My Mom is mid-stage Alzheimer’s and is generally pretty pleasant to deal with, needs help with most ADL's. She lives in a small care home with nice roommate who had stroke so uses iPad to communicate with. 1 other Alzheimer’s patient in other private room, but she generally stays in her room (wheelchair bound). My Mom has adjusted well since moving in almost a year ago.
Last week a 4th housemate moved into other private room and is making everyone crazy. She has mid stage Alzheimer’s also, but is loud, combative, and constantly screaming get me out of here. It is stressing everyone out. Caretaker said she refuses all meds so far can’t get her to calm down. She doesn’t sleep well so caretaker said she was keeping everyone up all night last 2 nights. I’ve tried engaging new lady to make feel comfortable but she will have none of it. What to do? Whole house on edge because of her. Was told prior Nursinghome discharged her since she was upsetting everyone!?! This is small home so would think she would be happier, but she will have none of it. I am afraid she will relapse my Mom into her paranoia she used to get 2 years ago, since new lady saying everyone there are liars and mean. Not true, I visit all the time; dementia talking. Frustrated- finally so happy with Moms living situation within last year after 4 years of struggle and now worried over this; hoping will improve in time...feel bad about new lady but all other residents suffering from her outbursts...
What I do know is a medical team should be involved as well as the possibility of Adult Prtrective Services.
Every person with either dementia or Alzheimer's reacts differently as there isn't 1 specific way or instruction book.
We should not expect more or less from 1 person than another with conditions such as these.
Protect your family....yes by all means
Talk with those in charge....by all means
If need be, bring in APS to check things out
We as non professionals can't say specifically this person should be removed or anything close to it
None of us know her background or her medical issues. She's in a new environment and she's confused. Have her children "dumped" her because they don't care any longer
We just don't know, all we can do is give suggestions not prognosis
Try to place that shoe on the other foot because this could be any one of us sooner or later being talked about by someone else.
When we actually did place her for a respite visit, we came to realize that she was much safer there than in the home in which she had been born decades before.
Within 6 weeks we, and the staff, observed a significant behavioral breakdown, and our sweet, compassionate, gentle LO became an unnerved, anxious and depressed, unfocused wanderer, looking for her mother, attempting to have us take her “home” or she’d “call a cab”, and VERY hostile when anyone attempted to refocus her.
The answer, which came VERY SLOWLY, was with the initial help of a wonderful psychiatric PA, who did a sympathetic interview/assessment and placed her on a low dose of an anti-anxiety/anti depressant medication IN ADDITION to the one she’d taken at home.
With careful observation by loving family and staff, placement on a restricted floor, and continued observation by the trained psychiatric specialist, she is slowly becoming more calm and more comfortable.
Fortunately she had adequate funds to support the level of care she has received. UNFORTUNATELY, the NECESSARY CARE was excruciatingly expensive. We, her POAs, have committed to doing everything necessary. There are many, too many, in this country who can not afford this level of care, which is a human tragedy.
Summing up, OP, you MUST do everything people have mentioned previously to safeguard your mom. The expectation that the new resident will receive the care to remedy her present situation is not realistic unless a remedial plan is presently in place, and if that is so, private room and one-on-one aide are essential to the other residents and staff.
Be firm, insistent, and ready to move up “the ladder” to the next level of management if your concerns are not addressed. Someone is LETTING this go unaddressed. YES, to contacting other families.
I´m working as a dementia coordinator in Sweden.
I red your description of your moms situation and her new housmate.
It´s obviously a challenge for everybody involved!
It seems to be a classical situation. Therefore I´d like to point out a few important facts and circumstances.
Based on your description of the new housmates behavior and diagnosis we can presume that she suffers of behavioural and psychological symptoms in dementia (BPSD).
BPSD are described as a change in behaviour which is demanding for those around the patient (e.g. aggression, shouting, wandering), as well as psychiatric symptoms that are troubling the individual (e.g. anxiety, depression and hallucinations).
Generally it´s important to know that approximately 9 out of 10 person diagnosed with a form of dementia will at least once go through a phase they will experience BPSD.
As for the newly arrived housmate we must presume that the combination of diagnosis and circumstances leads to a significant risk for suffering BPSD.
Change of enviromnent, new housmates, new staff generates a huge stress and it will take some time until she feels more balanced again.
How to treat BPSD? There are generally 3 areas we try to influence. Most important of all is adequat treatment and communication. Then vi have to adjust the environment and sometimes there are the possibility to mitigate the symptoms by medication.
With kind regards,
Jürg
Mpost of what you're experiencing is what my Mom/Step-father were doing when I had to place them in an assisted living group home. The only difference is how the staff AND manager handled the situation(s).
My husband and I visited a couple of "group homes" that were nice, but were really just a drop off and let us know when they die, before the caseworker took us to the one we relocated them.
The care givers are absolutely FANTASTIC regarding the total care they provide including the meals they prepare for all the residents, they even offer to make a plate for me if I'm there at meal time.
Yes, there are a few residents there who are under hospice care BUT all of the staff are trained in that area of care too.
I was so afraid of the "group home" setting, but the owner has 3 group homes and NOT 1 HAS RECEIVED ANY...ANY BLACK MARKS FROM THE STATE!
IF it is determined that a resident is like what you have described, the group home manager will have the family, the Doctor and if necessary the State come to evaluate to find a more "suitable" facility.
On average it takes a person to accept their new situation about 6 months. I'm grateful it only took about 2-3 months for Mom/step-father. I just saw them this past weekend and had to tell my step-father that neither he nor Mom will ever go back to Mom's house. That God has given him the job of helping the staff to take care of Mom and He have me the job to take care of them and everything else.
DON'T let the owner TELL you this person is staying. It is not a good situation for anybody else.
Rreview State records for this facility
CALL Adult Protective Services....it is all CONFIDENTIAL
This owner could be keeping this person there for financial gain! IT HAPPENS ALL OF THE TIME....LOOK AT THE FOSTER CARE SYSTEM....SAME THING HAPPENS AND MANY, SO MANY OF THE CHILDREN DIE NEEDLESSLY....BECAUSE OF THE MONEY!!!!
Talk with a reputable in-home care business and ask if they possibly have/know of a great caseworker who will sit with you and discuss YOUR NEEDS FOR YOUR MOTHER. That's what we did.
These caseworkers are NOT the State. They are an organization that are provided grants from the Federal government, do their due diligence, vetting and arrange time to take you to the various homes that fit your/Mom's need within the money range one can afford.
DO NOT BE AFRAID TO CONFRONT THE PEOPLE YOU'RE PAYING TO CARE FOR YOUR MOTHER AND THE OTHERS ABOUT THIS!!
I am blessed that Mom's youngest brother who loves his only sister so very much that he and my Aunt visit Mom at the very least once a week and calls me. This is great for me as I live out of State....11/2 day's drive.
The manager will call me, text me regarding any thing! The in-home doctor contacted service calls me and I have a patient portal to use with ANY QUESTION(S) and vise versa.
I hope this helps you and gives you a few things to think about, after all it is your Mom's well being.
I have a Mom who is one of those new difficukt patients in a care home. I completely understand your fears and frustrations.
The care home was told about Mom’s difficult personality. They were confident they could work with someone with dementia. We were honey in our observations and experiences caring for Mom, but still the preadmission assessment process was inadequate to tell a prospective home everything they should know.
The transition to a care home would be frightening for anyone, especially someone who cannot understand why or what is happening. We didn’t expect a smooth transition.
Mom’s behavior worsened. Her delusions and confusion became worse. She began doing things we had not seen while living with us. Her agitated episodes increased in frequency and duration. She regressed in her ADLs. But, she is never violent or physically aggressive.
To address concerns of her sundowning and night wandering, we bgan adding medications. It is heartbreaking to hear Mom’s voice sound drugged and to see her suffer some of the side effects.
The medications weren’t working to the home’s satisfaction, so they were increased. We sought the help of her geriatrician, his geriatric nurse and a social worker. (I work in healthcare and also consulted other geriatricians.). We were referred to a geriatric psychiatrist who has evaluated Mom and is systematically working to find the right medications and doses.
Improvement wasn’t happening fast enough for the care home. (Medications take 4-8 weeks to show results). So, after 6 weeks in the home, we were given a month notice to move her out. A week later it became move out ASAP.
So, now Mom will go through another transition which will set her behavior back again. We found a case manager to help us. The new home has more experience with difficult behaviors and dementia. It is run by a nurse, not a CNA.
It is not the cozy environment you would want for your loved one and is located in a rundown neighborhood. This was all done in less than a week while I took more time off from work, which my employer is quite tired of already.
Mom transfers this weekend and I am terrified about how it will go.
The system in our state is inadequate and unprepared to deal with the aging population. Emergency rooms are seeing increasing numbers of admissions by elders with dementia because their behaviors are not understood or managed. Our elders are going to psychiatric hospitals that are completely inappropriate for dementia patients. There is no geriatric psych ward in our state.
While there are better resources in other states, I do not think our nation is adequately prepared for or able to support people and families living with the many forms of dementia.
I was crushed by every phone call and text telling me how much Mom disturbed the other residents and families. I sleep less now than when Mom lived with us. The stress of worrying about her, the care home owner, the other residents and their families is crushing.
I am sorry for those of you whose loved ones have to tolerate difficult residents. And, I hope, if you read this, you’ll understand how much we (families of the difficult ones) struggle to find the best care for them in a system where adequate, affordable supports do not exist.
Wishing you all the best.
i am glad you shared what it is like to be related to the difficult resident. It's awful and I didn't see any compassion to your post. My mom has gone in cycles with her behavior. I have seen this often and I think the family member with the disruptive residence needs a big hug and a lot of compassion. Good luck
I think it is not fair when family members don't address this problem when their loved one is so disruptive. Moving them to skilled nursing or memory care is not a good solution as it is disruptive to the other residents there. Sounds like she needs to be in a psychiatric facility.
Good luck and hopefully they can fix this problem so your mom can live there peacefully again.
The staff in the nursing home where we placed my Dad gave him an injection of haldol when he started swinging a fire extinguisher around. Then had a psych consult come to the nursing home to work on meds.
I hope you have a nice calm conversation with the person in charge there about your concerns.
It took several weeks for them to get the right combination of things for my Dad, and he has settled down.
I heard of another similar story a few years ago about a personal care home which had a strict policy against admitting combative dementia patients and the signed acknowledgement they would be evicted. Well, a family had a grandma who was loud and violent and they totally LIED about her condition. The first few days and nights were HELL there for the other residents until the facility successfully got her into a psychiatric ward and then a SNF.
Family members often get into that mode of thinking they simply CANNOT "have grandma in a NURSING HOME! She will do so much better in a lovely assisted living facility." They think putting her into a calm and pretty facility is going to calm her azz down. Doesn't happen and makes life hell for the other residents.
Hang in there, stay strong and vocal.
The new res is in wheelchair, but my Mom is mobile and twice myself and caretaker had to tell my Mom not to touch her as she might hit her. Worried when I am not there...
There may already be plans to find her another facility. You need to find this out. It’s not a violation of her HIPPA rights if the administration tells you her family is looking for other placement. Hopefully they are considering a full time aide for this lady until this happens.
If you are in contact with the families of the other residents of the home, you need to speak with them and present a united front to the administrator of the home. This lady has to go. It’s not a happy situation, but it’s not your worry. This lady should not have been placed in this situation. She sounds like she is too “far gone”. It’s not fair that your mom, who previously was happy there, should have to leave. This lady could present a danger to the staff and other residents. She needs to be evaluated and be placed in a more appropriate situation.
Tell the owners that you cannot keep your mom there if this continues. Either this lady needs a one to one aide or to take her meds.
Call the Ombudsmen if you need to.