Moving to facility...should he keep his cellphone?

jaymeschoch

My father with moderate Alzheimer's is moving to a facility (board and care) today.  I wanted to take care of him until the very end, but he started getting extremely violent towards my mom with a delusion that she has been unfaithful to him...so he cannot stay.  I went ahead and deleted my mom's number from his phone, along with his family's because we are all completely exhausted, burned out and in desperate need of break from caring for him.  But I left his friends' numbers because he really enjoys talking to them.  But I'm nervous his friends (some are showing early dementia) will somehow take him out of the facility and bring him home.  I thought about taking the phone away from him, but I feel that would make him feel so disconnected and lonely in an unfamiliar place.  Any thoughts would be appreciated.  Thank you so much, and my prayers to everyone who is taking care of their LO.

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Quilting brings calm

Without your family as a buffer for his aggression, he’s going to turn that  Aggression on his friends.  His possibly demented friends can’t deal with that.   So either put your numbers back in the phone, or remove the phone. Either way, get him some medication to treat the delusions and aggression.

harshedbuzz

jaymeschoch wrote:

My father with moderate Alzheimer's is moving to a facility (board and care) today.  I wanted to take care of him until the very end, but he started getting extremely violent towards my mom with a delusion that she has been unfaithful to him...so he cannot stay. 

My dad went through a stage in which he was convinced my mother was unfaithful. It's a super common delusion. We addressed it with medication and validation. In terms of validation, I was able to disabuse him of the notion that mom would step out by laying on praise and complements thickly with a trowel. It did not work for mom to defend herself. It's pretty common to have other delusions at this stage that could also trigger agitation and aggression, so medication was useful to relieve him of the feelings that drove the behavior. With meds and validation strategies we were able to keep dad home at least an extra 18 months. He ended up on a cocktail of 3 psychoactive meds at fairly low doses that took the edge off and allowed validation to work. 

I would be prepared with a Plan B. If he can get violent over the false belief that mom is unfaithful, he has the potential to become violent over other delusions-- another resident is stealing his things or staff is trying to poison him. If this happens, especially in a B&C where staff isn't dementia trained he could be asked to leave. In that case, you might consider transporting him to the ER and transfer to a geripsych unit for medication management and discharge home or to another facility. 


I went ahead and deleted my mom's number from his phone, along with his family's because we are all completely exhausted, burned out and in desperate need of break from caring for him. 

Many MCFs suggest families take a 2 week break to allow their PWD to settle in and bond with their care team. It's best not to supply a phone at this point. You can bring it later. And you can call the facility for updates.

But I left his friends' numbers because he really enjoys talking to them. 

This seems inappropriate. If your dad can't reach out to his family, it's very likely he'll ramp up his calls to his friends. Aside from the burden of constant calls from a person who is angry and not oriented to time, it is more the role of family to bear the burden than friends. IME, friends will drop off with disease progression and placement anyway. You can arrange calls when you resume visits. 

But I'm nervous his friends (some are showing early dementia) will somehow take him out of the facility and bring him home. 

What's the policy of the B&C home? These don't really exist where I live anymore, so I am unfamiliar. Are you placing him using a POA or is he legally joining the home himself?

At dad's MCF, which was a secure unit, we filled a form on admission stating who could sign him out. We left it at mom or me initially and added dad's brother after dad had settled in. I recall there was an option to restrict certain visitors (I have a sketchy niece) but we declined to add anyone. 

I thought about taking the phone away from him, but I feel that would make him feel so disconnected and lonely in an unfamiliar place. 

All PWD who go into a care facility will need some time to adjust and settle in. Some will feel abandoned. We got dad into MC using a fiblet about it being rehab to get stronger and ignored the advice to stay away for a few weeks. Those first visits were hard and dad was very nasty (dad and I never had an easy relationship, so not new to me but really hard for my mom) but it did improve over time. We did not supply a phone as dad wasn't using it reliably by that point and staff would make calls for those who asked. 

We chose dad's MCF for their dementia training program and he did well there after settling in. He accepted care more readily from professionals. This allowed mom to just "be the wife" instead of nagging and their relationship improved which was nice. 

Any thoughts would be appreciated.  Thank you so much, and my prayers to everyone who is taking care of their LO.

Good luck. This is difficult stuff.