Mom is hitting; is it reasonable to expect an action plan?

krwebb

I'm new here, struggling to find some info so any help is appreciated! - also, sorry for how long this is.

Last fall, my sister and I convinced our dad to put Mom in memory care. She's advanced enough that she can't manage personal hygiene or communicate her needs effectively.

Mom has this fun thing where she often has paradoxical reactions to medication. For example, coffee puts her to sleep, but sleep medications will have her climbing the walls. Getting her medication sorted out has been a challenge and is still in process.

About a month ago, Mom started hitting other residents. Understandably, this is an issue for the MC facility. The nurse told my dad that the state would intervene if we didn't have a family member with her 24/7. We worked out a schedule and made that happen. I'd asked about plans or next steps, but the whole thing was pretty open-ended.

As the new medication seemed to be working, we tapered back to just being there when she's sundowning. Then she got up at night, wandered into another resident's room, and hit her. We're back to full-time coverage and the nurse says the other resident's family is threatening legal action.

There have been five incidents of hitting other residents. Three of those were in response to another resident yelling insults at her (the nurse said that they don't have the resources to control resident's verbal abuse and Mom was the one completely at fault because she escalated it to physical).

My frustration is that I don't feel like we're getting any information. We keep adjusting medication, but the nurse doesn't believe that Mom has that paradoxical reaction and seems mad that we insist it's happening. I don't feel like we're getting much guidance on medication - beyond her pushing for THC. The facility has a part-time PA, so all of our communication and counseling goes through this nurse.

I don't know if Mom's behavior is normal (based on what others have written here, it seems like it), or if she's so out of left field, they don't know how to deal with it. As best as I can tell from the nurse (she's not great at responding to messages), the current plan is for my family to continue to provide the 1:1 care indefinitely (and the resentful part of me wonders what we're paying them $12,000 a month for).

I would really like some sort of action plan. It doesn't have to be written in stone, but something like "when this happens, we handle it this way." Or, "here's how we're working to resolve the hitting so you can maybe go back to your full-time jobs and raising your kids." I've asked the nurse about next steps, but she indicated that the solutions were up to us. Is that normal?

I don't see other families in the facility doing this 1:1 care, so I feel like either Mom's behavior is so unusual that there is no plan for dealing with it, or it is typical, but the facility is getting paid for us to do their work, so they're ok keeping us in the dark.

But I also worry that I'm selfish for expecting any answers or any normalcy in my life right now.

Anyway, I'd love to know if this is a common stage and will likely pass or if we're a total anomaly. I can also handle being told that Alzheimer's is just a crappy disease and we need to suck it up and power through.

Thanks for any info you can offer (and thanks for reading this entire novel).

Lynn24

Yes, the combativeness is normal for some dementia patients according to information and feedback that I have gathered from my mother’s hospice comfort care team. My mother has lived with us for over a year and a half, and has become combative and more angry. The only thing that helps is THC. It keeps her calm. The only medication that we have recently found that helps is Seroquel plus it helps her sleep 6 to 8 hours every night.

M1

ask if they have a geriatric psychiatrist they work with. She may need to be hospitalized for stabilization on different medication; ask if that's a possibility or research it yourself. You don't want her to be expelled from the facility.

SusanB-dil

Hi krwebb - welcome to 'here'. Combativeness does sometimes happen, but it seems the correct dose of the correct meds for an individual person would help that aggression. Since this facility is not communicating, could you maybe get her to her doctor for meds corrections, and even perhaps look at another facility?

harshedbuzz

@krwebb

Hi and welcome. I am sorry for your reason to be here, but pleased you found this place.

Given you mom's history with meds and active aggression in the context of other families considering legal action, I am surprised your mom hasn't been asked to leave.

In your shoes, I would proactively have her admitted to a geripsych hospital where medication can be trialed by those with the most experience with psychoactive meds in the elderly and those with dementia. They may be able to create a regimen which reduces or eliminates the agitation that triggers her fight-mode. From there, the social worker should be able to help you decide if you want to return to this facility or find one which would be better at managing and anticipating behaviors.

There was a hitter at dad's MCF. She typically had one of the aides within arm's reach keeping an eye out when she was with others. But this wasn't foolproof. I had an aunt who was both aggressive and wasn't supposed to stand without an aide. She was in a SNF which insisted family provide a 24/7 sitter to keep her safe. This isn't unheard of.

HB

wctraynor

I can't imagine having to pay $12,000 a month for care you have to provide yourself. I have heard other families have to go to the care home daily to verify their LO is being changed and bathed regularly. I am debating putting my mom in a care home but the stories are frightening. I might be better off hireing some one to come to the house once or twice a day, plus my regular care hours i provide. At least I can see whats going on. Gah! I'm so sorry!

krwebb

Thank you all for your info! We've reached out to some local resources and have gotten Mom in hospice care. They're getting her medications straightened out and she has a lot less anxiety.

We've also met with the facility director to talk about communication. Turns out the nurse is brand new to memory care, so everything does seem scary and new to her.

It really helps to know that this isn't unusual and that there are steps we're able to take to resolve it.

Kmart79

This is extremely helpful and encouraging to read as I am currently helping my husband care for his mother who becoming more and more violent and verbally abusive with everyone. the family has not completely discussed options as far as removing her from the home.

Many blessings to everyone

Lynn24

My mother was hitting and scratching a few months ago, and. I was able to admit her to Hospice comfort care services. Hospice nurses come out four days a week to assist with bathing etc. All of her medical concerns are coordinated through and assigned case manager RN.

She is now taking Seroquel, of which has helped her stop hitting, since she has veen taking it for over a month now. She is in mid to late stage dementia, and it is a very difficult process to serve as caregiver. She has been living with us for almost two years.