Caring for a Resident With Serious Mental Illness

Mrs. R is an 89-year-old resident with a history of schizophrenia, insulin-dependent diabetes, hypertension, osteoarthritis, osteopenia, vascular dementia, and iron deficiency anemia (underlying cause unknown). She had a hip fracture two years ago and has had a right total hip replacement. She moved into the nursing home after an acute hospital admission for increased confusion and delusional ideation with distorted body image. She believes that her feet and legs are absent and that she cannot walk.