Altered Mental Status: A Case Study

Teaching and learning the mental state examination (MSE) to post-graduate nursing student or professional to improve skills and knowledge to document findings during assessment of the patient/client, and would improve the quality of documentation of patient's mental states.

CCIB received SOC 341 reporting that during a meeting with the resident, James Brown (DOB: 09/18/84), social worker from Solano Adult Day Healthcare Center, the resident stated that staff Marco has hit him on multiple occasions. The resident kept repeating that he did not want to return to the facility. RP consulted with resident's previous social worker who affirmed that the resident has a history of making allegations that are not true due. Resident also has a history of Schizophrenia/Delusions. Facility staff stated that the resident has a history of making allegations whenever he is assigned a new social

Reporting party (RP) called CCIB to cross report that resident Gerald Gilliland (DOB: 4/22/41) reported that while he resided at this facility, unknown male staff locked him in a room against his will. It is unclear what room the resident was locked in because resident was unable to convey any details about the room. Resident then stated that it was all of the nursing staff who locked him in the room. Resident was hospitalized at Kaiser South Sacramento on 9/18/16 through 9/22/16 and is currently residing at Eskaton Greenhaven. RP stated that it is unclear if the resident has Alzheimer's or not. RP stated that the original reporting party is Sacramento Sheriff's Department (Report#16-286176) and RP will forward the SOC 341 to CCIB.

While on patrol, I was dispatched to Mental Health clinic to meet with MSA Vanessa Reyna. Upon arrival I met up with OFC Figueroa and Reyna and was taken to room 2B108. We were in informed that Veteran Travis Leonard was involved in attraction with his spouse Tracy Leonard, which turned physical when he choked her. I asked the staff if he was under the influence of alcohol or narcotics and was told he use Marijuana two weeks ago. At 1245hrs, I notified Bastrop County Sherriff Dispatcher – 7015, and requested they send deputies to 197 Marlin St, Mcade, TX 78650 for a family violence in progress. Dispatcher gave me the Case Sheet Number of 17020877

The main purpose of the ensuing evaluation is to determine if Ms. Tyler is competent to stand trial for accused crimes, and needs to be evaluated for criminal responsibility. She exhibits signs of mental illness; further investigation via a mental status assessment is required.

Reporting party (RP) stated that when resident Nancy Leonard (DOB: 1/14/26) moved in the facility on 7/28/14. Resident's husband, Dick Leonard, was told that the facility that the facility was in the process of "deep cleaning" and that the facility would possibly be fumigated. Facility accepted resident and placed her clothing in a bag and sealed it. RP stated that the facility had an outbreak of scabies. Resident was visited by her primary care physician, Dr. Rudich, who prescribed cream for the resident. RP stated that the facility failed to quarantine the residents and allowed visitors to enter the facility. RP stated that the family was not notified that there was an outbreak of scabies. RP stated that the facility had another outbreak

The reporting party (RP) stated his wife Charlene Anderson has residing in the facility for 7 months. Charlene has been assigned to the "memory unit" and suffers from partial blindness. The RP stated he received a phone message from Charlene stating 'urgent, urgent." When the RP returned Charlene's call she disclosed she was in serious pain due to her arm being twisted by staff member Sara Duarte during the night shift. According to Charlene the staff member became angry and twisted her arm for not moving quickly while preparing for her shower. The RP notified the Simi Valley Police and immediately drove to the facility. When the RP arrived to the facility he observed Officer Eric Owen talking with Charlene. Charlene reported her arm and shoulder

The reporting party (RP) stated on Friday October 4 the director Sandra Carroll was observed pulling 17 year old Andrea out of the bathroom by her hair. Later the same day the director slapped Andrea so hard that she fell to the floor. The RP stated after a few hours Andrea began to have seizures. According to the RP Sandra was observed slapping and yelling at resident Brianna. The RP stated when the director is having a bad day or not getting along with her husband she takes it out on the children and the staff persons. The RP stated child Andrea has flea bites to her body (parts not mentioned) and that fleas were observed in the facility. The RP stated the administrator displays her frustrations by hitting and yelling at 12 year old Jacob.

Reporting party (RP) states that her mother is a 95 year old resident (identifying information not provided) who has purchased a life-time contract over 15 years ago. The resident is currently residing in the newly added memory unit known as Maggie's Place. RP is the residents POA and stated that for the last year (especially the last 4 months) the facility has ignored her requests to be notified of medical appointments, medical information such as resident's medications and any changes to her health condition. RP often receives calls at odd times informing her of unexplained bruising or falls that occurred days prior with no explanation; she was assured that the nurse would contact her but she is never contacted. Over the past 2 months,

The applicant requests an upgrade of his general, under honorable conditions discharge to honorable and a change to the narrative reason for his discharge. The applicant states, in effect, he has submitted two requests to have his discharge upgraded. The applicant contends, unfortunately, his requests were denied on both occasions. The applicant further contends, he has been receiving disability compensation for multiple disabilities. The applicant states, he has an anxiety disorder that is associated with Post Traumatic Stress Disorder (PTSD). The applicant further states that on September 3, 2014, the Secretary of Defense issued a memorandum to the Boards for Correction of Military/Naval Record (BCM/NR). To carefully consider each and

The report of the grand jury in Dade County, Florida had several recommendations for dealing with the mentally ill who find themselves incarcerated. What this jury concluded was that far too much tax dollars is being spent on trying to temporarily control the issues associated with the mentally ill and too much focus is on reacting to crisis care. This panel of jurors believes that shifting the focus to long-term care would not only save costs, but also prevent the predicament we face by incarcerating the mentally ill.

RP stated that his mother has resided at this facility since 2015. RP stated that since the facility has changed ownership (end of 2016-beginning of 2017), the services are not being provided to the residents. RP also stated that there has been a shortage of staff which has affected the care of the residents. RP stated that he visited his mother on 4/24/16 and noticed that her teeth were not brushed. RP also stated that the facility has hired an outside agency to provide the care giving for the residents. RP stated that the employees of this agency are unaware of the resident care plan. It was reported to the RP by his mother's roommate's daughter, Mindy Kaplin, that on one occasion, she found his mother in the closet scared and crying. Mindy

The claimant denied previous hospitalizations for psychiatric reasons. Her mother reported that claimant has received outpatient mental health treatments in Armenia. Claimant’s mother denied receiving current mental health services and denies past and current suicidal or homicidal ideation, attempt and plan.

Reporting party (RP) stated that he has resided in the facility for 1 month. RP stated that the residents at this facility are predominately gay, lesbian or transgender. RP stated that he has had some incidents with the facility manager, Shelley who he described as "Mexican, Lesbian and a Deisle Dike." RP stated that Shelley shows favoritism to the gay residents and speaks down to him (Shelley orders him arround and gives him commands rather than ask him). RP mentioned an insident where the facility called law enforcement (LE) and was placed on a 5150 hold. RP was taken to St. Mary's where he was released back to the facility. When RP attempted to return to the faciity, the facility refused to let him back in. RP contacted LE who confirmed

Two of the possible diagnoses for Ruth are generalised anxiety disorder and major depressive disorder which is also known as dysthymia.