Dad in AL memory care is getting nasty. Any advice?

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Dad, 95 with Dementia is in AL Memory Care. 3 months now and he's been a pleasure they tell me. Until recently. He also has 70 to 90% blockage of the right carotid artery. Anyway, he walks around the facility constantly. No problems until recently. He screams at other patients who also walk. Lately he's put his fist up to another man's face. To me that is totally unacceptable. First time I saw him raise his voice, I told him that was being rude and we are not rude people! Now the AL is testing him for a UTI. They tell me that it's very common and will lead to aggression. I'm not sure if it's that or progression of Dementia. I am not against a mild tranquilizer if needed. Of course I'm hoping it's a UTI. His unit is small, only about 20 people and only he and 3 others walk unassisted. Anyone else encountered this with their loved one? Am I wrong to suggest medication?

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we often forget no matter what the diagnosis is other problems will plague the patient. people require observation when they cannot say what is wrong think of how you would act if you were ill and could not tell someone. keep doing right hugs and love.
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Checking for a UTI is very wise, since that often is the cause of such behavior. If a UTI isn't the cause, the right medication is justified to keep your father more peaceful and out of "psychic pain" as it has been said. He doesn't need to be suffering from this kind of distress when something can be done about it and he can also not be a potential threat to others. A geriatric psychiatrist is best, I agree.
Treating our elder patients is different than younger adults in many ways. With the right care for this problem, your Dad can be back to walking around and about as friendly as before. But we do have to recognize that dementia isn't static and will continue to go through stages of change. You sound like you're doing a good job of caring for your Dad and his changing needs.
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no one is in a good mood when they have a uti so how can a person who cannot understand why he is uncomfortable be. maybe the walking is a way of handling this sitting maybe uncomfortable. what is great is how you are there for him. your family shows concern and love which is half the solution,
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Thank you Babalu. Psychic pain. That's what I was trying to describe. I would have a doctor (preferably a geriatric psychiatrist) evaluate him so that it could be addressed.
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When a friend for whom I have DPOA became uncooperative in her memory care floor and resisted the staff's care (due to her incontinence), I was told to take her to a geriatiric-psych ward at a nearby hospital to find an anti-psychotic medication that would help her. Those are tricky meds to deal with an must be used carefully. It took 3 1/2 weeks there to find the right meds, the right dosage and the times of day to administer them. She was not dopey from them, could function more normally with them, could walk, etc. and allowed the staff to clean her up and see to her needs. Her health insurance covered those costs. Her downward spiral from frontal temporal dementia was nearing the end, though, and she only lived another 3 months before her brain would not allow her to swallow food anymore. Hospice saw to her needs at the end and monitored everything to keep her comfortable.
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Most Memory Care facilities operate on the Assisted Living model, where there is a menu of care levels. As you need more assistance, the price of your " package" goes up.

Make sure he's seen by a geriatric psychiatrist who can advise about meds. You are not doing meds for convenience, you're doing them because your father is in psychic pain.
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It's nice they don't mind charging you a greater fee to clean up behind your dad. Is that legal? Sounds odd to me.

I would keep in mind that him acting out is an indication of his state of mind. Just because he's not hurting anyone doesn't mean he is okay. That agitation is stressful on the patient. What point is there to allowing him to be stressed out and agitated? He's your dad, but I would really read a lot about dementia and really watch your father.

The staff at the facility should understand the difference between medications and how some are not tranquilizers. Plus, they are not doctors. I hope he works out for you all.
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Had a meeting with the Memory Care director this morning. Dad does not have. UTI and they feel that redirecting his behavior will help. If it doesn't help they will talk to the doctor about a mood elevating medication. They are a facility that tries not to medicate unless absolutely necessary. They feel that he's fine. The biggest problem is that he won't keep Depends on. They make sure he's dressed in the morning, but he will go back to his room and undress to nap. He tells them he never wore underwear! Of course he did! They've raised his fee because they have to clean his room more often due to him urinating on the floor by the toilet. He doesn't realize that he's not finished and leaves a puddle on the floor, then proceeds to walk in it. They are not bothered by this and told me today to let them do the worrying and cleaning. As for the nastiness, he hasn't yet attempted to touch someone, he yells at them to get out of his way. Again, they will take care of this. The carotid artery blockage is there. He isn't a candidate to repair it due to his age. It's basically a time bomb. My mind was eased this morning. He's not as bad as I thought he was. Thanks everyone for your input. This site has been a blessing for me.
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I am sure you have had many good suggestions, thoughts. my father also would get nasty but this was before we placed him into NH. they do have medicines that will help to calm him but they might find that he needs to use walker or eventually wheelchair. when being calmed with medications it could cause them to become a little drousy. And your father at 95 with dementia will not remember doing any of these things (unfortunately) and the NH where he is at should be handling the situation, not you. good luck.
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hi there, it was unclear to me if your dad is AL or Al memory care... in either case, lets hope its the UTI. If not, I would really sit down with the community and reevaluate the memory care he is receiving. Unfortunately, the aggressive behavior does come with territory. As mortifying as it is for us the children, it does happen. As for the community - they should be able to modify his behaviors. The walking around my very well be the culprit. You mentioned it being a small area. Again, these are the parameters that the community should be well aware of. Ask what a day entails for your dad. He needs to be engaged (appropriate with what he enjoys and possibly recalls) Again, caregivers at the community should know the residents. I'm not a fan of the meds just yet...I have a feeling they are not tailoring things to his needs. Outbursts happen but structure, continuity and interactions help a great deal. Keep in touch. Best Regards, Kat
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