Updates from the LTC world

Let's see, yesterday I learned that medical marijuana has arrived at my local SNF. Apart from any other considerations, my first thought was that no one will want the zoloft I offer, if they can get pot.

Time will tell.

I have been having even more fun at my ALP. I had a fairly new resident reporting suicidal ideation. Although he seemed to be adjusting to the setting, I had almost no background information on him, and there was no family to call. So I agreed with the staff that he should be sent to the ER.

He came back a few hours later with a statement signed by the physician, quote: THIS MALINGERER SHOULD NOT BE SENT TO THE ER.

That was last Friday. Yesterday, I learned he was admitted to an inpatient psych unit.

I went to another resident's room yesterday to see how he is doing, as there were some reports about him not eating, and not cooperating. In his room, I discovered discharge paperwork from the ER, with a COPD dx, and scripts for nebulizer treatments and an antibiotic. All from several weeks ago, and it was never filled.

Next, I reviewed a potential admission from another ALP. The resident would like to move closer to family. Allegedly she has schizoaffective disorder, but the psychiatric medications are only seroquel 100 mg po at hs, and depakote 500 mg. She attacked staff about a month ago, but now she is described as doing well.

Either she doesn't really have schizoaffective disorder, or she is a ticking time bomb. We declined the admission.

The care in many LTC facilities is haphazard, and slap-dash, to say the least, partly due to poor quantity of staff, but also due to poor quality.

But I am not going to change the world. This is their home, and I just work there.