What if.......

[Carolynlott]

Hi,

Haven't posted for a while. I was away on holiday last week and when I got back there was a message on my answer machine from a nurse at Dad's CH saying that there had been an incident the previous night when Dad had gone into the room of another resident and hit him. She said the other resident was "fine", Dad was "fine" and they had called the GP who hadn't changed Dad's medication.

My mind is racing - what if the other resident HAD been badly hurt - or worse - what would have happened to Dad? Would they have asked him to leave? I can't begin to imagine what I would do if they did. Surely this is not Dad's fault - it's due to a lack of supervision and lack of proper sedation. I know the last time he got aggressive it was because he refused his pills and the staff on duty didn't think to hide them in his food.

And .... the thing that keeps coming back to me is ... surely someone who acts this way is not just someone who needs social care - but has a real mental illness?

I'd really appreciate your thoughts and words of wisdom.

Best wishes,

C

 

[Skye]

Hi Carolyn

Iknow how upsetting these incidents are, but they do happen when people have dementia. Luckily no-one was seriously hurt.

Have you discussed the possibility of transferring your dad to an EMI unit? There would be a higher staff ratio, and they would be trained to handle situations like that.

Regarding the medication, they're not allowed to hide the pills in food. They can try to persuade people to take their meds, but if they refuse, they have to accept that.

I'd make an appointment to talk to the manager and se what they can suggest.

But try not to worry too much, these things do happen, and it was good that they notified you.

Love,

 

[Carolynlott]

Hi and thanks.

Dad is already in an EMI unit (since last December) and I don't see there is any other option than to hide the pills if he won't take them because the alternative is for him to go around hitting people. Dad is long past the stage where he can make a rational choice as to whether he wants to take them or not. I was just wondering what the next stage is if the CH decide they can't control him.

C

 

[Lynne]

Hi Carolyn

Have you asked if your Dad's meds might be available in liquid form? They might then be more easily disguised in a favourite drink.
Re, the "attack", don't waste your energy worrying about what MIGHT happen in the future. If it has been discussed fully with the CH staff & management, they are aware of the possibility now and it is up to them to manage the situation.
If necessary, they may have to get the doctor in change of his care to re-assess his medication
- ASK THEM TO KEEP YOU ADVISED OF ANY PROPOSED CHANGE BEFORE IT IS PUT INTO EFFECT, SO THAT YOU ARE IN THE KNOW.

Best wishes

 

[TinaT]

Hi Carolyn,

Your post set me thinking about a recent event in my husband's care home. A very noisy, elderly, lady resident disturbed the whole home as she constantly shouted out non stop during all her waking hours. This had a 'knock on effect' in upsetting some other residents and caused many of them to become agitated and difficult to handle.

The staff told me that she had been refusing any medication for some time. I suggested hiding it in food and they told me they were not allowed to do this - Human Rights Bill perhaps once again?

Sadly the lady died last week (peacefully and quickly in her bed). The staff agreed with me - it was a release for her and a relief for us visitors, the residents and the staff.

xxTinaT

 

[Canadian Joanne]

And .... the thing that keeps coming back to me is ... surely someone who acts this way is not just someone who needs social care - but has a real mental illness?

Carolyn, this is part and parcel of dementia. My mother, who was the model of decorum when she was well, had several phases of violence and aggression, to the point once that it required five hospital attendants to subdue her. The part of the brain that regulates social behaviour seems to be the first to be attacked by the disease. They behave in these ways because of the disease. My mother, when she was well, would never have taken an old man's cane and hit him in the head with it because she wanted his hat. It's the disease. I know I'm repeating myself but this disease does many strange and odd things.

Quite honestly, at the beginning before my mother was diagnosed, I was hoping that she would be diagnosed as a schizophrenic, as that can be successfully treated. I was desperately grasping at straws at that time. Even months after her diagnosis with Alzheimer's, I was hoping that the doctors would be proved wrong, it would turn out that she had had a long psychotic episode and would suddenly snap out of it.

I know the last time he got aggressive it was because he refused his pills and the staff on duty didn't think to hide them in his food.

I don't know how it works in the UK but here the power of attorney can request that it been done and the home has to follow the directives. The power of attorney is the ultimate authority, which is how it should be, in my opinion.

My mind is racing - what if the other resident HAD been badly hurt

But it DIDN'T happen. I know how hard it is, but for your own sake, please don't go into the "What ifs". You have enough to deal with as it is without anticipating all possible bad outcomes. Try to focus on the situation at hand and also try to somehow relax and destress.

Take care.

 

[Carolynlott]

Thanks for all your replies.

Joanne - I think the new power of attorney in GB (LPA) covers health issues but the one I have for my Dad (EPA) doesn't. I know it doesn't do to think of what ifs (that's the way I am) - best to take each day as it comes.

Interesting that replies show the difference between Care Homes regarding the "disguising the pills" issue.

Dad didn't look too good today but he was so glad to see me, which made me feel great - he had no socks, and I had bought him some new ones, so he was thrilled and so grateful. I'm not the sort of person who is good at making a fuss but there are issues I'm not happy with about his care and I know I should follow them up.

Thanks again for listening.

C

 

[Canadian Joanne]

Would he take his pills from you? That might be an avenue.

I'm not the sort of person who is good at making a fuss but there are issues I'm not happy with about his care and I know I should follow them up.

I don't like making a fuss either because I don't think it gets anybody anywhere. It may in the short run or once or twice but that's it - my opinion. If you feel uncomfortable about certain issues, would writing it down help? That way, you can take your time and polish it up nicely. For myself, it helps me articulate exactly what I mean.

If you don't care for that, perhaps bringing a list with you & going over it. People do seem to respect things on paper more.

 

[Carolina]

Hi,
Same thing happened with my dad, except he went into a lady's room (without his pyjamas!) and when she shouted to him to get out, he hit her. Like you, both parties were 'fine' afterwards, but I was very upset. My dad's care home got round it by having an alarm fitted to the door of his room. So, if he came out during the night, the night staff were made aware of it and they could get to him before anything happened. So far, it has worked fine.

 

[Nebiroth]

It's not possible for a care home (or anyone else) to give people medication if they have clearly expressed their wish not to take it. To do so would, legally, be abuse.

However, it is possible for someone to lack "mental capacity" to give consent, in which case, this decision can be made by someone else such as a relative, doctor, nurse etc. Of course, the problem is that this is quite a responsibility, and some people may be averse to it - for example, should a care home medicate if a resident has refused to take their pills? What if the relatives later object to this? etc etc

Someone who has been sectioned under some provisions of the Mental Health Act can be medicated without their consent.