confused patient Flashcards
You are the SHO covering the Care of the Elderly and Stroke Wards overnight. You are contacted by one of the nurses asking you to come and see Mr Jones who is trying to leave the ward. He is a 92 year old man, admitted following a fall. He subsequently developed hospital acquired pneumonia and is on IV antibiotics. The patient has also been refusing food and is receiving IV fluids. On arrival to the ward you find Mr Jones in an argument with the nursing staff. He is trying to leave the ward and shouting that he doesn’t want to be kept in prison. He is trying to get through a door that a nurse is holding shut. He has a background of dementia, heart failure and COPD.
rying to calm the situation. Nothing will be solved in the corridor with the patient agitated and upset.
If he agrees to this then I would ask one of the nursing staff who he knows to accompany us
seek information, trying to establish what is wrong with the patient and why he is upset.
I need to make an assessment on whether the patient has capacity.
and are there any simple measures you can do to help it?
Having pictures or clothes that the patient recognises as their own may make them feel they are in familiar surroundings.
Taking the patient out of a busy ward and giving them a side room may help.
Having the same nurses look after the patient will help them to recognise where they are and feel more comfortable.
giving them their visual or hearing aids
reassuring them constantly
what do you understand by capacity ?
ability to make decision by themselves
2005 Mental Capacity Act states that every adult has the right to make his or her own decisions and to be assumed to have capacity until proven otherwise
You determine that the patient does not have capacity. The patient is still trying to leave the ward. What could you do next?
I have a duty of care to the patient and need to work in his best interest. In this instance that means stopping the patient from leaving the ward as leaving would likely put him at harm.
As the on-call doctor I can sign an emergency DOLs which is valid for seventy two hours. The paperwork must be signed and sent to the Trust Safeguarding Team who will then review and authorise the standard DOLs.
How do we safeguard patients who are deprived of their liberty?
