Monday, July 22, 2019


I'm sitting in my office with an elderly lady with Alzheimer's disease and her devoted son.

Dr. Grumpy: "So how's she been doing?"

Mr. Son: "Better, at least a little. I mean, her memory is still pretty bad, but she's calmer, and the nurses tell me she's more cooperative and isn't yelling since you started the new medication."

Dr. Grumpy: "Has she..."

Mr. Son's phone rings and he looks at it.

Mr. Son: "I better answer this, it's Casa DeMentia, her memory-care place. I'll put it on speaker phone in case you want to ask them anything... Hello? This is Mr. Son."

Susan: "Mr. Son, this is Susan. I'm the charge nurse at Casa DeMentia. I'm calling to let you know that your mother isn't in her room, and we've searched the building and grounds thoroughly and can't find her. We're afraid she somehow wandered off..."

Mr. Son and I both look at the patient, who's calmly sitting in my office leafing through an upside-down magazine.

Susan: "... so our security people are going to review video to see what happened, but I wanted to make you aware. I'm going to call the Grumpyville police for a Silver Alert, too, and..."

Mr. Son: "Um, my Mom is right here with me. We're at Dr. Grumpy's office. I signed her out at the front desk when I picked her up."


Susan: "Cindy, before you told me Mrs. Memory was missing, didn't you check the sign-out book first... WHY THE HELL NOT? You (expletive)."


Susan: "I'm so sorry to bother you Mr. Son. Will she be back for lunch?"


jimbo26 said...

Ummmmmm , yup , ..........................

Reds Kevin said...

Cindy will not be back for lunch, because, Cindy has been suspended from work.

Anonymous said...

The dementia camp is really on top of things! Welcome back doc. Hope you had a great vacation with the tribe.

Mad Jack said...


That's priceless.

bobbie said...

Time for a new place???

Welcome back, Dr. G ~ can't wait to hear about your vacation adventures!

clairesmum said...

Case dementia gets points for noticing that the pt was not present in the facility or on the grounds and TAKING ACTION - that is better than many places, to be honest. Even 'secure" (locked) units in assisted living facilities lose patients and don't realize they are missing until mealtime or bedtime.
OR when the local police department returns the resident to them.
Also in large ALF with locked unit - nurse manager informed me pt was not back from trip to ER that they had sent her on (even though she is on hospice care, and they didn't call hospice team). Family had informed hospice team when pt was back at facility ( 18 hours earlier). Presumably the actual staff on the locked unit knew that the patient returned a few hours after departure.
And families are not always careful about signing residents in and out, so sometimes they are with family who just 'forgot' the logbook.

Ms. Donna said...

First, welcome back.

Second, has something like this when Mom was in a rehab facility. (Nurse tied up with difficult pt, told two aides, and signed her out in front) Maybe I am weird or missing something, but I was glad they were counting noses and had plan in place.

Shash said...

Some of these facilities have scary staffing; luckily others are fantastic. I don't think Cindy will forget her error any time soon though. Is it to early to ask for a raise? ;)

Moose said...

Welcome home, Grumpy Family.

I'm with ClairsMum. I'd rather the place be over cautious (and informative) than not giving a flying fudge.

It's really, really hard to find a good Alzheimer's care site, unless you have lots and lots of money. :/

Anonymous said...

I have to say that as a daughter, I'd be unhappy that the manager cursed her staff member in that situation. Be frustrated, revisit the process, etc.--that's all ok. But to lose your temper enough to start cursing the person directly, in front of others... it would make me wonder what goes on when patients are being frustrating. And it's not as if the charge nurse couldn't have checked the book herself or asked if Cindy had checked the book before she picked up the phone.

I actually think that the charge nurse was more in the wrong than Cindy. Cindy spotted a potential problem and alerted her superior. You want the people in her role to do that. The charge nurse is the one who didn't do a double-check and is also the one who became really unprofessional and abusive.

Anonymous said...

Oh, anonymous at 10:27 -- the staff member deserved a curse word. And i expect the charge person can still be nice to residents, and pi$$ed off at her staff at the same time.

Packer said...

She didn’t check the sign out book because she forgot, of course

It happens

Brian said...

Welcome back!

The facility where my father in law was in residence once got a call from a person in the village about a half mile from their facility. Seems my father in law had wandered off, took a stroll down a busy state road and was chatting up some poor guy out doing yard work. That person kept my FIL entertained while his wife called the local facility and let them know they had a rogue resident.

Wasn't long after that we had to place him in a much more secure facility. It's an absolute horrible way to spend the last years of ones life.

Mountain Woman said...

My friend Emily's mom was in a secure facility in their small town. Emily got a panicked call from her brother. He saw their mom walking down the street and realized she had escaped. He was frantic because he assumed the facility called Emily, and thought she'd be frantic. Nope. The facility found out mom was missing when they brought her back.

Anonymous said...

This happened quite a few years ago. My sister in law was an accountant for an assisted living facility. She was on her way home one afternoon when she spotted a resident walking on the shoulder of the freeway. She was able to stop and talk him into getting in her car where she then took him back. They didn't even know he was missing yet.

Anonymous said...

Ah. Welcome back Dr G (and clan). I'm with Claire's Mum and Moose on this. At least the facility acted, whether from panic or over-zealous 'in-charge', I'm not sure. But, I do think the charge nurse could've been a little more restrained (though maybe perhaps less honest in her response) with her style of interpersonal communication. I'm not a snowflake, or whatever that means, but as I've been in healthcare for more years than I care to count (more than 40 to be sure), one of the features us underlings rather expect from our bosses is 1. care for the patients, 2. intellectual capacity, 3. some degree of calmness under pressure, and perhaps this comes from 'experience' or faith in the divine mixed with experience, but notice it's number 3 on the list.

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