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I haven’t been active on here in a while due to yet another situation with my dad. He had moved to to his new facility about an hour away from my home. He was only there maybe a week and a half and they called and said they had sent him out (called 911) for evaluation. He hit one of the female residents. He went to the emergency room at a small hospital and was supposed to be admitted to a geri-psych bed. He waited in the ER over a week (I know this sounds unbelievable but it happened). He ended up being re-evaluated by psych and they said he could return to his facility....I also about that time received word that my dad was nonverbal and unable to even stand without assistance and had been that way all day. I had not visited him in the ER because it was not a locked facility and I knew my dad would run after me resulting in more traumatic events for he and I. The hospital ended up admitting my dad to a regular hospital bed due to his decline he also had fever of 102. That same day the director of his facility called me and told me that the state had done an investigation on my dad's behavior and he would not be able to return to their facility.
My dad’s rapid decline was due to a UTI which is being treated now. Today I went to see him and he is back to walking, trying to say words, eating etc. I am literally so wiped out and just at the end of my rope with all of this. I feel like I can barely even type this.
There are three centers in the state of North Carolina that take aggressive Alzheimer's patients and that is now what we are faced with once he becomes medically stable. Yesterday he was unable to do anything at all and I really thought maybe this was the end of his disease process but now he is bouncing back only to be placed in an environment that I find devastating. I feel there is such a lack of education for the workers at these memory care facilities and it so much easier to deem a resident as aggressive that doesn’t fit the bill of sitting and watching tv all day just so they do not have to put in the extra work. I am so sad and literally feel helpless with all of this. Please send good vibes my way as this upcoming week will hold some of the most difficult circumstances for me and my entire family.

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So sorry you and your Dad are going through this very rough crisis.

Is there an appeal process to the state investigation? Any chance to get the "state" investigator to review or include the hospital evaluation that Dad could return to the facility and consider revising the decision in state report? My father's MC required any resident involved in a violent act against a person to be re-evaluated and stabilized before returning. You may not want him to return to the same facility but getting the aggressive label revised would give you better options for placing him somewhere his needs would be better met.
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Swise02 Nov 17, 2019
Unfortunately this is not his first offense. He was discharged from his last facility for pushing an elderly resident and she broke her arm. She was yelling at him and they had also not given him two of his meds for three days. I feel like every time my dad has lashed out there is a reason behind it. But my dad has been labeled dangerous now. I know that my dad will not do well in any regular memory care facility at this point due to people not knowing how to handle him. When he goes into a hospital setting he does great and becomes a “favorite” of all of the staff. But they seem to handle him so differently and are quiet with him and that is what he needs. I am right now trying to figure out what to do about all of this. It seems so hasty and unjust. Thank you for your response!
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I am devastated for you and your father. Somehow it doesn’t seem fair that he not be allowed to return to the facility when the aggressive behavior was triggered by the onset of infection and is not a routine behavior. But I’m also aware that fairness is not the standard and my opinion is not helpful. Our country desperately needs better psych/mental health care. No one should be stuck in an ER for a week because there is no appropriate place available for care and treatment. Sadly, it’s not uncommon. Hugs to you and I will absolutely send good vibes your way this week.
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Swise02 Nov 16, 2019
Thank you
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So sorry SWise. Hugs and good vibes coming your way! Your Dad is so lucky to have you for his daughter and advocate. This disease absolutely sucks. More hugs to you and to your Dad.
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Swise02 Nov 17, 2019
Thank you I really appreciate those words of encouragement!
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I spent hours watching YouTube lately on stages, Types based on behaviors and how to deal with them. While I’ll admit it’s very time consuming and much patience is required, I learned tons. I would have to say the staff is not trained nearly enough, add in low wages and more patients to each staff member and that’s the recipe for disaster as they don’t have the time or energy or intestinal fortitude to perform their job. I’m wonder if they’re even qualified for these positions. They need so much training they probably don’t get and you’ll see that in the way they handle situations.
If he’s definitely going into an aggressive labeled facility I’d go see how chaotic their environment is. Watch how they handle the others especially if a patient has an outburst, if they don’t approach slowly, diffuse and redirect then they’re probably administering big doses of drugs instead. You might reconsider where he’s was, that he wasn’t receiving the care he needed if they didn’t bother to check for UTI, a number 1 aggressor...I’d be worried about their quality and thorough care. Keep trying on the appeal but perhaps winning means you should inquire other places. It’s NOT ok and quite dangerous to have psych meds “forgotten” don’t you agree? The withdrawal is painful, aggravating and makes people want to crawl out of their skin (imagine a heroine addict and the burden of withdrawal) and that seems completely negligent, dangerous even deadly and irresponsible of their behalf. Considering that was the problem both times, sounds like it’s not his fault or his disease.
Continue advocating, it’s your best effort to get him placed appropriately so you sleep better at night knowing he’s okay. Hugs from California
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Swise02 Nov 17, 2019
Your response is right on target and I completely agree with everything you said. Thank you!
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This is unbelievable. Nobody thought to check for a UTI?! That is often the cause of aggressive behaviors.

My mom was an agitated Alzheimer's patient, too. She had to be admitted for a geriatric psych assessment on several occasions. When she was home, it was always a UTI and easily recognized because of the behaviors. But, when moved and she became agitated it was not a UTI. She needed med adjustment.
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If my mother was one of his victims assault. I would not want him returning to the same facility. The residents may become wary. His behaviors are extreme and not of just confusion. Sorry for the tough love but even with a reason, he had a second offense. Sure there was an explanation...sort of like when a psychotic person goes off his medications and wreaks havoc.
I do not think it is lack of education in memory facilities but a patient and caregiver ratio. Then again most residents are not violant
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Swise02 Nov 18, 2019
I agree.
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How could you not be sad? Geeez, what a nightmare for your dad and you? How in the world could he be in the ER for a week? That’s just ridiculous! Actually it’s neglect.

Fever makes everyone feel awful. It’s terrible that he was suffering like he was. So, when was he tested for the UTI? This is so disturbing to see.

Why does a UTI cause so many problems for the elderly? It’s so sad.

sorry that you and your dad experienced this ordeal. Hugs!
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My FIL kept getting thrown out of facilities bc of bad behavior. Hubby rented a 2 bedroom, 2 bath apt close to us and hired a company that provided 24 hr care. I checked on him every day to make sure he took meds that kept him calm. This worked for us.
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Why would you want him to be back in a facility that has failed him and clearly does not want him there?

Long term care psych facilities have the staff who are trained specifically to deal with people like your dad. It's for the safety of others as well as your father. They will give your father his meds. They will adjust his meds as needed. They will identify when he has an infection and treat it. They will treat him with dignity and respect. They will help you cope with your father's illness.

In my opinion, move forward and get your father settled into one of the "three centers in the state of North Carolina that take aggressive Alzheimer's patients".
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Swise02 Nov 18, 2019
Right...I never for one minute wanted him back in either of the two facilities that have discharged him because they are obviously unable to provide proper care. I have never fought it or argued their decision because it is pointless. I was just saying that it is unfortunate that he is faced with a state facility due to lack of training in regular memory care facilities.
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(((((Hugs))))). No good answers. Cruel, terrible disease. You are among friends here.
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Swise02 Nov 16, 2019
Thank you for your kind words
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