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My Mom has dementia and in a Memory Care unit with about 18 others. The unit recently introduced a patient who has outbursts all the time and bangs the table/floors, screams at other patients and I witnessed her hit another patient. She is stealing the peace of the others. When does the welfare of the others outweigh the needs of this one? They all get agitated. Shouldn’t there be other units where people are cared for based on their level of behavior. It seems very wrong. While I am sympathetic for that woman and her family, I’m concerned about my Mom and the others who don’t have a voice to change this. This is hard on the aides/staff also. I’ve brought this to management’s attention. Has any one else dealt with this?

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There have been a few news exposés in Canada recently but resident on resident violence (and resident on staff violence too) isn't new and is a dirty little secret in long term care homes wherever you live. Violent residents can be more than just annoying, they can cause real harm and even death to those unfortunate enough to be the recipient of their ire. I don't have all the answers, but wringing our hands and talking about the patient's right to care and privacy isn't it. I believe that a protocol for assessing residents for violence and making available appropriate interventions needs to be mandated, and the only way that can happen is if we bring this issue to light and apply pressure to our legislators.
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jacobsonbob May 7, 2019
Thanks for pointing this out, cwillie!
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I am going to "play the Devil's Advocate" here.
You see what happens but you do not know what is being done for this patient.
And HIPPA laws prevent them from telling you what is being done.

*They may be trying to have this person's medication adjusted. This can take a while.
*This person may have been just been uprooted from the home they have known for years and is ..angry...scared...lost...
*Taking things from another person's room is VERY common and if you read many of the posts others have asked about it. There is not much that can be done.
*The administration may be having discussions with the family that the behavior is unacceptable and they may have been given some time for adjustment and if the patient/resident does not adjust they will be asked to find another facility.

Continue to monitor what is going on.
I would also send a letter, not an email, that you are concerned about your Mom's safety. If you have or if your Mom has a lawyer that handles her affairs a copy to the lawyer might be a good idea. You might even ask, since you are concerned about your Mom's safety and theft, if you can put a camera in her room to monitor her safety and her possessions.
And yes there are facilities that will take agitated patients/residents but I am sure this persons family is trying what they can to avoid that. There are forms of dementia (LBD) that the person can have more violent tendencies and it is a matter of medication adjustment. But like with all medications for Mental Illness it can take time to find the right medication, the right dose.

Continue to have meetings with the administration but Please be patient..
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thepianist May 7, 2019
Excellent comment. This type of situation isn't uncommon in memory care. I also wonder if possibly Jackiehar might be more distressed by this woman than her mother is? Sometimes we are project our concerns onto the person with dementia who at this point might be less worried. My uncle, who had very tight boundaries all his life, paid no attention whatsoever when another resident would come into his room (during the day) and lie down on his bed, or just sit with him and stroke his arm. My sister had hissy fits over this, but uncle had no problems with this new intruder.

And yes, patience is the big challenge.
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My mom was the agitator. She was sent for a psych assessment a few times. There they would try to adjust her meds to help keep her more calm. It would work for awhile, until another med adjustment. Over the two years she was in a facility she needed an outside caregiver to be with her on a one on one basis as a diversion, that helped. This was an additional charge as the facility had others they had to provide care for.

Moves are very hard on those with dementia.
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Lokken May 7, 2019
You are speaking about your mom in the past tense, so I'm assuming she's passed away? I am working as a private caregiver in the home of a 74 yr. old woman who has had Alz. for 10 years. She is very angry, especially when someone interacts with her directly. She used to be a head nurse in a cardiac unit, so I'm wondering if losing that voluminous mental capacity is just really pissing her off, or maybe I'm projecting? I also wonder if when it gets worse to the point of being non-ambulatory, non-verbal, etc. she might not be as angry? thoughts?
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Thank you for all your responses. Heart to heart I appreciate your insights. These are all thoughts I will consider. I’m still going to push for a peaceful environment for all trying to be respectful to all parties. Thank you.
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If this person has violent tendencies, then she needs to be in a Psychic facility. Like said, for med adjustment. Yes, the safety of staff and residents should be the priority. Wait and see if anything is done. They maybe trying to adj her meds first. If nothing seems to be happening call the Ombudsman and see what can be done.
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If this unfortunate lady hit another patient then she is not just stealing the peace of others, she is a threat to them. Your mother has a right to personal safety. I would be worried, too.

What was the management's response to your concern?
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Jackiehar May 8, 2019
Thank you. Management asked for me to work with them. They are aware. Of course they won’t discuss particulars due to HIPPA. I don’t want to know someone else’s business in any case. I just want my Mom to be safe. My current plan is to request another meeting to review my observations since I’m there everyday. My sister is there often too. :-(
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My mother could be the agitator too. She slapped two other residents that I know of, and when she picked on the wrong person, she herself got shoved into a wall. Luckily, the families of the people she attacked never brought charges. There was a very large man on the regular floor who was very loud and could be combative. To the best of my knowledge, he never attacked another patient. He was medicated, monitored and supervised. The facility, both the regular floor and the Alzheimer’s lockdown, handled it the best they could. Incidents were documented and reported. If one resident took a dislike to another, they were supervised more closely. My mother was given a room across from the nurses station.

You can always speak with an attorney if you feel the facility is not handling this the right way, but chances are that they are doing all they can. And remember, if you do speak with the facility’s administrators, there is only so much about this woman that they can divulge.
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jacobsonbob May 7, 2019
Ahmijoy, your comment brought up an issue that so far I haven't seen mentioned on this forum. Yesterday my mother asked what it cost to keep her in the nursing home, and when I told her, she wondered how we can afford it. I explained that she could afford it unless she lives to set a new longevity record--AND unless she bites, hits or kicks someone! Considering that she is bedridden and very easy-going and cooperative, this isn't likely to happen, but I wonder how often it does, how often a resident gets sued and how big the settlements are. I also wonder if there is any kind of "insurance" against such events, such as "dementia liability insurance". In any case, I'm thankful your mother didn't have any charges pressed against her. (However, I guess there could be both criminal and civil issues--I was thinking primarily of civil charges considering that some people will try to make a fortune off of anything even if minor.)
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In January, we moved my mother into a private home memory care facility (fully licensed and regulated). She was not on any meds and threw plenty of fits, throwing objects, banging, breaking things. I was very concerned for the four other residents and worried that my mother would get kicked out for her behavior. We were assured the staff was "used to this" (though I doubt the other residents were) and they said once meds were introduced (and if she would consent to take them - a whole 'nother battle), regulated, and she got used to being there, she would likely settle down. It has been 3+ months now and Mom is definitely less combative, less yelling and screaming, though she's still very angry.

Difficult as it is, try to give this new resident time to calm down. Meanwhile, if possible, keep your mother's door closed and introduce sound - even white noise - into her room if possible to mask the sounds of others. I wish you luck.
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Jackiehar May 8, 2019
I am sympathetic to others adjustment. I’ve talked to management and told them I’d give them a little time. I also know that doing that puts my mother at risk for a little longer. I placed her in this facility for her safety and peace. I wish we all had better answers.
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This reminds me of an extremely disruptive student in my child's classroom. All students suffered the entire year. In other words, it happens in many realms. I would communicate my concerns by framing it around the impact on your loved one's day-to-day quality of life. Work your way up starting with your loved one's social worker. My parent was paired with an abusive roommate (mostly verbal). I expressed my concerns and requested a room change. Nothing. Finally, I witnessed an explosive physical action by this roommate. I also saw how upset dad was not only because he felt threatened but because he was concerned for my safety. I was taking him out of facility that day and on the way out, we bumped into his lawyer who happened to be visiting someone there. He implored her to act on his behalf to mitigate this matter. I reinforced to the social worker that he had requested his lawyer to address the matter with the director. That's what it took. After I had asked multiple times for him to have a new roommate to no avail, another bed miraculously opened up and dad was moved. So, ask for your loved one to be moved as far away as possible from the offender because of the detrimental effect on your loved one (ie. lack of sleep, safety fears, missing items, etc.) I would also like to add that many facilities ask (don't require) that you sign a form that says that if anything happens to your loved ones, you won't sue, but instead let the complaint go to an arbitrator of their choosing. I never signed that form for either of my parents. The facility must ultimately know that they are accountable for the welfare of their residents.
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Jackiehar May 8, 2019
Thank you
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I have a friend who works in an Alzheimer’s unit. She said some places withdraw a patient’s antipsychotic medication to get a better ranking from the state. This makes the patients with violent behavior more prone to pick on the innocent others, no fault of their own. She said they even went so far as to tell a patient’s family who was beaten up by another patient that “she fell”. My friend reported what was going on and there was complete turn over of management and a lot of upper level employees. Make sure this isn’t going on with your loved ones.
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Jackiehar May 8, 2019
Good to know, wasn’t aware of this rating process.
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