ASBO behaviour in a care home

Helly68

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Mar 12, 2018
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I think I posted something like this a while ago, and got good advice, but things are moving on a bit.

My Mum is a permanent care home resident, in a dementia unit of a care home where she has lived for the last three years. She is becoming increasingly combative with staff over personal care. Sometimes it takes four staff to manage her, which is very hard for the care home.
I am attending a meeting on Monday to discuss what we can do to aleviate this, for her sake and the staff. We will discuss medication, but as she has bipolar disorder as well as late stage mixed dementia, she already takes lithium and large doses of mood stabilisers.
We are currently funded by the Local Authority. Does anyone have experience of an LA social worker helping to find a placement for very challenging behaviour (should she have to leave the home)?
I think the home will make great efforts to keep her, but for my sanity I try and think a bit ahead if I can. She does have a social worker but I think, having met her, that this would be a bit beyond her experience.

Does anyone else have experience of the mix of late stage dementia and bipolar? Her bipolar was well controlled before dementia but now her mood varies a lot, though personal care is a particular issue and I wonder if she is becoming too accustomed to the lithium and it is no longer working?
Anyone have experience of this?
 

Feistywoman

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Aug 11, 2018
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I’ve no experience of this @Helly68 but will keep everything crossed that you get a positive solution from the care home.
 

Helly68

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Mar 12, 2018
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Just FYI for anyone in a similar situation, they are going to try Mermantine and extra stimulation activities, as some of the aggression may be from frustration and boredom.

Fingers crossed....
 

Helly68

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Mar 12, 2018
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Just to give an update, after not much effect from the starting dose of Mermantine alone, they have upped the dose and added Lorazepam.
Mummy is now very sleepy, though less ASBO. I hope she will become a bit more awake as she gets used to the new drug regime (its been a couple of weeks) but as a family we made the difficult decision that increasing the medication was probably the "least worst" option in order for her to stay at her current CH, which is what we want. It has been her home for about the last four years.

The only other option mentioned, should the drugs not decrease the aggression, was a nursing home. The benefits mentioned for this were that they would be able to inject her with drugs (medication administration is a problem) and were more practised in restraint. There may well be other benefits, but it wasn't sounding like much of a trade off for the upheaval of moving her.

Fingers crossed she is able to stay....
 

Sirena

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Feb 27, 2018
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I hope the medication works out, Helly. It sounds as if the CH is committed to keeping your mother there if at all possible, which is good news as she's familiar with the environment. As you say, sometimes you just have to choose the 'least worst' option.
 

Helly68

Registered User
Mar 12, 2018
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@Sirena - thank you. It has been a difficult decision but the care home are very good. The whole situation is compounded by the fact that GP can't prescribe, as Mummy's medication is too complex and needs to be handled by the CMH team and the fact that there is no clarity about what if any options there are for PWD whose behaviour is very challenging.