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I just received a call from my 94 year old father’s memory care facility stating he had been physically aggressive to a resident assistant. This is completely uncharacteristic - he is sometimes depressed or anxious but never physical. What can I expect? I don’t know if he can handle yet another change in living conditions. Please advise me on next steps.

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Best to check for a U.T.I. and overall medication check.
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Reply to Llamalover47
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Aggressive behavior is not unusual when routine is disrupted. They get disoriented and confused easy, and I think flip flopping time daylight savings to standard and visa versa has a profound effect on behavior disruptions due changes in routine.

Sadly chances are your dad will be put in the psych ward..where more environmental changes occur and they will give him psychiatric drugs so he won't lash out again..I think after several occurrences they kick him out of the nursing home due to the liability.

Now my mom has severe Alzheimer's (now end of life stage) and through the 20 years of this I never had to resort to any kind of psychotropics. Routine care was the key..and I kept her moving as I took her to the park daily and walked her. If she acted crazy back to the park and walk her and she would settle down afterward. But am her only caregiver . I also think due to this routine exercise she managed to live all these years but she really is near of life. Her body is wore out and insulin dependent diabetes did not help matters..in a few months she will be 90.
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Reply to cetude
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Not all memory care facilities will react in the same way

since a couple of days have gone by, you might have better info on what prompted the aggression- oftentimes staff may try to direct the resident against their will say to use the bathroom or shower

during the past three years, I've seen firsthand some over the top behavior and it has to really get out of hand in order to call 911 for a psych hold

unfortunately with dementia, aggressive behavior occurs in both men and women and meds are necessary- for this reason, some memory care facilities will not admit residents with this issue which makes placement challenging

When mom at nearly 93 managed to elope and put up a fight with staff trying to get her out of the street, her facility threatened to call 911 - gratefully this didn't happen and while it was a rough couple of months, with UTIs and changing her from one antipsychotic med to another, she became more manageable although at 95 and now immobile, she is still a handful and doesnt want anyone to come near her
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Reply to MsMadge
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As states..also check for an uti. Rule out physical..then let him know what you will do before doing it..such as Mr. Smith, i am going to change your shirt.
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Reply to RacklaMSW
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Stop changing environments, that can confuse him. Get Geri doctor. Someone who knows the elderly population. Make sure the caregivers are explaining to him what they are going to do first before starting.
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Reply to RacklaMSW
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Was he checked for infection (UTI)? What happened to lead to the act of aggression? Get details on the incident from the facility then go from there.
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Reply to mmcmahon12000
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Given that this is a first for him I'd start by going in curious about what they feel triggered the aggression and what steps they are planning to take to ensure that the trigger is dealt with - remember even the most loving and docile person can lash out when feeling overwhelmed, frightened or threatened.
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Reply to cwillie
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NeedHelpWithMom Apr 9, 2019
cwille,

Very compassionately answer.
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Sometimes sudden changes in behavior or cognition/mental status are indications of an UTI.  Ask the memory care unit to have a UA done to rule out an UTI as the cause of the behavior change.
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Reply to DeeAnna
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I think it really depends on the facility as to how they will handle it. My mom slapped two different residents on two occasions and was herself pushed into a wall once by another resident. She was put into a room by herself near the nurse’s station so they could keep an eye on her. Since she was on Medicaid this was against the rules, but the facility wanted to protect her and the other residents. It’s common for people with dementia to revert to self-preservation. They can hallucinate, like my mom did, that everyone wants to do them harm so they strike out, especially when strangers (like the RA) are touching them.

You need to request two meetings; one with the facility's physician and a care conference with as many staff who interact with him as possible. Don’t automatically assume and worry that they’re going to throw him out. But make sure that you are proactive about letting the staff know you are aware of his behavior and want to work with them to help him.
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Reply to Ahmijoy
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There are others on this site that have also experienced this. They should be along at some point.
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Reply to gladimhere
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The facility may very well ask dad to leave. He is a danger, now, to himself and others. My mom was too. She was asked to leave a memory care that she had been in for a year and a half, self pay. The facility cannot take the risk of dad harming others.

My mom was on hospice at the time and hospice recommended an excellent care home where there was a much better resident to caregiver ratio and it was cheaper too. Smaller, homier place for mom. She probably would have been better cared for there from the very beginning. And this care home all residents had been kicked out of their previous facilities. Can you imagine?! But, it worked well.

Dad's facility may request the he be admitted to a Geriatric psych facility to try different meds to see if they can come up with some combo to help dad. Has he been checked for a UTI recently? Sometimes that alone can push them over the edge.

Realize that dad's facility wants what is best for dad and others. Another move may be in the near future. If he goes for a geriatric psych assessment the current facility may decide to not allow him back. Time to look for help. If he is not on hospice you could certainly call one and ask if they have any recommendations.

Just checked your profile, mom passed just five months ago? Dad's behavior may very well have something to do with mom's passing. When my mom was asked to leave it was four months after stepdad passed. Maybe she just knew something was not right but unable to understand or process feelings of grief. Who knows.
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