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My father is the sweetest guy, and yet in the last 24 hours he became aggressive with a caretaker and eloped from the Assisted Living Center he is at with my mom. Both are brand new behaviors. Before everyone goes to the extreme in care, what should be considered or done? Suggestions please!!!!
Move to memory care side of the building, wait and monitor the behavior, increase the caregiver support to 24 hours and leave him in the room he is with my mom, move him and leave her where she is? I just don't know. I just don't want to go too extreme if this is a one time occurrence. Am I being naive?

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In addition to CM's excellent suggestions, I would make sure he gets tested for a UTI. They can cause weird behavioral changes in elders.
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Acruelly unless your mom didn't want your Dad to stay with her, your Mom and Dad should have never been separated in the first place.

If it's ok with your mom then of course your dad should stay with your mom.

You call it aggressive behavior when he's just trying to do what he wants for a change instead if letting everyone else make decisions fir him.

Juse put yourself in his shoes and do what you really would want someone to do fir you if the situation was reversed.

Also, kerp in mind that you can't believe everything you hear from a Caregiver.

The Careguver might have done or said something to make your Dad want to leave.

You should always have a Camera installed in their rooms so you can keep an eye on how they act and how they are being treated. I use the Nedt Camera for my 86 umbrella old Dad.

If I'm suspicious about something or a Caregiver says my Dad did something, I can back my camera up to the past 30 days and see exactly what went on, it just might surprise you.
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UTI is something the staff should recognize. Ask if they have a test there to determine that it is a UTI. My Mom started to hit and the staff tested her. Its common in older people because they don't void completely, incontinent and use Depends, or don't clean completely.

Best thing is if UTI is discovered to have a culture done to make sure the correct antibiotic is used.
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Step one: find out what happened. Ask your father why he left, and if he is upset about anything in particular. I don't doubt dementia-related factors had something to do with his inappropriate *response*, but something triggered his upset in the first place. Talk to him.

Meanwhile - aggressive in what way with the caretaker, and what was the caretaker doing at the time? Is this individual known to him and vice versa?
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A check for a UTI would be the first thing to do.
A move to Memory Care might be in the very near future.
The question would be how well he would do without mom and how well she would do without him. If she does not have dementia she could move to MC with him and she could still be free to come and go so she can partake in other activities.
If the aggression continues there is medication that can help.
Wondering if there was a reason for the aggression if this has never happened before. Did the caregiver surprise him in some way, did she accidently hurt him in some way, did she try to make him do something he did not want to do? If he tried to make his wishes known and she ignored him or she did not explain what she was doing that may have been his only way to get her to stop what she was doing. And if this aggression occurred right before the elopement he just may have been trying to get away from the situation. I would not jump at moving him (or both of them) I would try to find out what exactly happened.
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Physical evaluation for this sudden change, starting with checking for a UTI.
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As soon as I hear about a sudden change in behavior, my first thought is UTI.

Don't expect staff to recognize this. The hospice nurses certainly didn't recognize it for my mother even though I brought it up with dad several times. I should have called hospice my self.

Don't rely on physical symptoms because there may not be any. Insist on a urine culture, will take about two days to get results. You may need to get aggressive and demand the culture. Don't dawdle.

It took over three weeks before they finally did a culture on mom. It was too late then. It stole her sanity and shortened her days. Please don't let this happen to your dad.
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Nandring Oct 2020
Thank you for all the great feedback, the UTI was ruled out. The aggression was due to him wanting to find my mother, and the care taker needing him to sit down before he falls. The elopement was to get to a hut??????? We are planning a move to memory care, but it just seems like everything is moving soooo fast. I am struggling with the rate he is deteriorating.
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I agree with the others - have him tested for UTI. A simple home test can be done first, but I agree with JoAnn29 about having a culture done. Even if the home test is negative, it is probably best to have the better test done, as you could get a false negative.

It could be that his dementia has progressed to another level, but often when something changes that quickly, a UTI could be the cause. I was skeptical when I first joined and read so many posts suggesting this. That skepticism vanished with mom's first UTI in MC!! She developed sun-downing to the MAX! Had to get out! Set off all the door alarms! She had guests coming and needed to go home! EVERY afternoon-evening. In the morning, she would be fine. Of course this happened on a Friday evening, no access to doc and they wanted ME to come up. Like what was I going to do? She NEVER had anything like this before. Monday she tested positive and we had to treat her with antibiotics AND an anti-anxiety for the duration. Once the UTI was gone, so was the sun-downing. Since then her UTIs have resulted in night-time bed wetting. Once treated, all was good again.

So, yes, any sudden change in demeanor or behavior should call for a UTI test. It could be something else, but this test is simple, cheap and can get the problem taken care of quickly! If it's not a UTI, other testing may be required and/or medication to help ward off the behavioral changes.
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UTI?
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tevincolorado Oct 2020
Urinary Tract Infection
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It would be helpful if mom and dad are in the same room - many facilities can accommodate this. Then he can be with her and they can spend their time together. I imagine she has a calming influence on him.
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