setting limits in long-term care

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Hello all,

I am new to this forum. My position is nursing education with a behavioral specialty. What is unique to our facility, is that the average age of our patients is about 50...with that comes a whole different set of problems. I would like to receive feedback as to how your facility handles "time outs" when putting the patient/resident in their rooms for this type of intervention

is not an option.

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

Im not exactly sure Im catching what you saying. Are you talking about a actual time out for geriatric residents?

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Specializes in Med-Surg, Geriatric, Behavioral Health.

moving thread to the ltc forum.

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Specializes in PeriOp, ICU, PICU, NICU.

welcome to the site. enjoy your stay and best wishes to you. :balloons:

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I have been in LTC for 11 years, and we are NOT allowed to "Punish" residents. The Residents rights protect them from "discipline". You can redirect their behavior or suggest that they need time alone to calm down, but in no way shape or form are we allowed to seclude them. I hope that answers your question. That being said, it does make it hard to deal with psych. pts, because in LTC we are getting more and more of the cases.

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

I had to re-ask the poster to clarify. I just cant believe anyone would think it is ok to put elderly people in time out... HOLY COW...Redirection is the key.

I have been in LTC for 11 years, and we are NOT allowed to "Punish" residents. The Residents rights protect them from "discipline". You can redirect their behavior or suggest that they need time alone to calm down, but in no way shape or form are we allowed to seclude them. I hope that answers your question. That being said, it does make it hard to deal with psych. pts, because in LTC we are getting more and more of the cases.
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Specializes in Med/Surg, Urg Care, LTC, Rehab.

Before I was a nurse, my grandpa was in a geriatric behavioral unit of a hospital due to Alzheimers. This gentle man became increasingly violent as his Alzheimers worsened. One time when I went to visit him, they had him in his room, the door was locked but it was a glass door and they were watching him closely. He had become violent and they had put him on a "time out". I know this sounds really weird, but it felt totally respectful the way they were treating him. It was not abusive at all it seemed to me. I've been a nurse for several years but have never worked with people who were this bad off. I am on a clinical now (working on my RN) on a locked psych ward, and there are "quiet rooms" for if/when people melt down or get out of control.

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Specializes in LTC,Hospice/palliative care,acute care.

I think we need some clarification -why type of facility is this?

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Specializes in LTC, home health, critical care, pulmonary nursing.

I work in a facility for Alz's and behavioral health. We can put them in their rooms if their behavior is out of control, however, the door must remain open and it MUST be careplanned as an intervention for that particular behavior. We rarely do it. And the behavior has to be something that is being done in a common area where it is upsetting other residents. We can't just stick someone in their room and lock the door.

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The only time I've ever used controlled isolation with a resident was a lady with a stroke that left her with incessant chanting. With assessment and observation, we saw that her chanting escalated to almost fever-pitch when she was stimulated, whether by the TV, noise, lights, just about anything. She would quickly become utterly exhausted but unable to stop herself. She couldn't eat and lost weight.

We adjusted her behavior by putting her in her room for periods of time with her back to the door. She continued to chant, but it slowed to a whisper after time. This was all documented in her careplan and nurses notes. She was served meals in her room to ensure she ate. It worked well for close to 7 years until she passed away.

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