Abstract
Psychiatric disorders are common in long-term care residents. In the elderly, these disorders are often attributed to conditions associated with aging, such as Alzheimer's disease, dementia, and other cognitive impairments. Rarely, the psychiatric disorder may be an underlying condition that manifested much earlier in life. Management of such cases may be more challenging, especially when it involves an individual who exhibits aggressive and immoral behaviors. While such cases are uncommon, they may be encountered more frequently as the number of individuals requiring dependent care services continues to grow. The authors report the case of an elderly man with a personality disorder and aggressive drug-seeking behavior. The patient was admitted to a nursing home for care, where he abused staff and made threats in attempts to gain access to opioids. The authors discuss the obstacles and ethical dilemmas that surround the care of such individuals, including in dependent care settings.