Aggressive behavior(4)

Saya_G

So how many of you have an aggressive LO. Mine is at stage 6, never wanted to go to assisted living, however for several reasons it became too hard and really impossible to keep her at home. 

She is often verbally aggressive, since going into the facility she has become physically aggressive too. Today, she dealt the staff fits! Last time this happened they threatened to throw her out - I’m expecting that might be the result of today’s outburst as well. 

They told me that she threaten to kill them and to call the police on them. She claimed that she had owned the facility at one time, but that they had manipulated her ownership and had taken it away. 

She clawed one of the staff across the chest! 

By the time I got there she was all over the place, glad to see me, then I was one of ‘them’! She can be pretty scary! She is strong as an ox - even in a wheelchair she can be a formidable foe! 

She’s on antipsychotic and anxiety meds already, if they give her more she sleeps all the time! The facility has already stated that they do not believe in ‘chemical restraints’. I’m not wanting her doped up, but if you’ve experienced this - we’re you able to find a happy medium?

 Any suggestions?

dayn2nite2

Okay, well this is beyond mild aggression and injuring others is pretty bad.  She needs a geripsych ward stay, but the facility may use it as an opportunity to discharge her from their care.

Is she really in assisted living?  Someone with delusions sounds further along than that, more like memory care.  If she really is in assisted living only, she should be moved to a higher level of care.

​fesk

Sorry this is happening. I would have your mom checked to make sure she is not in physical pain and there aren't any infections - including a UTI. I would also have her medications reviewed. Was she put on them recently and they are not effective or has she been on them and her symptoms were in control for some time? As mentioned above, it does sound as if assisted living cannot meet her current needs if that is where she is.

MN Chickadee

I agree, have her PCP rule out UTI and other infection first. 

If it is true assisted living and not MC then that is likely part of the problem. Not the right level of care. When a PWD does not have the structure they need, and the staff around them are not at the right staffing ratio and had extensive training, then it can lead to them in a tailspin of negative behaviors. If she is in MC or SNF with a dementia staffing level and training then it is probably time for a geriatric psychiatrist. They are best equipped to tinker with meds to find what works for an individual with dementia. They are the ones most likely to find the combination and dosage that doesn't make her sleep all day but dials down the behavior. Many people do find the sweet spot. Facilities are not allowed by law to use chemical restraints and zone out a person just to keep them in check, but if she is under the care of a doctor who is trying to find a concoction that improves her quality of life and anxiety and makes care possible that is different. Find out if the facility has a geri psych they work with. It is possible she may require a stay in a geriatric behavioral health unit. Most people stay a few weeks to get stable and find the right meds and then are discharged back to home or facility. No facility is going to keep her or accept her as a new resident with aggression, the meds will be essential to keeping her in care.