Ogailf

You are right CapeCod - we are all stuck in the cycles that are set-up. Even in acute care some of the patients end up in the psychiatric intensive care unit with much younger and sicker mental patients because they cannot be watched close enough on a unit with other elderly patients that can be hurt when they hit or throw things. I guess it all comes down to where would be the appropriate place for these patients? I think that CMS needs to rethink some of their requirements. There is a big difference between "chemical restraints" and medication that helps a person function at the highest level possible for them. We just all have to work together and hope that solutions to this questions come and are listened to by the ones making the "rules".

I agree with anndoodle. I also work at a geri-psych unit in an acute care hospital. At times we look like a dumping ground for LTC. They can come up with some of the most minute reasons for sending a patient to geri-psych. Like a little old man in his 80's-90's making a "pass" at a staff member or another patient etc. Another problem is the patient's that have reached a point of dementia that you could throw every medication in the book at them but you aren't going to change a thing. Ann, a big amen about the medication issue. We keep a patient until they are stable (doesn't mean cured) send them back on medications and then the office of LTC dictates that the NH has to try them off this medication? Get real - what is the point of sending them to a geri-psych unit and then not keeping up the treatment plan that was found effective. Also, I think alot of people thing that geri-psych units are LTC for the demented, those with mental disorders, etc. They aren't. They are acute care to stabalize so that they can return to whatever their normal living situation is to be. Big problem is that not enough LTC facilities provide units where the staff are trained to care for these patients. And it does take more training than dealing with the nondemented old person.

I manage a geripsych unit and will say a hearty AMEN to the fact that staff have to be dual trained for the unit to run well. Also, they need to really have a heart for working with the elderly and their families. It is really hard to get and keep good staff. Most of the nurses that are interested in psychiatry have no interest in doing the hands on patient care required in geripsych. What I would give for nurses and CNA's that would come to work with a positive upbeat attitude. I know they are out there somewhere!:sofahider