The 90-year-old patient suffering with post traumatic stress disorder has been a patient at Beacham Ambulatory Care Centre since 2000. She further had other chronic conditions including urinary incontinence, osteoarthritis and pernicious anemia. She was fully independent and also took care of her homebound husband who had severe COPD. The two lived in a room “close to the hospital” for ensuring that her husband had convenient access to house calls.
However, unfortunately, her husband died of a respiratory arrest in the year 2000. In October 2002, her home was broken into, robbed and the patient was raped. She was taken to a local hospital that specialized in rape, she was reported to be emotionally distraught, delusional and distressed.
The patient was seen in a community nursing home about 3 weeks after the rape. She was moved there after staying 4 days at the hospital. After 2 months, the patient showed improvement and was transferred to a senior living building in eastern Baltimore County.
The patient was still very emotionally ill even after almost a year
She was emotionally ill, stressed about her new home, depressed and crying. She wanted to move to a new facility because it was on the bus route so it would make it easier for her to get around. She also hired a middle aged woman as a caregiver.
9 months after moving to a new facility, the patient became acutely ill and started showing severe paranoia and psychotic symptoms. She would hallucinate that men and women are in her bed and called for help at all hours of the day. She was hospitalised in a psychiatric unit and showed improvement in about 14 days without antipsychotic medication.
However, a week after she was discharged from the hospital and returned to the senior apartment, her symptoms rapidly recurred. She showed signs of disruption and also threatened with eviction unless something was done right away. She was diagnosed with post traumatic stress disorder.
The patient refused medical care, for which an emergency petition was prepared. With help from her companion, the doctors were able to convince her into taking neuroleptic drug for her recurrent incapacitating hallucinations.
She slowly showed improvement and stabilized.
Reference
Tatara, Toshio and Lisa Kuzmeskus. Summaries of Statistical Data on Elder Abuse in Domestic Settings for FY 95 and FY96. (Washington, DC: National Center on Elder Abuse, 1997)
