Today's story comes from a rural nursing facility in Iowa
A 91-year-old patient with dementia with behavioral manifestations was sent to a psych hospital for control of his behavior.
He would get aggressive, hit people and throw things.
At the psych hospital he fell and broke his hip. He was then returned to the facility, agitated and disoriented.
The family was very involved, very upset about the dad’s fall and hip fracture and was sounding litigious. We were asked to see the patient and help control his behaviors, keeping the patient and the staff safe while communicating with the family.
Our NP saw the patient, received council from our gero-psych specialist and worked with the patient, facility and family several times a day and night. We were able to see and exam the patient several times a day, modified medication, reassured the staff that they were not alone and kept the family informed.
The patient was able to remain onsite and confidence was restored with the family. The attending was very pleased.
Oftentimes, the path of least resistance will keep patients like these in an endless and vicious cycle of rehospitalizations and decline. It takes time, resources and skill to properly care for these patients and Telehealth brings all of this right to the bedside in even the most rural nursing facility.