I went into a home to do a start of care for an elderly female discharged from hospital after an acute exacerbation of a chronic condition.
Present in the home was the patient's elderly spouse (also in fragile health) and a middle aged son who is developmentally challenged.
As I approached the patient, the son began raging at his mother - "I hate you you b****" and struck her in the foot with a wooden back scratcher. The foot began bleeding.
The elderly male moved toward the son and the backed off into a corner. I assisted the female to another room - still open to the area the confrontation was occurring in. The patient was terrified and called 911.
In the corner, the son took two swings at his father. The father pulled a tazer out of his pocket and held the son at bay with the tazer. The son is middle aged with bulging muscles and hands like hams. His jaw was clenched, his fists were balled up, he was standing on the balls of his feet ready to attack. His eyes were filled with rage.
The mom handed me the phone and I related the events to the dispatcher.
My instincts were to get out of there as fast as I could, but I was torn because the mom was bleeding.
The dad backed the son into a far bedroom and guarded the door, still holding the tazer. I helped the mom to a chair and began bandaging her foot. Before I was finished, the son re-entered the room, this time, without the dad. He was acting like nothing had happened. No one referred to what had happened. I was scared that if I said something, he would go off again. I finished the bandage job and went into my car to wait for the police.
Five minutes later, the dad came out and gave me the phone number for the son's mental health worker. I told him to go back in the house and protect his wife. I felt like I had left her in danger and it was awful. I spoke to the mental health worker who did his best to convince me that the son was really a "nice" guy and it was the stress of his parent's illnesses and a stranger in the house that had caused the son to go off. The mental health worker told me that the son had never physically hit a non-family member. I flatly informed the mental health worker that I had been doing this a long time and I know what I saw and felt. The mental health worker gave me information about an acute care placement where the son could be taken.
My agency immediately placed the patient on a non-admit list as it was unsafe. Thank God for supportive agencies.
My big problem. My heart is hurting for that patient. I cannot send in personnel and that patient will not get the care she needs. I am open to any and all suggestions.
Thank you for listening.