My father has Dementia / Alzheimer's and is at a stage where he flips out, hits, extremely combative. Any suggestions on placement?

When Seniors act out like this, it’s usually because they are scared and feel like they have to protect themselves. That’s why my mom used to become combative. Have they tried any medications with him? You can’t really blame the Memory Care. They have to protect their staff and other residents. Also, have you filed for Medicaid for him?

I am very surprised that the VA has no solution for you. You would think they would have special places for Vets with your dad’ issues.

Have you considered a Group Foster Home for Dad? I understand there are some who are trained to handle combative dementia patients. Maybe a smaller place would be more peaceful for Dad. Also, have you tried contacting your local area Agency on Aging?

I wish you good luck finding a place. Having had a parent who acted out, I know how you feel.

Have you tried medication? Like Ahmijoy said, your dad isn't comfortable in some area which is why he's acting out and he may not be able to convey to you what's wrong. Maybe his doctor can help.

If he is in a psychiatric ward I assume they are attempting to find a good combination of medications to help him be calmer. Perhaps finding the right placement should wait on the results of his psych ward treatment. At that point their discharge person should be able to help you.

This is heartbreaking. Good luck!

Daddy1941, has your father been tested for an Urinary Tract Infection. Such an infection would create out of control issues with an elder. It's worth being checked.

This is heartbreaking
Try to stay in touch with the hospital staff both as they work through the meds - even after a discharge it may be different ones will be needed - mom was started on seroquel and rather than keep increasing it, was switched to risperdal - and to work on a discharge plan

Great suggestions about meds and UTI test. They are worth a try even if they turn out to be all for naught. Keep in mind that different ppl respond well to different drugs. Keep looking for the right one. My husband is on seroquel but he is still sometimes combative. If he gets worse, I will try a different drug.

Medicaid does help pay for home care if qualified. Lengthy process. Check with your CERTIFIED eldercare attorney.

I'd make an appt with dad's primary physician and discuss what's being done/options, and to keep you in the loop. The medical team needs to see the whole picture in order to help and make recommendations. I would think they would adjust meds to make him more comfortable. It's not just to make things easy for staff. It must be scary to be in a strange environment, have moments of clarity, and also know your mind is slipping and to feel a lack of control over basic things, and to not understand whats going on. I'm not saying that to give you more anquish, (my dad had dementia) but to see things from his point of view. That may be the reasons for outbursts. You can always stop in, or call nursing staff for weekly updates. The more your presence is known the better for your dad's care.

I went through this with my husband. It was the most difficult thing I’ve ever been through. I would suggest seeing an elder attorney to begin the Medicaid planning/application process. I would also see what the hospital can do in terms of behavior management. Along with that, work with the hospital to find suitable placement. I would not let them force you into bringing him home. They can’t do that because if you can’t take care of him, he needs appropriate placement, and they are obligated to find that. Be prepared for something less desirable than what you’d hope for. Placement for combative people is particularly difficult. However, do not accept someplace that does not give good care. Check out CMS.gov for the nursing home compare star ratings. There’s a wealth of information in there to help with decision making. Good luck.

I don’t have this experience (yet), and my heart goes out to you! In addition to the good input above, I just want to pose for the group: does care for folks in this state ever make sure to provide exercise and some time outdoors? With my mom indoors so often now, she’s expressed a desire to ‘hit someone’ often lately, and I’d swear it’s pent-up energy. It wouldn’t be feasible for some, but sheer boredom and lack of movement could make you a little crazy, no?

One would THINK that a test for UTI would be standard for a dementia patient who is hospitalized for psychiatric eval, but you would be wrong in some cases. Sometimes staff act like it is the first time they ever considered such a possibility when a family member asks about it.

Also, make it VERY CLEAR he has nowhere to go and NOBODY to care for him! Don't let them send him home for your mom to deal with and TELL THEM under no uncertain terms you are not available to care for him. Sometimes a discharge planner will try to shove that task (of finding a facility) off onto the family. Don't let it happen. A combative, fighting and hell-raising dementia patient is a nightmare!

My recommendation is to see an Elder Care attorney ASAP to get your dad on Medicaid before your mom is left destitute by paying for his care.
Add, perhaps the attorney will have experience and knowledge of placement options, too.

This was my question when I came on here a year ago screaming! My Mom went to the psych. Wing of the hospital. They got her on medication for dementia. They cleared up a U.T.I. They cleared up M.E.R.S.A. This 2 took weeks in there. She had a fall and broke her pelvis and back. She had hospital and N.H. rehab psypsychosis. They will get them on the right meds and get them off the old ones and make it better. The social worker there found a nice place for my Mom to go to for the reminder of her rehab. She has been at home again and we are just now going to see a neurologist next week. It seems awful while you are going through it, but it was the very best outcome for my Mom. Hang in there! Also, you can visit in there and you should. Just every 3 days or so. They had certain visiting hours only but it lets them know YOU are on the team too and keeps them on their toes!

Our mom has been going through similar. FTD and had to go to foster care because her husband had heart surgery upcoming. she didnt transition well, meds made her anxiety worse and she fell and broke her hip. behavior so bad that memory care wont take her. now 6 weeks in the rehab facility (2 weeks beyond Medicare pay). Psych eval such that Geri Psych hospital in network wont take mom. How can families be put into this situation? Family members have been doing shifts of one on one care from 8am until sleep often to 10pm at night. everyone exhausted and desperate. mom now on scheduled Buspar and Haldol. only cries now. no smiles. we are in Oregon. any suggestions welcomed. thank you.

As others have said, check for UTI first.
My dad was also combative at the beginning. Out of fight or flight, he was a fighter! It was a lot of change very quickly, so of course, he was overwhelmed, confused and resistance about what was happening (being in the hospital, etc).
Even though I use natural medicine as much as possible, what really helped him, almost immediately was the drug, Depakote 3x/day. It evened him out...
Almost a year later, we weaned him down to 2x/day and a lower dosage.
Unfortunately, he still needs something. We tried letting it go altogether, yet it didn't serve him, and we're not going to let him suffer needlessly when it worked.
Luckily, we had a very conscientious doctor helping us. That's a BIG plus!!

All the best to you and your family!!

Unfortunately, it may be hard to find a place to place your dad, because of his actions. It would be noted on any papers associated with his care that he is/was prone to acting out, hitting, etc, which would be shared with any facility that would consider taking him.

My brother had dementia and he started becoming combative. The nursing home sent him to the hospital psych ward and they got him on medication. They also found a place for him in an in-patient hospice facility. He was a vet, though, and another option was a psychiatric facility with the VA. There is one in our town. However, with the influx of combat-related PTSD cases, they did not have a lot of availability. Medication is the answer. If he's medicated, he should be able to be in a memory care unit. Dementia brings psychosis so it's not unusual for them.

Like someone else answered, check for a urinary tract infection. For my mom I always found it best to try to redirect attention to change the focus from whatever is bothering him and start talking about something else, such as talking about something to do with his childhood

I’m in same position as my mother was in SNF private pay...Medicare stopped covering her since she refused physical therapy...I didn’t want nursing home to take everything she owned...so I renovated house to take her home...w lift machine, hospital bed& reclining wheelchair ...seroquel meds is the answer. Ask your dr for a script. Let us know how you’re doing

I forgot to tell you my mother extremely combative w punching. scratching, pulling my hair, threw mouthwash in my face & eyes...I hire private duty aides to help. Just give him the Seroquel & you can leave him in bed when extremely combative. Nobody wants to deal w this kind of patient including the children....Medicaid my mother didn’t qualify for & they charged private pay...if he has funds he spends down...also see elder law attorney....I did & changed my mind back & forth from nursing home/home care. Ultimately, it’s your own mental health that’s at stake

Well my first thought is that the care home had to dismiss him if he was uncontrollable. He is going to the psych ward to find a solution (some combination of meds) and then the home should be able to take him back, if you would agree to pay for his room while he is away getting help. If they do not want him back there must be other reasons, like finances or personalities or something. So take advice offered above and get some counsel and find him another place.

When my friend, Beth, became resistant to all care after she soiled herself in her memory care apartment, I was advised to take her to a geri-psych ward in a hospital to find an anti-psychotic drug that would calm her down without doping her up. The third hospital I phoned had an opening for her. It took 3 1/2 weeks there to find the proper medication and dosage and after that she could be worked with until she passed away. I would think the hospital ward he is in would be trying this. Such behavior is not uncommon with different forms of dementia as they go through phases of the brain shutting down. He may have frontal temporal dementia since it is that part of the brain that keeps things "in check." Good luck!

Please have a doctor review his medication. My mom when through a stage where she started hitting and punching...it was after we increased her Aricept. Doctor immediately brought it back down and those behaviors stopped.

My heart goes out to you. My Mom with Lewy body dementia and psychosis of a Parkinson’s became like this. She was in the geriatric psych unit for 17 days. A placement specialist helped me find the perfect dementia facility for her. Her fee was paid by the facility. You want success so be completely honest about your Dad’s needs. Please keep us posted.

I also had that with Dad. I was very lucky to have him in a memory care unit where not only tolerated it, but tried to find the underlying condition causing the agitation aside from the ALZ. They gave him some pain meds and he calmed down. So they took him for an xray and discovered he had a fractured hip.

We live in Puerto Rico, and at the AL homes here, patients do not get kicked out of facilities for these problems, but I understand this is not the norm. Very sad story indeed.

This is a very hard situation for you. I hope that you have family that may help you out. There are too many of these situations with with very little or no help. Hospitals do not have enough rooms or staff to take care of combative patients, and Nursing Homes cherry pick their residents and will accept only few Medicaid patients; if any. Try to see a geriatric psychiatrist Doctor.

have you been in contact with a qualified music therapist - they can help with suggestions of how music can help in lowering the level of anxiety.

Have you been in touch with a qualified music therapist. They may have suggestions has to how music can lower the level of anxiety. This is not just entertainment but a a specific individual plan for each patient

I understand, going through similar thing with my Mom. She is in SN and got a call late this evening she was moved due to altercation with another resident. She is fine and then the switch flips and she starts yelling at EVERYONE to get out of her house. And because she is a wanderer, she is hard to control. They called me yesterday to discuss changing her meds, putting her on risperadol which was mentioned above, and who knows how all this impacts them. I too have questions about how to manage this and am nervous about what next. I'm sorry that you are weathering this, and hope that the social worker is more helpful. It would be good if you get him moved while you are still able to private pay, as there is likely more options than once he gets on medicaid.

Please look up combative behavior in an elderly person with Alzheimer's or dementia online. There is a lot of info there. Like the person may be bored, depressed, too much/not enough activity, in pain, and medication interactions. There is a wealth of knowledge there. And remember the staff is there to work WITH family, not tell you - you are on your own. This isn't the first patient with this issue. So put in calls to physicians and charge nurses, and social worker to discuss issues. They will charge for an appt. As far as I know not for a phone call. I don't think they charge if you are there for the care team's plan meeting. That is where physician, nurses, OT/PT, social worker didcuss ongoing care. They should let you know about that meeting before it happens. Also chat with social worker. It's better to say I need help, I'm overwhelmed than go in demanding answers. Ive seen both. The first one will get you a lot further lol. Good luck.