Aggression in Alzheimers

[Lexi]

My father who is 88 has been in the assessment unit of the hospital for two months and has been on level 3 (one to one nursing) for most of this time. He has been diagnosed with the late stages of Alzheimers. He has regular falls and constantly marches along the corridors from the time he gets up until they manage to settle him to sleep. This is usually around 3.00 a.m. and he wakes between 6.00 - 7.00 am. He rarely sits down to eat so they try to feed him on the hoof.
He is drastically losing weight and his ankles and feet have become quite swollen, which they tell me is due to his constant walking.

Recently he has become very aggressive and has had several 'incidents' with other patients. Most of the time it was him that started it. What I cannot understand is how this is allowed to happen when he always has a nurse or carer with him. His head has several large bruises on it and he also has a bruise on his chest. His eye has been stitched on two occasions. I dread the telephone ringing as it's usually a call from the hospital with news that he has either fallen, is on his way to casualty (where they just can't handle him) or has been involved in an incident.

We are due to have another CHC Meeting next week to discuss what type of care he will need. It was suggested at the last meeting that he may require EMI but he also may have to be placed outside our Area as there are few, if any, vacancies in our Area.

My mother is of ill health and is now worrying that he will be taken too far away from us.

I am also concerned that unless he calms down he may not get a placement. He is on the highest dose of medication which is allowed for his condition but it doesn't seem to have any effect on him.

I would welcome any advice please.

 

[Butter]

I am sorry to learn of your worries over your father. Unfortunately, this level of agression is not uncommon. Over time the hospital should be able to settle your father more. But people do get hurt. We do not restrain people nowadays as we used to - either physically or chemically - as that used to cause hurt too.
My experience with my mother, who hurt people and who was often bruised and cut herself, was that over time she was settled. But last time it took 8 months.
Of course your mother will be worried - I think you can make that point loud and clear at any meeting. She needs to be able to visit your father. It is as simple as that.
If you are not happy with a placement offered you may not have to accept it - but others should come along here who know more than me and can advise you.

 

[SWMBO1950]

Dear Lexi

I am sorry to read about your fathers agression. We went through this with my FIL at one stage but it did settle down. My MIL became wary of him at this time however these days he is more like a child than an agressor.

He would also walk around a lot in fact he would run at unbelieveable speed if not stopped. Sometime the carers could stop him in his tracks but he had obviously been watching too much athletics on TV prior to becoming ill as he could go off at such a speed! On one occasion he shot off tripped and put his head through the plaster board wall. Fortunately not too much damage to him but I think the wall came off worse.

However these days are long gone and like everything else with this awful disease it goes in phases or peaks and troughs!

Please stand up for his rights to be close to your mother (you are the only ones who have his very best interests at heart) as she will need him as near as possible (my MIL has to get 2 buses unless she gets a lift but it works most of the time) and dont be pushed into anything you are not happy with. This is something we have always done with my FIL.

I am now the 'champion' for my mother also - I am not that good with the caring side although I have learned and got much better but I write one hell of a letter

Best wishes and let us know how you get on at the meeting.

 

[Lexi]

Thank you both for your comments.
Last night my daughter and I visited my father and was greeted by the Nurse in charge advising us that he was now in isolation as he was very agitated and was charging into other patients, and generally causing problems throughout the ward. As he is continually walking or running he was put into a long corridor without obstacles so that he could not hurt himself, but he managed another fall and the doctors arrived to review him. There didn't appear any damage to him this time and as he was on a mission the Doctors were unable to examine him. He was on such a rampage, he was quite scary and I do understand why the hospital staff decided to isolate him.
We then had a meeting with the Ward Manager who explained the events of the day and advised us that a psychologist and been called to see him, and would be calling me today another brain scan had been requested and a Specialist Doctor would be seeing him today.
The hospital appear to be doing everything they can for him, he just does not seem to respond to any medication he is given.

I am now dreading this CHC Meeting.

 

[elaine n]

Hello Lexi

I'm sorry things are so difficult at the moment.
Reading your post was such a familiar story for me - I could have written it word for word about my husband last year, his behaviour was exactly the same. He too walked non stop, was aggressive, on a level 3 watch, isolated, hurt himself and others, the assessment unit staff were wonderful but he had to go into an EMI home eventually.

We had a CHC funding assessment and Gary scored so high that there was never any doubt that he would be awarded it - However - they decided, in their wisdom, to defer funding for a month in case he improved once he was in a home! I challenged it immediately because in my opinion they'd stepped outside their normal frame. He clearly was meeting all the criteria at the time of assessment and they backed down and paid up.

I was anxious about him being moved but the care home were wonderful and had developed all sorts of strategies to cope with him. I also asked for a protective helmet for him so that he couldn't hurt his head if he fell.

Thinking of you xxxe