in an emergency.
I wonder: if any of you were that CNA who was pinned down against your will, and the patient was pulling down your pants about to rape you ... how would you feel? Perhaps you would view it differently if you were the one who was attacked. Why is the healthcare worker expected to take this kind of abuse because of illness ... and then expected to be potentially exposed to that trauma all over again?
:typing
Or perhaps I would feel just the same as I do now. I've worked as a nurse for a while. I've seen and experienced things that you may not have and they shape my views just as your experiences shape yours.
Trying to get a dementia patient sent to a criminal psych facility seems pointless to me when they can be managed safely in the hospital (even assuming there is such a facility able to take them in the first place which isn't the case in a lot of the country). I DO NOT expect anyone to be put in danger again. That's what security is for. No, you don't wait to call them and hope they get there in time. In cases like this they can be stationed in the patient's room or outside the door. Few people seem to know that LTC has the highest rate of nurse assaults. They can't send them all to criminal psych hospitals. That's just not practical.
Or perhaps I would feel just the same as I do now. I've worked as a nurse for a while. I've seen and experienced things that you may not have and they shape my views just as your experiences shape yours.
Trying to get a dementia patient sent to a criminal psych facility seems pointless to me when they can be managed safely in the hospital (even assuming there is such a facility able to take them in the first place which isn't the case in a lot of the country). I DO NOT expect anyone to be put in danger again. That's what security is for. No, you don't wait to call them and hope they get there in time. In cases like this they can be stationed in the patient's room or outside the door. Few people seem to know that LTC has the highest rate of nurse assaults. They can't send them all to criminal psych hospitals. That's just not practical.
I agree with this, but the question then becomes, how do we get facilities to pay for adequate security? I would think in our sue happy society, risk managment would be all for increasing security staffing to provide a safe work enviornment for the staff. A lawyer needs to be consulted about these organizations who are not providing a safety net for the staff who must take care of these potentially dangerous patients.
I agree with this, but the question then becomes, how do we get facilities to pay for adequate security? I would think in our sue happy society, risk managment would be all for increasing security staffing to provide a safe work enviornment for the staff. A lawyer needs to be consulted about these organizations who are not providing a safety net for the staff who must take care of these potentially dangerous patients.
I've worked in a lot of hospitals and not one of them would refuse to station security somewhere when necessary. I've dealt with drug moms, gang members, abusive husbands, prisoners and just plain crazy people. When someone is a known risk to staff, security can be posted with them. Any facility unwilling to do this should be taken to task by their staff. No one should be put in any unecessary risk. If they are unwilling I think your idea of calling a lawyer is a good one and the police can be involved as well.
True. That would be for a court to decide. The circumstances of this particular case notwithstanding, it's not unusual for patients with dementia to be placed in criminal psych facilities because in those cases, they are very dangerous.
I wonder: if any of you were that CNA who was pinned down against your will, and the patient was pulling down your pants about to rape you ... how would you feel? Perhaps you would view it differently if you were the one who was attacked. Why is the healthcare worker expected to take this kind of abuse because of illness ... and then expected to be potentially exposed to that trauma all over again?
I do draw the line at that point. I'm sorry about the patient and the family but, when I've been attacked by patients, I've never felt more horrible or more violated in my life. I do care more about my safety at that point. Why that's considered "harsh" .... because I don't want to be beaten, raped or even worse ... is beyond me.
Hospital security? I don't know what it's like where you work, but where I work it's a joke. Yeah ... they get there eventually, but you can't count on them in an emergency.
:typing
Agreed, while I feel badly for someone who is mentally ill, if they are dangerous or have comitted a violent crime, they should be institutionalized. Why is it harsh to want them off the street where they can't hurt someone? I think a lot of this comes from the ridiculous notion that we nurses shouldn't look after our own safety or say something if we are hurt by a patient. Sorry, not a martryr here..Sure, patients have rights but when others start getting hurt that's where they end.
Let's paint the picture of the normal combative dementia patient. We'll say he's 79. His family had him placed in a LTC or Assisted Living dementia unit due to unsafe wandering a year and a half ago. During this time he declined from the grandchildren loving, car fixing, fishing every weekend, would give the shirt off his back to a stranger if they asked for it grandpa to someone who was became combative with cares and sexual inappropriate. This is a man who could be anyone's lovable Grandfather who was made this way by a disease!
When he was found on top of the CNA chances are he had no ability to comprehend the significance of his actions. For all we know in his mind he was making love to his wife of 20 years and she was a willing participant!
In honesty we don't know HOW exactly dangerous this person is. This could have just been his response to the chaos of being on a general hospital floor! Those with dementia need organization, routines, and lessened stimulus. Where he was probably didn't provide this as they don't specialize in dementia or behaviors related to dementia. There are ways to deflect these behaviors and prevent them from occurring, but he wasn't in a facility that had the training or resources to do so.
If, due to dementia, an individual is unable to tell the difference between raping a CNA (or a small child, or an elderly female, for that matter) and making love to his wife, THAT PERSON NEEDS TO BE IN A SECURE ENVIRONMENT.
NO IFS, ANDS OR BUTS!!!!!
And, no that is not too "harsh".
The have a right to humane treatment and we the public, have a right to safety. When they interfere with our safety, we have the right to confine them as necessary to ensure safety of society at large...and the dementia does not alter that. And being permitted to attack others (even mistakenly) is not acceptable, nor humane.
Because one day, they will mistakenly attack the wrong person, and they will stabbed/shot/murdered due to their behavior. They attack someone who owns a gun or is otherwise armed, and the outcome will be far from humane for any involved.
And before you ask, if one of my elderly relatives, due to dementia, attempted to rape me or my grand/child....I don't care how loveable they once were, they are now a dangerous, if demented, predator, and I would defend myself and those being attacked.
If, due to dementia, an individual is unable to tell the difference between raping a CNA (or a small child, or an elderly female, for that matter) and making love to his wife, THAT PERSON NEEDS TO BE IN A SECURE ENVIRONMENT.
NO IFS, ANDS OR BUTS!!!!!
And, no that is not too "harsh".
The have a right to humane treatment and we the public, have a right to safety. When they interfere with our safety, we have the right to confine them as necessary to ensure safety of society at large...and the dementia does not alter that. And being permitted to attack others (even mistakenly) is not acceptable, nor humane.
Because one day, they will mistakenly attack the wrong person, and they will stabbed/shot/murdered due to their behavior. They attack someone who owns a gun or is otherwise armed, and the outcome will be far from humane for any involved.
And before you ask, if one of my elderly relatives, due to dementia, attempted to rape me or my grand/child....I don't care how loveable they once were, they are now a dangerous, if demented, predator, and I would defend myself and those being attacked.
fergus51
6,620 Posts
How can you prosecute someone who is mentally incapable of assisting in their own defense (as a man with dementia would no doubt be)? Doesn't the constitution say something about that?
It is possible to protect the staff from him without prosecuting him. That's what security is for.