They recommend a caregiver to be one on one with him for 24 hours. Hesitant to do it because it will twice as much. Concerned they will want to make him leave if we don’t do what we recommended.

Has anyone asked Dad why he is upset? If there is a reason, address it. If not, try meds. I am pretty sure he isn't upset because he wants someone watching him 24/7.
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Reply to DrBenshir

Is your father-in-law truly on the Memory Care floor (with locked access)? If so, ask them how they recommend to deal with it. If they don't have an recommendation other than 24 x 7, then move him. They are not qualified to deal with your FIL's condition. (It is helpful to ask them to describe the specific behaviors and situation that occurred.)

The reason why they might not have any recommendations other than the 24 x 7 caregiver, could be because the rest of the Memory Care floor does not have that type of behavior. The interview for a resident can go just so far. After that, it is a leap of faith that the resident will fit in with the rest of the community and that the staff can adequately work with them.

At my Mom's MC, they did ask a lady to leave the community. It was because she would threaten with suicide and harming the staff. She did try to act it out once. They did NOT have the facility or the staff to handle that kind of behavior. She had a separate 24 x 7 caregiver that lived in the room with her at the MC. I talked to the caregiver after that, and she said that prior to her being at the MC, they lived in 2 adjoining rooms in a hotel. However, the family thought that by placing her in MC, that would give the caregiver some relief while also giving her client some social interaction. She thought that it might be back to the hotel and 2 adjoining rooms for them.

So yes, you can talk to the doctor and getting meds and staying at the MC. However, another way would be to ask the facility what they recommend other than a 24 x 7 caregiver and moving your FIL if they won't budge from that recommendation.

P.S. As you are interviewing other MC facilities, make sure you ask them what they recommend. If they immediately shy away, then that MC is not equipped to handle your FIL.
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Reply to ChoppedLiver

It's time to find another memory care center for him.

When you say assisted living, I am assuming a sort of independent apartment as his living arrangement. It may be time for a different level of care.

A care facility will try to manage patients behaviors with medication, or other accepted techniques. Try a different memory care facility with staff trained to manage his behaviors, or a skilled nursing facility which is more hands-on care and will use medication to control behaviors, as prescribed by their own contracted doctor.
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Reply to CaringWifeAZ

There are medications that will help with anger, anxiety and agitation.
As far as a caregiver 24 hours, that is insane.
The facility should make sure that he is involved in activities. He certainly does not need a caregiver when he is sleeping.
Talk to his doctor about medications and talk to the facility about making sure that he is not being excluded and that they make an effort to make sure that he is involved.
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Reply to Grandma1954

He is anxious about being in a new place and expresses his frustration in bouts of anger. Talk to his doctor about mild anti-anxiety medication to help him relax while he adjusts.
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Reply to Taarna

RCL76PITT: This is the job of the memory care facility.
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Reply to Llamalover47

It's probably time to move out of assisted living since they are asking you to provide 24 hr care for him. Probably time to move in to nursing home where 24 hour care is provided.

And, yes, if you aren't looking after him 24 hrs a day as they said, the next move will be that he no longer qualifies as 'independent' who requires very, very little care to live in their facility.

Ask if they have NH attached to their independent living facility.
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Reply to my2cents

I had a client who had a 'sitter' in the hospital.
Client was mean spirited and very loud, and wanting / trying to hit the sitter.

Sometimes this behavior is caused (or a contributory factor) by medications. It takes a while, unfortunately, to find what works.

It is possible they could ask you/r FIL to leave. I believe any facility can do that at any time. Doesn't put you in a good position. However, if I were you, I would discuss with Administrator (not dept director):
* Medication now / what might work 'better
* If Sundowner's is a factor - (get someone in there in the evenings).
* Find volunteers to be with your dad.

Consider your dad is confused and scared. He may not know what is happening to him and he is alone. He is communicating the best he can. Even a volunteer could give him a hand massage / offer some supportive comfort.

Whatever you decide, try it out for 1-2 weeks and see how things go.
You do not say how long your dad has been in the facility. Adjusting takes time - perhaps up to 4-6 weeks. It is a very difficult position to see your FIL going through this - and feeling perhaps helpless, with the fear of him being asked to leave.

If I were you, I would talk directly and honestly with the administrator -
"At what point might you ask my FIL to leave?" Has it come to that?

It is better to know where you stand instead of fearing the worst, without knowing.

I'd investigate / try medication to calm him down. Gena.
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Reply to TouchMatters

They should have trained their employees to handle these situations. There are many ways to redirect behavior into something productive. Talk to the social worker there. If a personal 24 hour or 12 hour caregiver is what he needs then it would be less expensive for you to have him at home or even at an apartment near to you. If you have questions about resident rights, contact the ombudsman for the facility. They should have information posted and they have to tell you who the ombudsman is.

All the best
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Reply to DianaFS
TouchMatters Jun 13, 2024
Yes, employees can handle although not 24/7.
Most of the staff has so much to do with however many of residents they are responsible for -

I worked with ombudsman; she tried to help - a lot. Although in this situation, an Ombudsman may not address or be able to address the 'problem,' due to staffing / needs. From my experience, staff is not - and does not - have the privilege of 'time' to spend with individual residents, depending on their needs / time commitment required.

I would agree - getting someone in there even four hours a day to start would be good.

I am curious as to why medication hasn't been addressed. If on meds now, perhaps they need to be changed. Gena
See 2 more replies
Consider this do you want to be in a care facility? I dealt with my wife before she died. She was in a care facility after a fall and it was the worst experience ever. I brought her home.
I am sure her frustration comes from her life being out of her own control. I can’t imagine what anyone would feel with death knocking at their door and they are in a place they do not want to be. My suggestion is to put her somewhere she is happy or give her drugs so she has no idea where she is.
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Reply to Sample

What they do for memory care. Seems if no memory what's he mad and angry about? Take him elsewhere they will lose revenue and you might get lucky. Did they do an intake interview? What's a Doctor say. Especially in Ohio most are there for a paycheck n social life with employees. Contact the US Senate Committee on Aging.
They just Reactivated after a 20 years Hiatus. Best of luck maybe a prayer circle for you.

They're in a protocol is detached mentality. Road runners delivery meals n pills. Notice if staff laughs loudly and a lot it's a psychic reaction. They are sicker than the patients. Find out what a Angel of Mercy is legally. BE LEARY OF CROWD sourcing.
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Reply to AdVinn

All good advice. But, just because the facility asserts a competency in MC dosnt mean the staff i properly trained. I moved my father out of a similar situation. I sat with my Dad for ma couple of days to observe how they handled things. I as stunned and immediately moved him. Just because they claim to be experts doesn’t mean they are. I agree with comment that said to tell them to do their jobs. Be a careful and smart “consumer “ of services. I also agree with see his doctor. There are meds that really help. And sometimes anger and being upset are reasonable responses to what he is experiencing. 24/7 private care. If you can afford that you wouldn’t need them or he could be at home; that service is less expensive than facility. Mine is one opinion my prayers are with you and your father.
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Reply to Anne2024
BurntCaregiver Jun 13, 2024

You're absolutely right. Just because a facility claims to be competent in memory care doesn't mean that their staff is properly trained in that kind of care.

If they collect payment to provide memory care for residents with dementia and their staff isn't trained in that kind of care, they'd better damn well get that staff trained right quick before the lawsuits start coming in.

This complete and utter nonsense of hiring privately-paid help for a person in a nursing home or memory care is ridiculous. It is a smokescreen facilities put up for resident families because they don't want to hire enough help or train them well enough so they can meet what the facility claims they offer.

There is nothing unusual about the OP's FIL. People with dementia behave badly and 'act up'. They get agitated and angry over nothing. They can be unreasonably stubborn because they can't be reasoned with. They confabulate, get hysterical, paranoid, have hallucinations and freak out on a regular basis.

Memory care facilities know all of this and it's their job to deal with it. Not the family.
Did the personal care home give you any options? Medication ideas? You may have to transfer your dad to a different memory care facility. It sounds like they don't want to do their job. Speak to whoever is in charge.
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Reply to Onlychild2024

Forget hiring private caregivers. If you and your family can hire 24-hour, round-the-clock caregivers for your FIL, he would not need to be in memory care. Why pay them thousands of dollars a month if you're hiring your own help? That's ridiculous.

It's THEIR job to deal with your FIL. That is why they are being paid a king's ransom every month for his "care".

So tell the memory care that it's a hard 'NO!' on hiring privately-paid caregivers and that they can start doing the job they are being paid to do.

If they cannot handle your FIL in their facility, they can find him a different one to go to. Or his POA can give permission for them to start medicating him to help keep his anger and upset behavior under control.
Helpful Answer (13)
Reply to BurntCaregiver
sp196902 Jun 13, 2024
Exactly on the money as usual @Burnt.
HAve you talked to a geriatrician about medications to calm him?
Helpful Answer (2)
Reply to MACinCT

It sounds as though he is too far advanced for ALF.
He requires memory care now. And yes, that would likely in and of itself be about twice as much as ALF. However, an aid 24/7 would be enormously expensive; likely about 3 times what he is paying for ALF. Not doable I am thinking.

I would ask for an appointment with the ALF manager/administrator.
I think you should ask if it is the opinion of the facility that Dad now needs 24/7 care. If so, do they have a memory care?
If not, you will now be exploring a memory care facility or a nursing home. If that latter IS indeed the case it may be one reason the ALF that has no memory care wishes to keep him with them.

Explore options. Good luck to you.

You should also first consider seeing the doctor with your father. A try at a mild anti depressant (if this is not his advancing dementia that's the problem) or anti anxiety med may be the answer for him. It is worth a try if the current ALF is willing to work with you.

As we are just a bunch of caregivers out here, without knowing your father, his history, his overall abilities and appropriateness for ALF versus memory care there isn't a lot we can do other than ask you to work hard with his MD and with the facility itself on what the best way to go.

I doubt an aid 24/7 can be afforded unless he is quite enormously wealthy indeed.
Helpful Answer (2)
Reply to AlvaDeer
waytomisery Jun 8, 2024
He’s in memory care already .
I think you read too fast .
See 1 more reply
I'm sorry, this must be hard.

I did some caregiving, and sat with a lady that was violent, for a week, until they had another place ready for her, it was a MC that specializes in care for more difficult patients.

It was about an hour away in a larger city.

I feel like you mc should be helping you figure out you options, not just saying , this is the way it is. That's kind of disappointing that there not helpful
Helpful Answer (1)
Reply to Anxietynacy

My mother is upset and angry all the time. Her MC has not asked for a sitter.

Is your Dad violent? Raising his voice with others? Are people afraid of him? Are there behaviors that are dangerous to himself, or others?

Can you give us a bit more information?
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Reply to cxmoody

so he is in memory care, so presumably has dementia. Who are his doctors , besides primary care? Has he seen neurologist and/or psychiatrist?

I would recommend to speak with any/all of these doctors about what the memory care said. Having 24 hour sitter indeed with be a high cost.

Anger and being upset all the time could be depression or something. there may be a medicine they can give him that may help a lot. I think you should reach out to the doctors as the first step. Ask the memory care director if you can hold off the sitter for a week or so while waiting for the doctor's opinion.
Helpful Answer (7)
Reply to strugglinson

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