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MIL has been in same NH facility for 8 years - dementia - ST memory issues. She is mobile with W.Chair - dresses self- uses bathroom etc. herself- wandered into another Residents room (2 doors down - on the same side of the hall) - Res. is 60 yrs. old - non-dementia - had a stroke and has one leg that drags slightly. Resident slapped MIL. NH called to let us know. 2-days later I Rec'd call from NH that they are "concerned for MIL life" and want to move her (MIL) to 3rd floor. I then discovered that MIL had wandered into room again - and afterwards -other Res. came into MIL room & was found by staff wrapping tape around my MIL head and that she had told staff that she was going to "strangled her". No Staff had called myself or husband regarding this latest issue when it happened - in fact 3 days elapsed before we were informed. Other Res. has a history of anger-mngt issues. Multiple staff shared that they feel she should move not my MIL. I had just visited with NH the week before regarding moving MIL into double-room and it was agreed that it was important for her to stay in the same area and same floor that she is familiar with. I am at NH almost daily for the past 8 years and volunteer at church on Sunday - so know most of staff and residents. NH refused to tell us how they are addressing the issue with other resident - it is like they want to move and change everything about my MIL surroundings up on a floor where the majority of residents are not mobile at all. MIL quality of life will be impacted greatly if she is taken from the area that she knows and being mobile - on 1st floor - she knows the people and the area. It is like they just want the "problem" to go away and the easiest for them is to place MIL in an area where she will have limited interaction with cognitively functioning residents. I have been told multiple times and personally been aware of residents that wander and this was not an issue before other resident became violent and and threatening. Nurse on duty the day of the "taping" incident has been taking time off for the past 2 weeks when she has been scheduled to work - Other staff said that is very unusual and it happened right after incident - therefore we have not been able to get any clarification on type of tape that was used - location of tape on MIL head - if she was attempting to place around mouth and nose, etc. What are our options other than moving MIL to high-care floor and changing her entire surroundings?

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It sounds as if the resident with the anger problem is the one who should be moved. Unless there's indication that she is particularly hostile to your mother and hasn't become aggressive with other residents, my query would be how many other residents have been accosted and what can be done for the aggressive woman?

I assume the incidents weren't reported to law enforcement, but I'm wondering if the local authorities have been involved with the aggressive woman in the past.
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This kind of reminds me of the response to bullying in school, push the focus away from the aggressor onto the victim. Violence in nursing homes between residents is a dirty little secret that happens all too often and is hushed up immediately. Unfortunately there is no good answer that I can give you, staff can't be everywhere and they can't restrain the ones who act out with violence. Ideally they would immediately be evaluated and place in a psychiatric facility to determine their needs and stabilize their behavior, but that doesn't happen for a myriad of reasons.
It may seem unfair that your mom has to pay the price and move to a safer areas, but safety trumps fair. A Canadian news program recently uncovered shocking cases of repeated beatings and even murder frail elders in care, look after her needs first and raise H&LL later.
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Cwillie's comments reminded me of an incident when I was hospitalized last year (not related to caregiving). A totally uncooperative, belligerent woman with dementia and delusions was moved in as a roommate. After raising h*ll with the staff by refusing to cooperate with anything (ordered 3 meals as I recall just for breakfast but refused to eat any of them and demanded something else), (yelled very loudly and told a staff member to get the hell out of her room), she eventually fell asleep.

During that time a nicely dressed man came in to interview her. He identified himself as a representative of a local facility with which I was unfamiliar. I asked if he was going to accept her and if so, how soon, as the quicker she was gone the better - she was totally disruptive.

He asked about her - I don't remember the exact term but he was attempting to determine if she was violent, hostile, combative, etc. I thought for a moment that it might be a privacy violation for him to ask or me to say anything but decided I had no obligation to her. So I told him of her behavior. He said their facility wouldn't take anyone who was physically belligerent.

So apparently there is a facility that doesn't take people who act out.

(Rest of the story - she was so disruptive, hostile, loud, pulling back the curtain to peek over at me, accusing my guests and me of talking so loudly she couldn't sleep, on and on..... that I threatened to leave AMA if either of us wasn't moved. I eventually was moved that night.)
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DG, when the NH said it is concerned for MIL's life, are they talking about the irate other resident or are they talking about MIL's increasing wandering behaviour?

I agree that at first sight it seems completely unfair that MIL is threatened by someone else yet it is proposed that MIL should move and not the other person. And I also agree that it is undesirable to change MIL's surroundings, because of the almost inevitable disorientation; and undesirable for her to move to a less stimulating environment.

However. If being on the first floor makes it more likely that she could leave the building, for example, or if the problem resident's reaction is at the extreme end of a catalogue of complaints the NH is getting from several residents, then it could be that her current setting within the NH is no longer suitable for her - could that be part of it?
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Interesting. So it sounds as if there's a schism in the staff's point of view, too. I wonder if it could be finance-related… But there's no call for cynicism. And the interloper arrived only recently, is that right?

I should stand your ground, then, ideally aiming for the other person to be relocated. It's not going to be a problem, is it though, if they meet in communal areas, with other people about?

I'm sorry for this trouble she's having, and for your worry about it. I remember a brief (thank goodness) phase when my great aunt confided in me about a horrible member of staff and how helpless I felt leaving her behind at the mercy of this woman (she was disgusting rather than threatening, but even so). How is your MIL now? Hope she's not still upset.
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Sorry, one other thing - I'd also make sure that nobody, in trying to make sure that MIL doesn't mistake her door again, accidentally conveys the message to her that her innocent mistake was the cause of the problem. It is important to make her room easily recognisable to her, but equally important for her to have the assurance that she's safe in her home no matter what. Poor love, she must be a bundle of nerves.
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I found out that they have both my MIL & the other Res. on 15 minute checks - I know that they have "talked" to the other Res. but they would not say how they were "dealing" with her. After I talked to the chaplain, he said he was going to talk to the other Res. but said he knew it was probably only a "band-aid". My MIL due to ST memory passes her in the hallway (I have been with her at times when this happens) but doesn't seem to notice her. Staff has told me that my MIL seems to be more anxious and tries to say something to them, but that she is not able to find the words. Before I knew about the "tape" situation, my MIL was trying to say something about someone in her room, and not able to come up with the words that made any sense, and then ended it with "and that's how that went". It only made sense once I found out about it. The nurse that was on duty when this incidence occurred is suppose to be there today, so I will get more details before we decide if we should involve law enforcement.
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Ooh dear, I don't like the sound of that. If MIL is making substantial efforts to relate the incident it must really have frightened her. I think I'd be asking the Manager for a sensible and coherent plan, preferably in writing, about how they mean to deal conclusively with the situation.
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Yes there is a large sign in red block letters located on her door frame with her name on it - I also placed a wedding Pic or her and my FIL with a magnetic frame on the door below her name and showed her the Pic - my husband is out of town until tomorrow and I will share with him the info that I found out today - I was able to talk to the nurse who informed me she didn't witness the occurrence - but rather to NA - she did state that it was white medical tape that the other resident was caught and stopped placing around my MIL head - Also stated the other resident when caught and stopped said, She makes me so mad, I want to kill her. There has not been anymore incidence at this time. As I said they are both on 15 minute checks. But I believe we have a right to know what steps they are taking to address the anger with the other resident. Also severe flu outbreak and quarantine on the other floors this week.- so there is no way I would put my MIL there either right now. They have started giving my MIL Ativan - low dose to decrease her anxiety that she now is having since the assaults. :-(
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Separate the combatants, first and foremost. Get your mother to a safer place where she cannot wander into other rooms. When you go in the wrong room, the other person has a right to self-defense. If they hit you, it is self-defense if you are in their space.
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