Ms. K is admitted to the hospital with injuries related to elder abuse and an exacerbation of her congestive heart failure. The trauma team treats her rib fractures and the orthopedic team splints her ulnar fracture. Her congestive heart failure exacerbation, likely because her family has not been giving her medications to her, is treated with nitroglycerin and furosemide. She is placed on security watch and her name is changed for her protection, as she reports she does not want to see family members, who have been “hurting her.”

On the second day of hospitalization, though not yet medically stable, she demands to be discharged back into the care of her abusive family. Her capacity to refuse further treatment and be discharged into an unsafe environment is assessed by psychiatry, and she is judged to not have the capacity to make this decision. As a result, the team explains that she is going to remain hospitalized until she is medically stable and a safe discharge plan can be established.