A carer at an Edinburgh residential home who hit a 79-year-old dementia patient on the head has been jailed for four months.
The city's sheriff court heard that Valerie Stone, 49, also lost control on a separate occasion and shouted aggressively at the patient, Roy Brown.
Sheriff Deidre MacNeill QC said: "I cannot get away from how serious this is."
But she added the sentence had been reduced to reflect Stone's guilty plea.
At an earlier hearing, fiscal depute Aidan Higgins told the court Stone, who is morbidly obese and has mobility problems, had "particular difficulties" with Mr Brown as well as struggling generally in her job at Bupa-run Braid Hills Nursing Centre.
Mr Higgins said Stone had hit Mr Brown as she and a colleague helped him to get out of bed one morning.
He said: "As they were trying to get him to his feet he seemed to fall forwards and seemed to lose control of himself and lose his balance.
"It would appear that the accused thought that he was lunging at her and it appears she thought she would get in first and she struck out and hit him forcefully on the head.
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"The colleague who was with her shouted in shock and said 'what on earth are you doing?' and 'that is completely out of order'.
The accused replied 'he was going to hit me first'."
The fiscal depute added that carers were expected to be able to cope with dementia patients, who could be unpredictable.
Mr Higgins also described how on another occasion Stone had been helping Mr Brown in his room when she became very angry.
"This was observed by a colleague and she seemed to lose control and started screaming and shouting at him," Mr Higgins said.
He added that management were not told about the offending behaviour until January this year.
He said that as soon as managers were informed Stone was suspended and police informed.
Stone admitted ill-treating or neglecting Mr Brown under the Mental Health (Care and Treatment) Act 2003.
The offence happened on two occasions between 1 July and 30 November 2009, at the Liberton Drive home.
Defence solicitor, Ross Gardner said: "She knows this has been seen as a serious matter.
"Although she was not defenceless, the patient was.
"The one saving grace is she is no longer employed and will never be employed again in that position.
"She is unlikely to work again given her health difficulties."
Mr Gardner added that the offence was a real "stain" on Stone's character and that community service was not an option due to her health.
A letter from Stone's doctor was previously read out in court which highlighted the high levels of stress she had suffered.
The letter said she had been given anti-depressants which had not helped and had also suffered from morbid obesity.