Care home incident

[Flymo]

Like many with Dementia, my mum wanders quite a bit. She has been in a home for over a year now and so far we have been happy with the care she has received. Patients are well cared for, staff good, check on patients every hour etc. However yesterday she wandered into someone's room and he attacked her, hitting her around the face. She is in hospital as a precaution and my dad asked for the police to be called. The most likely outcome is that the attacker will be moved, either to another home or another part of this home which is more secure.

My question is, other than a review of the incident, what else should the home be doing or what should we be asking them to do? Would really appreciate any advice from anyone who has been through a similar experience.

 

[Jessbow]

Wow, Difficult.

Not sure about the police- gosh- If your parent was the attacker, would you feel the police were appropriate, especially as she has wandered into his room, not vice versa?

Presumably she wasn't directly supervised at the time, so no one really knows what went on, orwhat prompted him to lash out- maybe your mother did something to provoke?

Looking back, your mother went into care because of HER aggression..............!

I am not sure why the other person needs to be moved- maybe your mum needs closer supervision/secure placement.

 

[pamann]

Hello flymo, In my husband's care home there are a few residents that wander in other residents rooms, they do sometimes get aggressive, most of the rooms are locked in the daytime. Some residents do get quite aggressive if others invade their space, but the carer's are soon on hand to split them up. The police have never been called, not sure what they could do, as with Alzheimers they don't know what they are doing most of the time. Sorry you are having this bad experience.

 

[tigerlady]

My husband is in a home where the bedroom doors are locked. If a person is in their room, they can still get out using the latch, but it is still locked on the outside. He is a wanderer and before I got him into the good home where he is now, he was in a totally unsuitable one where he wandered all night into other peoples rooms, frightening them, and in the end he had to have 1:1 supervision to stop this. However where he is now he is free to wander the corridors, lounges and courtyard gardens, and cannot get into the other rooms.
Although there have been aggressive incidents with other residents, there is usually a carer nearby to intervene. As my husband is usually the cause of aggressive incidents, I am so glad that these are dealt with swiftly and efficiently, and no police have ever been called, because, of course, people with dementia either don't know what they are doing or else have forgotten about it immediately afterwards, so would deny any knowledge of it. In fact he came off worse after the last incident with a cut face, and paramedics were called, but it looked worse than it was, and he didn't need to go to hospital. I did not dream of asking the police to be called.

He had no knowledge afterwards of the incident, and when he felt the cut on his face, just didn't know what it was, and asked if he had got something on his face. I think if steps are taken to supervise your mum more closely, or removing one or other of them to a different part of the home, thats all you can hope for, and calling the police would not solve the problem

 

[Flymo]

Just to clarify, my dad (who is still in shock) asked for the police to be called to ensure that this type of incident does not happen again. He has said that he does not want to press charges against the attacker. A distressing incident for all involved.

As people have said, we don't know what happened exactly and probably never will. I have a lot of sympathy for the attacker who does not have dementia, but is unable to take care of himself and has no family.

Jessbow, I don't appreciate some of your comments. I was asking if anyone else has had a similar experience with a loved one and would rather the replies were kept to this topic.

Tigerlady, I agree with you that extra supervision is probably the best we can get.

 

[Jessbow]

Just to clarify, my dad (who is still in shock) asked for the police to be called to ensure that this type of incident does not happen again. He has said that he does not want to press charges against the attacker. A distressing incident for all involved..

What does he think the Police can do?

As people have said, we don't know what happened exactly and probably never will. I have a lot of sympathy for the attacker who does not have dementia, but is unable to take care of himself and has no family..

You still call him 'the attacker' ......

Jessbow, I don't appreciate some of your comments. I was asking if anyone else has had a similar experience with a loved one and would rather the replies were kept to this topic..

Do you suppose I don't speak from experience? Mother was the vunerable one that was pushed over. Not by an attacker, but by a chap with dementia who was on a mission. It IS distressing, but it happens.

Tigerlady, I agree with you that extra supervision is probably the best we can get.

At least we agree on something

 

[jugglingmum]

Jessbow, I don't appreciate some of your comments. I was asking if anyone else has had a similar experience with a loved one and would rather the replies were kept to this topic.

There is nothing wrong with going to previous posts to find out background, it is something I do all the time. It gives background which is not in the current post. If your mother has been aggressive previously this is relevant and is correct to bring into this post to answer it.

If you do not view your mother's previous aggression as relevant I suggest you need to do some research into dementia and understand the effects. You do not know what your mother did or said when she entered the room.

Your mother's act of going into someone else's room is aggressive behaviour to the occupier of that room so she is not an innocent party in this and in my opinion consideration needs to be given to if the home can manage your mother's behaviour. It can in no way shape or form be considered an unprovoked attack and maybe even was defensive in nature.Maybe she needs to move.

I personally think calling the police to be an extreme reaction, and not wanting to press charges...... this seems to come before considering your mother's safety and best needs. She did after all trigger this incident.

Focus needs to be on the home addressing your mother's wandering which is what triggered this incident, if the home is not dementia specific then maybe it is time to move your mother to a dementia specific home.

 

[Jessbow]

Thank you juggling Mum.

 

[jenniferpa]

I just want to remind everyone that this is a peer-to-peer support group, and that everyone is struggling with their own situations. We really cannot know everything about a given situation and while it's perfectly OK to ask questions to clarify, it's probably unwise to make assumptions about anyone's motivations. As such I would ask posters to remember that there are unlikely to be any winners in a difficult situation such as this and please try to always be respectful of each other.

 

[notsogooddtr]

I agree that no one can know what happened here,but must admit to feeling sorry for the resident who might be moved from what after all is his home.Is it easier to move him as he has no family to advocate for him?Problem is if Mum keeps wandering there is every likelihood that something like this could happen again.Maybe as others have suggested a different environment might be safer.Specialist dementia units have better staffing levels which might help.

 

[Kevinl]

Regrettably things like this will happen and there is very little that can be done about it, my wife is in EMI nursing so most there are more challenging and incidents of aggression are a part of the condition.
Just today I saw an incident where 2 of the residents kicked off as one was sat quietly in her chair (as usual) and one of the "nonsense talking wanderers" got in her face so she lashed out, fortunately not making contact. It happened in a matter of seconds but the staff were on it straight away it's sad but it's impossible unless everyone is 1:1 every minute of the day.
I found my wife asleep in the armchair of another resident's room yesterday, not for the first time but some of the residents rooms are unlocked during the day at their or the families request and my wife is one of the wanderers so it happens.
Just for the record can I say on the subject of "pressing charges" in the UK when a matter is reported to the police it is the DPP/CPS who decide whether to charge or not, once the matter is reported to the police the "victim" no longer has a say in the matter.
Small point and not relevant to our members in the USA but in the UK there is no such option available to the victim.
K

 

[jenniferpa]

Actually Kevin, in the USA the same thing applies: it's up to DA if charges are pressed, not the victim.

 

[MrsTerryN]

About a year or more ago mum was in the dementia restricted ward.
A resident was visiting his wife who resided in this ward. He suddenly decided that one of the staff, male attendant, had been flirting with his wife.
He got a knife and attacked the staff member. Mum intervened and the resident was verbally aggressive and threatened mum.
Mum was moved out of that ward as it was deemed safer as the wife of the other resident wasnt able to be moved.
Even though a staff member was assaulted no police involvement.

Note here in Sydney there is apparently a hospital/nursing home that takes the worse of the worse. There is an armed guard for each two residents and the ward is locked. Very heavy security

 

[Kevinl]

Actually Kevin, in the USA the same thing applies: it's up to DA if charges are pressed, not the victim.

So how come people are always saying it on TV and film? Just another myth.
K

 

[Hill Man]

Professionally I have been involved in three cases which involved violence between Care Home residents. In two of them the Police were called. In this case I think the involvement of the Police was entirely justified as the one of the parties ended up in hospital. The Police who in my experience are very sympathetic to the situation are not there to enforce any action against the individuals involved (as these clearly lack criminal liability) but against the home (who very clearly do). Given that these residents are effectively detained within the meaning of DOLS and the Mental Capacity Act it is the duty of the Care Home to keep them safe. Involvement of the Police means that the home will have to formally respond to the incident. What I would expect from them would be to seek formal assurance from the Home that an updated risk assessment should be undertaken for those involved and appropriate actions taken in response.

 

[Jessbow]

Wouldn't the CQC be more appropriate?

Big assumption that the residents are detained within the meaning of DOLS and the Mental Capacity Act - Why would that make a difference?

 

[Pete R]

Wouldn't the CQC be more appropriate?

CQC do not investigate individual incidents whereas the Police can.

 

[Hill Man]

Wouldn't the CQC be more appropriate?

Big assumption that the residents are detained within the meaning of DOLS and the Mental Capacity Act - Why would that make a difference?

Not a big assumption Jessbow. The default position for people with dementia is that they are detained and subject to DOLS safeguards unless it can be shown otherwise. It makes a difference because under the MCA the care home potentially has criminal liability for any neglectful actions or non-actions as well as civil liability for negligence. In practice it is used very infrequently but often it can be the spur that makes a care home take actions which they have failed to take in the past in response to a stern email from the CQC

 

[Pete R]

Not a big assumption Jessbow. The default position for people with dementia is that they are detained and subject to DOLS safeguards unless it can be shown otherwise. It makes a difference because under the MCA the care home potentially has criminal liability for any neglectful actions or non-actions

I do not believe this to be correct. Both the Mid Staffs and Winterbourne view enquiries pointed out that only individual staff could be held to criminal liability and NOT the actual providers. There are a couple of minor offences under Health & safety regulations but they were rarely used.

The government acted on recommendations from these reports and along with the New Care Act in April 2015 introduced Sections 20 – 25 of the Criminal Justice and Courts Act 2015.
Sec 20 deals with the individuals whereas Sec 21 deals with providers and if neglect or ill-treatment has occurred and a police investigation launched then the organisation associated with the alleged perpetrator will need to demonstrate primarily via its record-keeping that it had taken reasonable or adequate steps to prevent that conduct. Otherwise it will face the prospect of high-profile litigation and unlimited fines.

I have yet to find an actual prosecution of a provider so far but there are cases against individuals.

 

[Hill Man]

I do not believe this to be correct. Both the Mid Staffs and Winterbourne view enquiries pointed out that only individual staff could be held to criminal liability and NOT the actual providers.

You are quite correct, I was writing casually and was making the point that there are now criminal sanctions which can act as a motivator for care home staff rather than expressing a view as to who exactly would face them