Aggression and violence-early onset

campfairy

Hi

I have a dear friend that is dealing with her husbands combative, violent aggression. He is an early onset patient and 70 years young. He was placed in MC and they had to transport him to ER because he was harming the staff. The ER sent him to a geriatric psych facility 2 hours away. After 10 days there the psych facility sent him to an ER in the same city because they thought he was dehydrated. He did have a UTI, however no sepsis. He was put on IV antibiotics and his meds have been changed several times. She is now faced with no where to place him next. It takes 3-6 people to assist with him. It is the saddest thing I have ever seen. Has anyone else experienced this? If so what it another option. Thanks

Emily 123

Hi campfairy,

She will have to stand firm and tell them that he isn't safe to discharge home-that she can't handle his behaviors. The discharge planner/social worker will have to find placement for him. That will probably mean he goes back to geripsych until they can get his aggression under control and then he can go to MC.

Do not let her get talked into trying to manage him at home.

SusanB-dil

I agree with Emily - All the aggression may be due to the UTI and getting the correct meds, but agree that she should not take him on.

(he may be early-stage. Early-onset is under 65, but regardless, it is still sad)

campfairy

https://alzconnected.org/discussion/comment/231541#Comment_231541

Thanks, what happens if they can't get him under control? This all started when sent to MC (no UTI then, he wasn't even in depends). He started urinating wherever he wanted and refused all care. The aggression that was pretty mild started at home and escalated once in MC. They invited on a one on one, which is understandable. She hired some private duty and they all quit unless ME (wife) stayed overnight. I wonder if there is a time limit. The Geri/Psych facility has him in a geri-chair, not been shaved, fell and very bruised on his head and black eyes. After a few med combinations they started Depakote. The ER he is in now has yet another Psych consult and they increased dose of Depakote. I also wonder if it matters what state they are in. The original MC facility that sent him to the ER is in Sarasota Fl and sent him to Sarasota Memorial Hospital who sent him to Psych/Geri facility in Fort Myers who then sent him to the ER in Fort Myers. ME (wife) can not handle him for sure. Her last statement to me last evening was "no one wants to take hime" 😣 She has bruising from him which was witnessed by all facilities. This man was a CFO of an international company! So devastating. I believe he is sending a message to just leave him alone in a bubble so he can die.

campfairy

BTW definitely early onset, He was diagnosed at 64 or so, for sure started showing symptoms before that. His mom dies of EO some years ago.

SusanB-dil

uugh - yes, that is early-onset. so sorry… and sometimes that can progress faster than others. Grandmother had early-onset and that is so hard to see our LO in such a situation.

agreeing she should not take him home. It does sound like just too much for her to handle.

Mint

i agree with things said above.

Recently placed my hard to place mother with the help of care patrol. My mom was difficult to place due to her personality behaviors, but she was not aggressive. They are a national company, I looked and there is a franchise in Sarasota Florida. The number is 941-584-9122. You can look them up online by just putting in Carepatrol Sarasota Florida and it’ll pop up too. The case manager at the hospital where my mom was, was the ones who recommended them to me and it was fantastic. There is no charge to you. They sort of work like an insurance agent. She guided us through the process and she knows what facilities would handle someone with your situation.

it would be worth you reaching out to them to see if they can help you

Emily 123

Hi,

Yes, no-one wants to take him, but that doesn't mean she has to. They will have to continue to evaluate and treat him until he's able to discharge to whatever place is appropriate.

Any move to a new place removes all frames of reference for a person who can't use memory to understand why everything is unfamiliar. That can kick off new behaviors or confusion in the PWD and/or lead to them not maintaining things they used to be able to do like hygiene or changes in food or hydration intake. Add a UTI on top of that and it can escalate quickly, and it may take a month or two (or more) to get back to a steady state (and meanwhile the disease progresses in the background). UTI's very much send a PWD off the rails. First thing is to get those illness and dementia driven behaviors under control.

Tetonman

OMG I'm not looking forward to any of this but deep down I know some of it is in our future

Victoriaredux

The UTI should be treatable , the hospital social worker should be doing the heavy lifting in getting him a bed in a geri-psych that can handle the IV . If not then they need to house him until he can go back to a geripsych unit for fine tuning.

She needs to be firm and treat the requests to take him home at the same level as if they want her to get on the roof in a rain storm to fix a leak- not safe and not her wheelhouse. They just want the bed free and will try everything. Unsaid but hinted images of him not getting care in this limbo land just to play on her emotions.

Tell her to hang tough.

Care patrol looks like placement agency, paid by the homes. I'd probably wait until his UTI and meds are adjusted and then use the geri-psych social workers to place him . Taking him out now would get an agency a placement fee but probably just start the whole cycle again since he's not resolved.