Assisted Living Resident Assessment: Fill & Download for Free

“Excuse me Nurse, can you please dispense those pills from your p**sy.”The patient in question was one that we were attempting to find better placement. He was 30 years old and relatively healthy except for his mental illnesses and this was at a rehabilitation facility where long term residents tended to be older and/ or more disabled. We were worried for the staff and the patients because he could become violent at the drop of a hat.He didn’t require staff assistance for anything except for medication administration and he frequently harassed the staff. Especially if the staff member was a young Caucasian woman with blonde hair. The nurse that he said this to fit his criteria and happened to be one of my best friends.She was doing her medication administration rounds while I was walking through her hall assessing a patient and thankfully I was standing there when he said it. It wasn’t funny really but so unexpected that we both stopped what we were doing, looked at each other and burst at laughing.Afterward she sat in on his care planning meeting and tried to help myself and the social worker convince him that he needed to move to an assisted living facility or even to his own home. He was not interested and kept asking us what we expected him to do, “What am I supposed to leave here, live on my own, marry a pretty girl and live happily ever after in a house with a white picket fence?” He’d ask followed by threats to write our names in his suicide letter when he jumped off of the bridge because we kicked him out.He was baker acted a time or two and the last time he was baker acted for good after punching a hole in the wall. So not my funniest story as a nurse but definitely one where I was so shocked I burst out laughing.Another time was when one of my favorite Alzheimer’s patients asked me to squirt milk out of my breasts into a cup for him. He was harmless and never failed to say something offensive that made me laugh.If you want to be a nurse you need common sense, thick skin, and a sense of humor.

Yes. And she was dead 24 hours later.I was caring for an elderly woman who had taken a few spills at her assisted living home that resulted in a fracture. She came to us for rehabilitation with the plan of being discharged back to assisted living. Her stay was only expected to be 3–4 weeks. She was very hard of hearing but one of the sweetest ladies I ever had the pleasure of caring for. Her family was equally as kind.During her third week with us, she developed a cough. The cough quickly turned into general malaise with an added low-grade fever and her lung sounds were junky. She was so tired, started having setbacks in therapy, and was sleeping a lot. This was Wednesday, my “Monday,” and my spidey-senses were tingling. I was suspecting early sepsis, based solely off the mild fever and how she “looked.” I had a gut for sepsis. I contacted our NP early in the shift and let her know I was concerned. She disagreed with my sepsis theory and suggested possible pneumonia, so off to outpatient x-ray, it was. I arranged the appointment and transport, all while thinking pneumonia could lead to sepsis but at least an x-ray will show something.Her daughter was in town and accompanied her to the appointment, but she had to catch a flight later that afternoon so I knew it would be a quick turnaround. When they returned to the facility, I could tell my resident was exhausted. The appointment had taken everything she had. My wonderful aides got her comfortable in bed, I had a chat with the daughter about how the x-ray had gone, and shortly after she headed for the airport. I remember standing at the med cart talking to her as she teared up telling me how guilty she felt for having to leave. I touched her hand and smiled softly as I told her that her mother was in good hands and it was going to be okay. I told her to fly home and see her family and to call me when she got there. I’ll never forget that conversation.My resident showed no real change through the rest of my shift - no improvements but no worsening either.Wednesday night. Thursday morning. The second day in my three-day rotation.0630. I came in and received report. My sweet lady friend had experienced some drops in her oxygen saturation - a sign for both pneumonia and for sepsis, go figure - and the night nurse had put her on some supplemental oxygen. Otherwise, the night was uneventful. My CNAs obtained morning vitals and all seemed within normal limits, accounting for the 1.5L O2 of course, and I got started on my morning med pass. I talked to the NP and gave her an update. No imaging results yet. Breakfast comes and my aides pass out trays and get folks set up to eat their meals.This resident had a neighbor in a semi-private room who had a very strict preference on when she wanted her meds. 0900 and not a moment sooner or later. You’d hear about it. And that day I was late. I talked her off the ledge, got a smile as she took her pills, and stepped out into the shared entrance. I peeked over into my resident's room and could see her sitting upright in bed with her breakfast in front of her, working on oatmeal and coffee. “She looks miserable,” I thought to myself. She would be next on my list for meds.She only took a few pills, which was impressive for someone of her age, so she was a quick pull. It was probably no more than 10 minutes between leaving her roommate and reentering her room. I stopped at the doorway like usual, knocked loudly, and said “Good morning!”No response.My stomach dropped.I knocked again, harder, and said “Good morning” again. Louder.No response.“Fuck.” And I knew.I walked over to her bed, touched her shoulder and gently shook it. I said her name. But I knew. I set her pills down and checked for a pulse. When I felt none I started my pronouncing assessment. No heart tones. No lung sounds. Pupils fixed. Coffee cup in hand.I tried for two hours to get ahold of her adult children. And one by one they all called me back. And one by one I had to tell them their mother had very unexpectedly and very peacefully passed away. The last one was the daughter I’d comforted the day before. I’ve made those calls before, and since, but none like that one.When I sent out a facility notification of her expiration the NP called me and said, “What happened?!” Later that day she said, “I guess you were right.” I’d never wanted to not be told I was right so badly in my nursing career.I cried the whole way home and didn’t eat for a day after that. It tore me up for a couple of weeks.

The two dozen or so I have visited, multi level homes, (independent& assisted living, or skilled nursing), most all had some sort of Internet access. None were very current machines or much assess. A fee browsers, AOL. One or two even had classes, but most rooms laid idle.