A sixty-eight (68) year old female patient with a previous medical history of dementia and cataracts presents to the emergency room with a syncopal episode as her chief complaint. As part of the workup, per policy, a Human Immunodeficiency Virus (HIV) rapid antigen/antibody test was administered. After receiving a positive test result, a discussion between the residents and attendings began regarding the patients safety, as HIV positive tests among patients with dementia can be indicators of elder abuse. Further detailed history was taken, showing a past Hepatitis C positive test and a remote history of illicit intravenous (IV) drug use in the 1980s and 1990s. This, coupled with the patients high level of comfort around the daughter, as well as the patients lack of bruising and low CD4+ count, resulted in the conclusion that her new positive test was most likely due to an older infection from remote illicit IV drug use. Due to this evidence, it was deemed that she was safe to return home and begin treatment for her newly diagnosed conditions with highly active antiretroviral therapy (HAART). The care team ensured that the patient was referred to an HIV clinic near where she lived and that the daughter was properly informed of all necessary actions needed for her mothers continued care.
Key words: Ethics, Dementia, HAART, HIV, Adult Protective Services, Legal, Screening, Confirmative
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