Heather Schuler took care of a patient with admitting diagnosis: altered mental status, UTI, dehydration, mental status change, DM, HTN. Patient had a history of acute ischemic stroke and chronic CVD and had right-sided weakness and aphasia, making speech and communication with patient difficult.

Heather was able to observe and communicate with patient who was agitated and kept thrusting her fist. Heather used clinical skills and learned that patient was being hit at home. Heather contacted Care Management to assist with assessing patient's complaint. Physician was notified due to pending discharge.

A family meeting was held with Case Management and the adult abuse division of Department of Health and Senior Services (DHSS) was called, with family and patient aware of the call. Family discussed the situation and said they had suspected abuse and noticed their "loved one" pounding fists.

Patient was discharged home with family and the knowledge that DHSS will be in the home for investigation and assistance.

Heather's exceptional service and commitment to excellence in delivering compassionate care resulted in this patient with communication challenges receiving needed follow up in the community.