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Dad has been pretty much unconscious for a month in hospital supposedly from a stroke and then seizures while in hospital. Unresponsive, not able to follow instructions. He can’t speak and can’t swallow so there is a stomach feeding tube. Two days ago, he started to make some nonsensical sounds and then started to swear clearly. Now he constantly swears, kicks and punches us when we come in to visit. Then these behaviours translate to the nurses when he is agitated. He has his four limbs tied down to the bed and he is still agitated pulling loose a restraint. How can we bring him home like this? Not only we don’t have the heart to restraint him at home, but we don’t have the equipment. I don’t know if he is all there cognitively. I don’t know if he is mad at my mom and I for bring him in hospital in first place? Or is it delirium (which he had with prior hospitalizations but never punching and kicking- violent). Or is it dementia symptoms starting. Is he destined to go to a nursing home? Or how can we deal with this behaviour if we bring him home?

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Do not bring him home. Most stroke survivors are messed up afterwards. Some are worse than others mentally or physically. This is not something you can handle at home. It is an unfortunate tragedy to have him survive a stroke only to end up in this condition.
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Carev....please do not think that dad is mad at you guys. The man has had a stroke and seizures which have caused this behavior, not something a family member did. It's impossible to take someone home in this condition; he requires 24/7 care in a nursing home setting, unquestionably. If he can get stabilized with meds and calmed down, able to swallow, etc, then you can consider taking him home. But you have to realize how very ill your dad is right now, and treat that medical condition accordingly.

I'm so sorry for all the pain and anguish you're going thru with dad. May God bless you and guide you thru this leg of his journey with grace and kindness towards yourselves in the process.
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Carevdad Nov 2022
He was delirious last hospitalization but only verbal. Now it’s physically hitting, punching and kicking. Yes, he is in no shape to go home or be discharged, we are just thinking ahead… but it looks like if the violent behaviour remains then we cannot take care of it at home. Initially we thought we could after he is discharged to bring him home with help but if the hitting and kicking, violent behaviour does not stop then we cannot manage it at home
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Carev, oh my goodness!

Has he been tested for a UTI (again)?

Are they giving him meds for agitation? That would seem preferable to physical restraints.
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Carevdad Nov 2022
No UTIs. Supposedly a stroke and seizures afterwards
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My hubby punched out a neurology nurse when he woke up from brain surgery. Had an aneurysm (20mm) it clotted solid, had a nice blend of ischemic and hemmoragic stroke around the area. They had him on the vent and all and as they tried to slowly rise him out of it, he popped awake, ripped the vent tube out of his own throat, reared up, and clocked a nurse straight in the face while trying to escape.

He'd just had brain surgery. So his body woke up like ALARM ALARM IM IN DANGER DEFEND SELF.

This is a horrific thing to witness. Likely more horrific to him at the moment cause he really had no idea what's going on. I had to witness it through an iPad cause this was Dec 2020 so no visitors. NO visitors in the stroke ward is bad. The patient will have a hell of a time re-orienting with only strangers around. He thought I was a fake me, because he could very plainly see the real me in the room with him. (hmm. :D)

Hubby burbled like a toddler, barely understandable... until he got angry. Same thing. Then he would pop up, rip against the restraints (4 point also) perfectly clear words. He spent five minutes insulting me horrifically because, he said, I refused to open the door for him while he was trying to empty the "trash basket" (which apparently was a mild aphasia grab a synonym thingie). The restraints are also for the patients protection so they don't mess up their head/ surgery sites / etc. Also the urge to get up and use a toilet is super primal for us for some reason, so. My hubby wept like a baby cause he had to poop right in the bed. It was heart-wrenching.

After it was all calmer, his brain recovered from it's craziness, and he gained lucidity, hubby explained that he felt like he had been kidnapped, and was being shifted from building to building by some sort of enemy organization. In his memory he was tied up and endlessly throughout the day he was questioned, over and over. He didn't understand the questions and it didn't matter what he answered, they would ask, walk away. Come back, ask, walk away. This was the nurses/drs trying to check if he had re-oriented or not. He did not :D but he still remembered the being asked *something*.

(today he has no first-hand memory of this time, but as I was hooked to an ipad able to talk to him 13hrs a day I was able to hear some of his recall of the incident before his brain jettisoned all of those memories as "a bad time that doesn't need remembering". )

If he remembers names, it is a great sign. being angry could also be a great sign. You'll see the nurses and drs saying a lot of things that look super distressing are great signs. I am hoping for the very best for you and your family. Just wanted to respond here to point out that restraints can be used on ppl who pretty much fully recover. Strokes are terrible, TBIs are all terrible, and I think the body reacts with a level of instinct if the brain is aching. The fact that my hubby was calmed by my voice versus flying into a rage or something else, I kind of got the impression that was not as common as the latter.

Tell him you love him, they're doing the best they can, etc.

I know seeing restraints is heartbreaking, just remember - its there so he doesn't throw himsef out of bed to, pee, poop, escape from random enemies who appear to have captured him, etc, whatever it is his brain is constructing to try and make sense o all the crazy inputs its currently getting.

But without like. seeing a film etc, no one can predict. Even seeing films, no one here can really predict well from that. If he's using words, recognizing people, etc, you're already in a good place.

Also neurolyptic malignant syndrome is a thing. trembling fever mental disruption are symptoms
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Carevdad Nov 2022
Dad was hospitalized last year around same time for bladder infection and went delirious and blamed my mom for dragging him to hospital. I don’t know if he remembers this now when he sees her that is causing this. But before he never hit and kick. My mom and i decided not to go in for a few days and see if this improve the situation. The nurse said last night just an hour before i came he was fine. However, as soon as he opened his eyes he started swearing and hitting me. This then translates to the nurse and he would not stop.
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"we thought that if only he could swallow and eat then we can at least bring him home and not have to send him to long term care home".

Do I detect any *no nursing home* mindset? Forget that. At least for now.

Please listen to what Dad's medical staff is saying about his condition. If there are terms or things you don't understand, ask & keep asking.

I do understand wanting to wrap someone up & just bring them home.. to show your love. This is a valid emotional reaction. But don't panic or rush. He needs acute medical care at this time. Be patient. Keep common sense front & centre.
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Carevdad Nov 2022
Yes you are correct. We heard of the horrific stories. We thought we can manage with help coming in but if he is violent like this than it would be impossible to deal with at home. He is in no condition to go home now and i hope that they are not thinking of discharge. We were just thinking ahead, what if… and if he remains violent like this, we have no choice but put him in nursing home
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This is pretty rough. Of course, you can not bring him home in this condition. Yikes. Keep your distance so you don't get hurt! And talk to his doctor ASAP so that he can be properly medicated! He may rebound, he may not. Who knows? But his aggressive behavior will have to be medically controlled until you see if his disposition improves.

Good luck!
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Who is talking about discharging home from hospital at this stage?

Home can be the plan if/when safe & appropriate.

Otherwise other options are discussed: eg sub-acute, rehab, long-term care.
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Carevdad Nov 2022
we thought that if only he could swallow and eat then we can at least bring him home and not have to send him to long term care home. But suddenly yesterday and today, every time we come in he is swearing hitting and kicking my mom and I. And now the nurses too.
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You can’t take someone who is violent home. Other arrangements must be made ASAP. So sorry, but this is what stroke does to people. His brain is injured.
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Carevdad Nov 2022
Initially we were hoping that when he can swallow we can bring home with community care going into home. And just when he is improving on the swallowing bit, he is more violent then ever. Swearing and hitting and kicking my mom and I when we come in to visit him today and yesterday. I am not sure if he is mad at us for putting him in the hospital because he accused my mom of this last time and never forgot it
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The hospital cannot discharge him anywhere. No nursing home or rehab will take him until he is unrestrained for a day or 2. Restraints are ordered by a doctor under certain conditions because they are dangerous. If he did this behavior at home you will be bringing him back to the ER.
You might as well know that it is an unsafe discharge and taking him home would be a tremendous problem unless you have a few caregivers. You should speak to the social worker to at least look at long term care. You say you do jot have the money, you need to learn about Medicaid
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Carevdad Nov 2022
My mom initially thought that she can deal with the diaper change and other stuff with help, after all she is 74. However, the hitting and kicking is just too much. I myself had trouble holding him down to help the nurse put back the restraints. He broke the restraints after so they had to get a heavy duty one for his wrists cause he is too strong. Yet he is still able to kick hard.
We don’t have Medicaid here. We thought initially that he would be best home but now my mom cannot manage him; his violent behaviours, if it continues he can easily harm her with his strength. He already accused her of putting him in hospital last year when he was delirious.
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"Is he delirious?"
Probably yes.

If he has confusion - he has confusion.

Don't overthink it.
Don't read meanings into it.
Don't leap to conconclusions.
Certainly don't assume he is mad at you or anyone else or wishes to die.

Confused patients pull out all lines, tubes & remove their clothing too. He is showing basic flight & fight instincts.

Things have improved some.
Stay patient.
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Carevdad Nov 2022
Yes there seems to be improvements but his violent behaviour now would regress any improvements if he continues like this. When he is like this he refuses and pulls at everything and they have to use heavy duty restraints instead of the soft ones which sets him off more. He tries to cry also in between these violent lashing out episodes, showing despair on his face and calling God’s name.
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