title: Rapid change in status: the case of William.
abstract: In most geropsychiatric inpatient settings, the focus of care is reduction, management, or alleviation of psychiatric signs and symptoms through a combination of behavioral and pharmacologic interventions. However, unidentified or evolving medical conditions among frail older patients may precipitate rapid and unanticipated changes in status. The case of "William" illustrates how prompt adjustments in nursing care, collaboration within and between the geropsychiatric unit and other hospital services, and close working relationships with family may facilitate unexpected end-of-life decisions and promote quality of care.
authors.affiliation: John A. Hartford Center for Geriatric Nursing Excellence, University of Iowa College of Nursing, Iowa City, Iowa, USA. janet-specht@uiowa.edu
authors.forename: Janet
authors.initials: J
authors.lastname: Specht
authors.forename: Cheryl
authors.initials: C
authors.lastname: Puntil
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000451:nursing*; D015897:Comorbidity; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D016330:Frail Elderly; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000458:organization & administration*; D005852:Geriatric Psychiatry / Q000458:organization & administration*; D006331:Heart Diseases / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D009730:Nursing Assessment; D009733:Nursing Diagnosis; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning; D011568:Psychiatric Nursing / Q000458:organization & administration*; D013727:Terminal Care / Q000458:organization & administration