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November 7th of 2018 my dad was walking, talking, eating, and calm. He was put into a nursing home and a week later he hit a resident and was sent to a geriatric psych ward where he was almost killed and had kidney failure due to overprescribing psychiatric meds. This has been my nightmare the past two months. He has bounced back from the brink of death and can talk and somewhat eat and drink. However he needs to be diapered now, hand fed and is aggressive. He was in the hospital for a month and a half recovering. He was discharged and taken to a new nursing home. He was there twenty minutes, allegedly hit and strangled someone and was sent to the ER. Now he has been black balled from nursing homes in two counties as well as a geriatric psych ward. I am at a loss about what to do. I thought about bringing him home but I will lose my life and I don't know if I can handle his aggression. He is supposed to be discharged from the hospital tomorrow and currently they have nowhere for him to go. What do you do when things become this desperate? Any advice or experiences? I am at a complete loss and am losing my own sanity.

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You REFUSE to bring him home. Don't let them guilt you into it. Force their hand to find him appropriate residence. All you need to tell them is that he needs more care than you can provide.
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Reply to gladimhere
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The hospital must discharge your father into a safe situation and adequate care. Refuse to accept a discharge to your care and let the hospital social worker find a new situation for him.

If you haven't already, I would get all the records from that first week in the NH and see if there were any changes to your father's medications. Occasionally an elder will have a bad reaction to a medication and with your father's kidney problems he might have a bad reaction to even changing the dosage of something he has been taking for years. If that has persisted, it may still be driving his behavior problems. Consider changes in soaps and lotions too - many have aloe and other additives that can enter a person's system through the skin.

On the other hand, dementia is a disease of unpredictability. Your father's reaction may have just been the dementia combined with someone who didn't have enough training to handle dementia behaviors. My father with vascular dementia is in MC and occasionally has "fits" (1-2 a year) where he cusses and throws things to the floor. The staff rotates someone else to care for him and lets him complain to them in his room until he calms down. It seems diminished personal attention when my brother cannot make his daily visits for several days is the cause so now others visit more on those days or we arrange a companion for a few hours each day. As bad as it looks/feels now, you and the right care professionals can come up with a workable solution - just don't let the system try to dump it all on you.
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I so wish that when people start a
post - and several people take the time and effort to answer and provide suggestions - that the OP would return to say how things worked out.

Given the timeline stated in the original post - whatever happened - happened. Posting the outcome could provide help, insight and information to many others in similar circumstances.

Okay - that rant finished and on to the next. And actually, this is one of my top three complaints about “the system”...

”All you need to tell them is ...”.

Absolutly not directed and the individual that made this statement. It was in regard to refusing to take a compromised loved one - in the middle of a crisis - home from the hospital.

Easier said than done. Especially, if one is a Newbie and at their first rodeo.

How I wish there was some law against hospital workers pressuring people into taking home individuals who clearly need more help than they can or are receiving at home.

It it has been my experience that hospital social workers will outright lie in telling you - you have no option but to take the individual home. That - or they will apply so much pressure- so much guilt that you are made to feel like an unloving, uncaring failure of a human being - unless you buck up and bring the car around.

I honestly don’t know what the answer is - but there oughta be a law! AND hospitals should be held accountable.
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Isthisrealyreal Jan 21, 2019
Well said rainmom
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You refuse to take him home. The hospital will need to work on a safe release somewhere - and your home is not safe. Stand firm on this. They will have to get him somewhere that he can be helped. Good luck
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Ombudsman1 Jan 22, 2019
Very true! However, the nursing home willing to admit dad may be VERY far away and may be one that has a low census (due to poor performance) and just wants a "head in the bed." Whatever nursing home he goes to needs to focus on person-centered care and getting at the root cause of his aggression by looking at any triggers. The local long-term care ombudsman may be helpful.
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Kidney failure.. that means medications build up in his system and do not process normally thru his kidneys. Dilerium! A friend appeared as dementia for a year and a half and was placed in a nursing home before the meds ‘left’ his system. Over medicating? Wrong medications? Not a quick fix with someone whose kidneys don’t work and they keep giving calming drugs. And drugs that need the kidneys to break down. Get Dr to reevaluate and blood screen. Is he on dialysis?
Do not take him home. Elder Law Attorney.
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NeedHelpWithMom Mar 14, 2019
Best answer yet!
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I see from your profile that your father is only 70. I'm so sorry that he and you are going through this.

I'm chiming in strongly with the "do not get emotionally blackmailed into accepting a discharge home" vote. You are correct in thinking that you cannot possibly handle the behavioural challenges - it would be dangerous for both of you, as well as devastating for you personally.

I also strongly second the suggestion that you look specifically for dementia care units; but I assume you've already tried this to some extent. You may have to go further afield: what research have you done so far?
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Reply to Countrymouse
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Take a deep breath and know this too shall pass. Look into good memory care facilities. They may be better trained to deal with Dementia patients than just a nursing home. Look for places with all the employees being trained for memory care.
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Reply to MrSparks
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My husband went through the same thing with the medications causing him to quickly decline and become more aggressive and agitated, more often. For one year, he went through three nursing homes and six long-term psychiatric stays in four hospitals. He spent as little as two nights at one nursing home, a week at another and the longest stay was for three weeks. After sending him to the emergency room for medication evaluation, the nursing homes would not take him back. Also some of the hospitals would not let him return either. Talk about being blackballed. However, being a veteran, he was finally accepted at a long-term VA care facility for dementia patients and has been there six months now. That has been such a blessing. We found out much of the medication has a paradoxical (opposite) effect on my husband so that has been a big part of the problem. He still gets agitated and aggressive at times but they seem willing to provide the care he so desperately needs.
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Reply to JoyHill
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You put him in a nursing home. That's the problem. Nursing homes kill people. They just do it slower than Dr. Kevorkian. But nursing homes will kick them out if their behavior is not under control. Consider hospice..they will keep him drugged up and in bed until he's dead. I'm not trying to sound sarcastic and I apologize if I come across that way--but what I'm saying is the blunt truth. Institutionalized care really is horrible.
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Grandma1954 Jan 21, 2019
Hospice will NOT, I repeat NOT keep a person drugged up until they are dead!
An evaluation must be made to admit a person to hospice and Hospice will follow all protocol spelled out by Medicare.
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Your Dad needs to be properly diagnosed then he needs to be properly medicated.
If your Dad has Parkinson's medicating someone with Parkinson's can be very tricky. Many medications normally used for agitation can kill a person with Parkinson's. So finding the right doctor is extremely important.

Is your Dad a Veteran? The VA can help a lot they have trained people that can deal with PTSD (aka PTSS post traumatic stress syndrome)

Your Dad is not the only person in the USA that has a problem and he can be helped. It may take a while to find the correct medication, the correct dose but it is possible. Look for a good neurologist and if possible a neuro-psychologist.
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