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She is wheelchair-bound, has dementia, and gets very aggressive and agitated. She appears to be sundowning. She doesn't know me well, but yells at me, accusing me of being mean, or saying "What makes YOU so special?!!"
I want to be kind and gentle with her, and calm her down, but I don't want to get close to her in case she lashes out. I try just being cheerful, but she obviously thinks I am a threat. My feeling is that the staff should be trying to distract her. Mom has only been in this facility for a couple of weeks, so it's all new to me.

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Don't play her game! Simple, said and done!
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Sym - is mom a new resident? If so, the facility may have put her with their "impossible" roommate to solve their problem.

But whatever the case, there will be required by the Feds a "care plan meeting". First one should be within her first 30 days and then 90 days thereafter. A good NH will both call & mail you a letter as to scheduling the CPM within a set couple of timeframes. The CPM is mucho importante as at the end of it, you will be asked to sign off on a sheet within moms file that you are good with moms care. You go into the CPM prepared with details on the roommate in writing & a couple of copies. I'd record a couple of her rants too to play for their nonamusment as well. If you can get a photo of roomie on a rant thats good too. At the cpm there will be a rep from most departments - nursing, activities, dietary, social work - but rarely if ever will the medical director ever be at one. Ditto for the DON - director of nursing- who is the goddess an true ruler of a NH. When you are asked about your concerns....you whip out the detailed document on the roommate and state you feel that roomie is a health and safety threat to your mom and the situation needs to change and that the document is to be attached to moms file AND on the CPM meeting form where you sign off you write in "details on care concerns as per attached document" along with your signature. If you have issues on going all bad bitch bossy have another family member go with you to be supportive & go over this aloud in advance. I'd bet either mom or roomie moves within 48 hrs. If not, then you fax over the document to the DON & if you have an elder lawyer you CC it to them as well.

Just complaining verbally does no good, it needs to be in writing. comprende?
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[faintly] Health care… *debt*??? Oh, my, dear, Lord.

Gosh the world can be a depressing place!
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Country mouse - Omg "competive marketplace", I'm still laughing. In the US for the health care system it's a best a closed market system with a couple of dz players within it at the hospital level. There is no competive marketplace.

The slow death of community hospitals in the US starting in the 1980's ended any semblance of competivtive market for hospitals which are the gateway to getting into other facilities for most.

If your a health policy wonk, there is a especially great series just started on the New York Times on health care debt.
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There are advantages and disadvantages to shared rooms--I would think that a good home would make some effort to match roommates if possible. One way and another I've seen good things happen with hospital or home roommates--my husband was in the hospital with a back injury and his doctor was recommending surgery; his roommate gave him a recommendation to a another specialist who got him back on his feet without surgery. A elderly friend was in a rehab facility with a young roommate, and the roommate's family visited often and "adopted" my friend and was very helpful. Yes, sometimes it can be a bad match, and it would be worth a try to get a change.
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Don't get me started on shared hospital rooms. I was admitted to a room with a dear little old lady (probably my age) who was well down the dementia path. She kept coming over and tucking me in and telling me how many of the Drs were her brothers. They needed her bed at midnight so she got transferred and they replaced her with a young very mentally ill girl who had been mixing her drugs with alcohol. She only lasted a few hours because they could not keep her in bed and she activated the bed alarm every few minutes. she should have been in a locked unit. Another one wanted me moved because she did not want to use the same bathroom. I was more than happy to move. That room had a tiny window that looked out on a brick wall and you could not see the sky. and my bed was opposite the tiny bathroom and every time the door was opened the brightest lights shone in my face. After two weeks of only getting about 2 hours sleep every night I began to hallucinate. I saw a bushy tailed red squirrel in the wall vent and some huge black creature under the bed Then there was a large knife. I was a basket case when I finally escaped that dreadful place. My wonderful husband managed to secure me a single room but the damage was already done and i am still trying to wipe out those memories. I felt as though I had been detained and put in solitary confinement. The next hospital felt like a luxury resort. Amazing isn't it but I can totally empathize with the loved ones who resist being placed.
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I haven't checked the legislation, but I recall quite a hoo-ha over new accommodation standards introduced a few years back; and one of the topics of debate - apart from the tortured squealing from the private care providers and local authorities who were expected to absorb the costs, of course, or hypothetically anyway - was the uprooting of roommates who were getting on famously and now would have no one to talk to except the wall… What you gain on the swings, you lose on the roundabouts, eh.

Certainly none of the care homes we visited in the endless search for adequate respite had anything other than single rooms. Except for the really brilliant one that had set aside suites for couples, at around £1100 a week mind you.

Another result of the change was the appearance of horrible prefab annexes built on to beautiful old country house style care homes; so you'd roll up along the gravelled drive and walk into the gorgeous parquet-floored hall, then be guided along to the standard cheap motel type corridors built on the back, with their poky low-ceilinged box rooms and smell of new plaster and dank little ensuite wet rooms. But there is a huge growth industry in purpose-built retirement facilities, too.

The trouble is, isn't it always, the question of who's paying? Here in the UK it's a combination of scandalous staff pay, scandalous thinly-veiled subsidy of state-funded residents by private-pay residents, massive chunks out of the budget of local authorities, steadily increasing government debt and stealth taxation. Which I'd mind less if we got really good quality care for it; but we don't. And we do, also, have the problem of soulless private companies wringing every last drop of profit out of their residents and their staff; only, I suspect, perhaps not quite to the extent that it might be going on in America.
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Do you really all get private accommodation in the UK? Thankfully ward style rooms are mostly a thing of the past here in Ontario, but semi private rooms are still common and the entry level for most as private rooms have long wait lists. Trying to accommodate different personalities must be a nightmare for staff, and really it's not as though they can shuffle people around, when one bed becomes available it is filled with the next person on the wait list, there can be no consideration of personalities and needs. I think the only recourse available is to wait for a bed to open up in another room.
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Not fair? It's unbelievable! - how do the care home organisations get away with it? What are the standards regulators doing??? The idea of a competitive market is that there should be a choice of where to buy your care: is there no alternative provider near you? If the regulatory authorities aren't able or empowered to act, you should at least be able to vote with your feet (and your wallet).
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My Mom was in an "intermediate" care unit with 2 to a room. She got the small half (the bathroom came out of her "half"), which made her part of the already-small room barely big enough for the hospital-sized single bed... Her roommate's side was roomy (even for a drop-leaf table!), and the woman played her TV LOUDLY literally 24 hrs/day. I don't understand why there isn't some consideration taken by staff to ensure some level of comfort and peace to both occupants in a shared situation? Sorry, but disruptive or aggressive residents shouldn't be paired with lucid and quiet people - not fair! My Mom's roommate was totally lucid, but selfish - why didn't "they" require her to use headphones? Not fair! And - the fact that Mom paid the same price for her "half" of the room as the roommate with double the space? $9,000/month? NOT FAIR!
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No Countrymouse You are not spoilt at all. My Mother is due to avail of Her first restbite care on Wednesday next the 6th of January for six days, and She will be placed in an open ward of eight elderly Patient's. I know that My Mother will flip when She finds out, but I'm keeping My lips closed as I do not wish to discourage
Mom since I had great difficulty encouraging Her to avail of the restbite care offer.
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I almost never stay in my mom's shared room when I visit. In good weather I push her in her wheelchair outside. We sit in the dining room and have coffee and look at magazines. We color. We look at scrapbooks. But almost never in her room.
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Sym, can you take your Mom out of the room and visit in a sitting area or lobby? If your Mom is 'movable' it would be a nice change of pace for her and reduce the irritation to the room mate.
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I know I'll sound spoilt but I really can't get used to this shared room system. However - not for me to comment on other countries' social policy.

Johnjoe is right, it isn't for you to handle interactions with other residents. It must be very difficult to ignore her, exactly; but as far as possible, and as pleasantly as possible, blank her. If she continues to approach you, tell the staff what is going on and ask directly for help - don't wait for them to notice there's a problem. How is your mother settling in? Is her roommate bothering her?
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Hi sympavt I would say pay NO attention at all to Your Mum's room Mate. Do not make any eye contact as this will only agitate Her. Concentrate on Your Mother when You are there. It is up to the Staff Nurse at the Nursing Home to calm Her down.
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