Last year my father, 59, suffered a series of strokes in four areas of the brain. He is now non-verbal, can't walk, stand, eat, or do anything for himself. The most frustrating part for him is that he understands everything around him, understand what we say to him (sometimes he can respond with a thumbs up with his good arm or by nodding his head), but is trapped in a function-less body. I visited him at the nursing home a couple of times a week and he overall was doing okay. A few months ago I graduated from my Master's program and accepted a job in a city three hours away. I'm now only able to travel to see him every two weeks. Since I've moved, his behavior has declined. He will have fits of anger where he will swing his good arm, and unfortunately he's still very strong, albeit uncoordinated. While this is obviously a problem for staff trying to calm him down or keep him from falling out of his wheelchair, it's a much bigger problem now that he's hit several other elderly woman residents. Thus, the nursing home has politely said without directly saying that they want me to find another place for him. I believe if I am able to move him to a facility up here near me, his behavior might improve since I'll be able to see him more the way I did before. However, the first place that had availability took a look at his file and immediately rejected him based on his behavior. So now I'm in a spot where his current NH wants him gone, but his file paints him as a violent resident so I'm going to have a hard time getting him accepted anywhere else. Any advice? I feel helpless, backed into a corner, and I'm also 4 months pregnant so I've got a lot of other "life" on my plate at this moment as well. Feeling a bit defeated.

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Thank you all for your responses.

I'm not sure why the NH isn't offering guidance or assistance, other than my personal opinion that they're just not willing or staffed properly to do so. The social worker is often a condescending Jekyll/Hyde type, same with the head of nursing. I personally just think they don't want to deal with him anymore, and since I'm his legal guardian it's on me to find a new place for him.

Unfortunately he wasn't a candidate for hardcore rehab, both because of financial issues (his care is paid for entirely by Medicaid) and the severity of his strokes. One of the main arteries that leads to his brain is almost completely blocked, unfortunately. At the time his strokes occurred (and he did have more after the first round) the neurologist gave him an 80% chance of dying. Surprisingly it's been 13 months since then. So really his only prevention is being on the most hardcore blood thinners possible.

Someone also mentioned medication... the NH told us that there is one doctor for the entire home, and that he comes once a week. I've never met this doctor, and it seems to me that most of the medical decisions are simply ordered by the nurses. He's on Ativan for anxiety, but I believe he needs to be on an antidepressant as well.

I do believe if I can find a more appropriate facility (ie. one with a more involved doctor, for example), his behavior will improve. I logically know none of this is my fault, but I do feel responsible. I'm his guardian and was the only person who could step up into this role. He's divorced from my mother, and all of our other family is states away. His sister (my aunt) is VERY involved but more in a hyper-controlling way. Plus she takes the viewpoint of "well if this is how it's going to be, maybe we should pray the Lord takes him" (a terrible thing to say, really).

Thank you all again for your replies. I'm going to attempt to visit a potential facility here this week and perhaps explain his situation before they review his file.
Helpful Answer (1)

You may have to look at a geropsych facility first. That's a sad story, too! Did he get a shot at good rehab at any point? Do they know what caused the strokes and how to prevent any further?
Helpful Answer (3)

The Nursing Home, which admitted and has been caring for an adult with brain injury, and is staffed by fully trained and equipped professionals, wants you - a young pregnant person living three hours' travel away, and presumably not a member of the medical or nursing professions? - to find a more appropriate placement for your father.

Who are the professionals in this scenario? You or them?

At 59, your father is much too young to fit the standard NH profile. And the behavioural changes caused by his strokes seem to indicate that he needs a specialist centre for people with brain injury, rather than dementia as such.

But what makes me spit is the idea that they think you're better placed than they are to research care centres. Have they suggested alternative options? Can't they use their professional experience and network to point you in the right direction?

Perhaps you could go back to the neurologist who treated your father when the strokes happened and get advice there. Who else is involved, by the way? You say "we" - who are the other family members?

By the way: you also mention that your father's behavioural problems got worse after you had to cut visits back from a couple of times a week to once every couple of weeks. Well, that sounds like you're partly blaming yourself; and don't. I don't want to sound dismissive of your input, but there are much likelier causes for the deterioration than your slightly longer absences, such as post-stroke depression, very understandable frustration, possibly fear, and possibly also further strokes. None of which you could prevent even if you could be there every day.

Maybe there is a silver lining, in that it doesn't sound as though this NH is providing your father with the specialist care and support he needs. A change to the right setting could be very beneficial for him - but don't take him away from his own home town unless there's nobody else there for him, no friends or family, and you absolutely have to.
Helpful Answer (5)

I think he should be evaluated by a psychiatrist to see if there are medications that can help him feel less anger and despair. Violent outbursts are not uncommon in those with dementia and brain damage, why is no one at the nursing home giving you any guidance?
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