Mrs. R., a frail, 85 year old woman who lives alone, was admitted to a geri-psyc

Mrs. R., a frail, 85 year old woman who lives alone, was admitted to a geri-psychiatric unit because of irritability, confusion, and increasing incontinence. Mrs. R’s family stated she was continually refusing assistance from her home health aides and became angry when her family and home care nurses tried to reason with her about these refusals. During her hospital admission, Mrs. R. was hydrated with intravenous fluids adn a couple of her medications were adjusted. She subsequently became calm and cooperative with the care that she received while in the hospital. When the RN and social worker talked with Mrs. R. about the safety risks of her living alone, the patient stated, “I am 85 years old adn think that I should be able to decide how I want to live the rest of my life. I’m willing to take my chances. I will die if I go to a nursing home.” Mrs. R. was often unsure about the correct day of the week when questioned, yet she knew the name of the hospital and the reason that she was admitted for treatment. She was often confused about the names of hospital staff but was able to state her own name and the names of her children. Though Mrs. R. agreed to cooperate with the home care providers, her family continued to insist that Mrs.R. be admitted to a long-term care facility. Her family requested that the psychiatrist complete paperwork so that a judge could have the patient declared incompetent. The psychiatrist seemed willing to comply with the family’s wishes. The RN and social worker disagreed with the decision to declare Mrs. R. to be incompetent and were in favor of allowing her to return home as she wished.