Aggressive Behaviour

[3ll]

Hi,

My grandma has dementia and i moved in with her to help take care of her a few months ago.

She just came out of hospital from her most recent admission (falling over) and I cant cope with how different she is now.

She can’t do anything for herself, however she is very determined that she wants to get up super early in the morning and go back to bed late at night and won’t let anyone help her aside from family giving food and drink.

Sometimes she gets up in the night and falls down, but won’t call for help. Her alarm has been tested and is fine but won’t pick up her falls. She’s doesn’t press it herself when she needs help, only when she doesn’t need help!

She will try and get dressed before the carers arrive so they can’t help with any personal care, but just puts new pull ups on top of old pull ups.

When they do arrive, she hits, kicks and shouts at them until they go.

Shes now stopped taking her medication from them.

She is very unstable (mobility wise) and should only be transported in her wheelchair, but she tries to stand and falls over instantly the second she is left alone (even when asleep and you think it’s ok to pop to the loo or make a drink).

She’s is now turning on her family and being aggressive to us.

The GP prescribed 0.5mg of Lorezapam to calm her, however when we gave it, it knocked her out completely for nearly 24 hours. We hade a nurse visit and she said we mustn’t give that tablet again unless absolutely necessary. She is also in heart failure so this medication really was a last resort.

If we don’t give it, she’s trying to run around the house (with her toilet frame as a walker), hitting, kicking and shouting at everyone. Falling over, refusing meds and obviously very distressed. In addition to that, she has lots of skin tears from previous falls that don’t heal which are at risk of infection (and often do get infected), she gets UTI’s and redness/sores from not washing/changing.

My question is what would be classed as absolutely necessary? Do we just keep following her around and trying to minimise the risks as best we can or do we give the sedative? Is the Lorezapam the right thing to do or are we being unfair to her?

I felt awful seeing her so sedated, but to be honest, it was the first time we could get near her to clean/change her, get her meds taken and the only night I managed to relax a little and get some sleep myself.

The carers visit four times a day, but I also have a six year old and I work full time (from home) so I am struggling beyond my limits with this.

 

[Banjomansmate]

I think you need to get her assessed by Social Services and ask about residential care for her as this sounds well beyond what you can cope with. Your child needs your full attention and really shouldn’t be having to live with this either. In a Care Home scenario your Grandma would have 24 hour staff coping with her needs rather than frazzled family. Please consider this as a safer way of caring for your Grandma.

 

[Kevinl]

No idea from me and that's over 10 year on here as a carer. Never think what you post goes unread and thank you for posting

 

[canary]

Hello @3ll

What you are doing is admirable, but totally unsustainable. You are having to constantly chase after her, her needs now vastly outweigh what you (or any other family carer) can manage and to top it all you are not getting any sleep. Very soon you will burn out and your little boy needs you.

You could ask the GP to refer your grandma to the Community Psychiatric Team to see if there are any other meds that might calm her down without knocking her out. I must say, though, that I too think the only real solution will be a care/nursing home where she will have a whole team of people who are trained and experienced, working in shifts around the clock

 

[3ll]

We do have two carers that come in four times a day and I do take my son out of the house when they visit to walk the dog, visit my mum/dad etc so he doesn’t see the aggression. I am shielding him as much as possible, however I know that he is not getting my full attention.

My dad won’t agree to put her in a nursing home as she always said she would never go to one so I am in the process of applying for CHC funding to try and get her full time care at home - Although I’m not sure this would last (if approved) because of how aggressive she is.

He’s in complete denial as to how bad she is and thinks that she’s playing up most of the time because sometimes she can be very devious with the GP’s, Paramedics and other Medical Providers she sees as decision makers. She can convince them that she’s fine and lovely and compliant. Thankfully the GP arrived when the carers were here the other day and heard how she was and then saw the change in her once she walked into the room, so they now know what I have been trying to tell them is the truth. The carers are awesome at documenting everything now too.

She’s really restricted in terms of what meds she could have because of her heart failure. I feel she would be worse at a care home and we’d be told she has to leave or they’d sedate her. If they’re going to sedate her, wouldn’t she be better to be sedated at home?

I guess if I’m being honest, I’m looking for someone to tell me it’s the right thing to do, because my conscience is making me feel really crappy about it.

 

[3ll]

No idea from me and that's over 10 year on here as a carer. Never think what you post goes unread and thank you for posting

Thank you

 

[My Mum's Daughter]

We do have two carers that come in four times a day and I do take my son out of the house when they visit to walk the dog, visit my mum/dad etc so he doesn’t see the aggression. I am shielding him as much as possible, however I know that he is not getting my full attention.

My dad won’t agree to put her in a nursing home as she always said she would never go to one so I am in the process of applying for CHC funding to try and get her full time care at home - Although I’m not sure this would last (if approved) because of how aggressive she is.

He’s in complete denial as to how bad she is and thinks that she’s playing up most of the time because sometimes she can be very devious with the GP’s, Paramedics and other Medical Providers she sees as decision makers. She can convince them that she’s fine and lovely and compliant. Thankfully the GP arrived when the carers were here the other day and heard how she was and then saw the change in her once she walked into the room, so they now know what I have been trying to tell them is the truth. The carers are awesome at documenting everything now too.

She’s really restricted in terms of what meds she could have because of her heart failure. I feel she would be worse at a care home and we’d be told she has to leave or they’d sedate her. If they’re going to sedate her, wouldn’t she be better to be sedated at home?

I guess if I’m being honest, I’m looking for someone to tell me it’s the right thing to do, because my conscience is making me feel really crappy about it.

Technically, it's possible to get CHC funding for care at home but being realistic, it's pretty much impossible in fact, she's highly unlikely to get CHC in a care home.

This convincing everyone that she's fine is common, we refer to it as hostess mode. Most of them somehow manage to do this but it can't be sustained and in many cases, carers find their job harder over the next few days.

Before entering any care home, there should be a home visit and a time where you can give a clear picture of granny. The care home should then be able to assess her needs and decide if they can cater for her. If this is done correctly, she shouldn't be asked to leave and sedation has to prescribed by a doctor so it's not given on a regular basis.

Now Dad, he's your biggest problem and I hope he's paying you well for caring for granny. He needs a good shake and a reality check but this isn't going to be achieved while he pops in for a short time and then goes home to watch TV.

Dad needs to be told that his grandson needs a break so you're booking yourselves a weekend away. Go, leave him to it and turn your phone off.

Legally, you're not responsible for Granny and neither is your Dad however, someone has to make sure that she has the care that she needs but that's down to your Dad NOT you. If need be, you may need to move out but let's hope it doesn't come to that.

 

[3ll]

Technically, it's possible to get CHC funding for care at home but being realistic, it's pretty much impossible in fact, she's highly unlikely to get CHC in a care home.

This convincing everyone that she's fine is common, we refer to it as hostess mode. Most of them somehow manage to do this but it can't be sustained and in many cases, carers find their job harder over the next few days.

Before entering any care home, there should be a home visit and a time where you can give a clear picture of granny. The care home should then be able to assess her needs and decide if they can cater for her. If this is done correctly, she shouldn't be asked to leave and sedation has to prescribed by a doctor so it's not given on a regular basis.

Now Dad, he's your biggest problem and I hope he's paying you well for caring for granny. He needs a good shake and a reality check but this isn't going to be achieved while he pops in for a short time and then goes home to watch TV.

Dad needs to be told that his grandson needs a break so you're booking yourselves a weekend away. Go, leave him to it and turn your phone off.

Legally, you're not responsible for Granny and neither is your Dad however, someone has to make sure that she has the care that she needs but that's down to your Dad NOT you. If need be, you may need to move out but let's hope it doesn't come to that.

I do have a holiday booked next month. My dad thinks she’d be fine on her own inbetween carer visits! He does not accept she needs 24/7 supervision and just tells me to go about my life and leave her on her own when I need to go out. I have no idea what they’ll do when I’m not here - She’ll likely end up in hospital within a day or so.

I have applied for the CHC funding due to lots of health issues that she has or that constantly occur from most of the 12 domains which myself and the GP graded as clear A’s (x5) and B’s (x6). She only had one ‘no need’ which was the altered date of consciousness. The ICB came back asking them to clarify a couple of things yesterday so I’m praying that we hear back next week as it was a fast track application.

 

[Bod]

Enjoy your holiday.
Make sure your Dad is the person to call when you are away!
His attuide may be enlightened on your return.
Do not be afraid of Care Homes, my father had to go in, once settled he had the time of his life.

Bod.

 

[3ll]

Enjoy your holiday.
Make sure your Dad is the person to call when you are away!
His attuide may be enlightened on your return.
Do not be afraid of Care Homes, my father had to go in, once settled he had the time of his life.

Bod.

Thank you.