Abby advice on how to handle a patient that's exhibiting mental decline?
Yesterday I had a patient, who we've been seeing for years, scheduled for an appointment at 2:30. She's very flaky and often doesn't show up for treatment. At 2:40 she still wasn't here, so we sent an email that if she could be at the office by 3:15 we could still see her (we blocked a large chunk of time for RCT + crown). We hear nothing back. Suddenly she showed up at 4:30. We told her that we could no longer see her as we close at 5.
She says "well I thought you said you could see me if I got here by 3:15."
We told her "yes, but it's now 4:30 and we're getting ready to close."
She could not understand why we couldn't see her. Eventually she said okay and rescheduled. Then after we say goodbye, she opens the door to come to the back instead of leaving out the front. We try to explain that the exit is the other way (she's been to this office dozens of times) and she says "oh I know" and just stands there, clearly very confused. We get her back into the waiting area and then she sits down and just stares at her phone lock screen looking at the time (it's now 5:04) saying things like "but my clock says it's 5:04, so how am I late?". I was literally holding the door open saying "you have to leave, we're closed" to which she would respond "oh I understand, I'm just trying to understand the time". Finally we get her to leave the office, but rather than leave the building, she walks deeper into the office building despite everything being closed. We left, called the police and had them search the building to make sure she was gone. She was.
Now, the problem is, idk how to proceed with this woman. She's clearly not mentally well. She has no family in this state and her only family are her parents, one has dementia and the other isn't healthy (plus both are in their 80s). We don't know any friends of hers either. I obviously can't do treatment on someone like this, but she also has a lot of treatment that needs to get done, so I'm concerned about patient abandonment. More than anything I just don't know who to contact or what to do. Just a really weird situation all around. Any ideas?