Challenging Behaviour Threats to Remove from Care Home

[Bonniejax]

I attended an assessment for my father today. He was referred by the GP because of his challenging Behaviour. He has moderate to severe Alzheimer's.
Sad story my mother was his carer until last October when she had a significant stroke and died in hospital a week later. Adult services put him in emergency care home. It was unsuitable for many reasons. He is 82. I moved him to a dementia specialist care home. He gets stroppy when being washed and shaved, most of the time he is absolutely fine. The mental health doctor said if he hit someone he would loose his place and have to go somewhere else. I asked where, the doctor eventually answered me, a nursing home or another care home. They want to give him sedatives to reduce his challenging behaviour. Is this the pathway to end his life?

 

[karaokePete]

Hello @Bonniejax, although it's a sad state of affairs that has brought you here, I hope you find the forum a friendly, informative and supportive place.

The first thing that strikes me is that you say it's essentially only when being washed and shaved that your father gets stroppy. Has anyone tried to analyse why this is so? Might there be something in the environment that your father is objecting to(too public/noisy etc) or something like a perceived lack of control and/or dignity that may be an issue. I guess I'm wondering if your father is trying to communicate a need and that maybe that can be addressed rather than applying a chemical cosh.

I hope others with more experience than me may come along with some suggestions.

In the hope that it may be of some benefit, here's a link to the AS Factsheet about this issue https://www.alzheimers.org.uk/sites...ctsheet_dementia_and_aggressive_behaviour.pdf

 

[Grannie G]

Hello @Bonniejax

My husband became stroppy when he was being washed and toileted and the staff managed him. He hated being shaved so they left him to one male carer who seemed to understand how to do it.

Is the home giving up too easily ? Your father is in a specialist dementia unit. What could be more suitable than that?

You say he is fine most of the time , absolutely fine. You father could miss the odd shave or two. It`s not set in stone he should be shaved every day. If he doesn`t like being wshed, perhaps the staff could give him a warm face cloth and ask him to wipe his face to help him feel better. It`s what I used to do with my husband.

 

[canary]

Your father is in a specialist dementia unit. What could be more suitable than that?

Absolutely, but unfortunately, it seems to me that many care home who advertise themselves as specialist dementia homes still only want people in the early stages and as soon as a resident starts to show common mid-stage symptoms they dont know how to handle it and the resident is asked to leave

 

[Kevinl]

There's a similar problem on the thread below but they have already been asked to move on.
K

https://forum.alzheimers.org.uk/threads/mother-asked-to-leave-care-home-due-to-aggression.109965/

 

[kindred]

I attended an assessment for my father today. He was referred by the GP because of his challenging Behaviour. He has moderate to severe Alzheimer's.
Sad story my mother was his carer until last October when she had a significant stroke and died in hospital a week later. Adult services put him in emergency care home. It was unsuitable for many reasons. He is 82. I moved him to a dementia specialist care home. He gets stroppy when being washed and shaved, most of the time he is absolutely fine. The mental health doctor said if he hit someone he would loose his place and have to go somewhere else. I asked where, the doctor eventually answered me, a nursing home or another care home. They want to give him sedatives to reduce his challenging behaviour. Is this the pathway to end his life?

I have noticed that several of the men in my OH care home get really stroppy when being shaved, and some of the women hate being cleaned up after meals. It seems to me almost normal for dementia behaviour. Certainly the staff here take it in their stride. I doubt if it's a pathway to end his life, it shouldn't really be happening like this, especially as most of the time he is fine. I hope this gets sorted. Good to hear from you. G

 

[Elle3]

I attended an assessment for my father today. He was referred by the GP because of his challenging Behaviour. He has moderate to severe Alzheimer's.
Sad story my mother was his carer until last October when she had a significant stroke and died in hospital a week later. Adult services put him in emergency care home. It was unsuitable for many reasons. He is 82. I moved him to a dementia specialist care home. He gets stroppy when being washed and shaved, most of the time he is absolutely fine. The mental health doctor said if he hit someone he would loose his place and have to go somewhere else. I asked where, the doctor eventually answered me, a nursing home or another care home. They want to give him sedatives to reduce his challenging behaviour. Is this the pathway to end his life?

Hi Bonniejax I can certainly sympathise with you as my dad who has been in care now since April, is also known as ‘challenging’, due to his unpredictable aggressive behaviour, mainly during personal care like your dad, but it can also happen for no reason and also he keeps trying to leave.

His first care home could not cope with him, even though it was an EMI nursing home, after being there only a week he had been reported to safe guarding twice for aggression to other residents, he’d broken window locks, an emergency exit door and managed to escape for 3 hours before he was found. So he was asked to leave.

All I can say is thank goodness for dad’s Social worker, she has been so helpful and supportive and helped mediate with the care home and supported me until we could find dad a more suitable care home, that specialised in dealing with more challenging residents, this was called a Dementia+ Unit. They have a smaller ratio of residents to staff, 3:1 and are much more tolerant and able to deal with all behaviour.

Unfortunately whilst at the first care home, so they could cope with dad, we had to pay for a 121 nurse for 8 hours a day and dad had to be prescribed Lorazepam, but this drug is only given if required when they get very agitated, it helps calm them. I too wasn’t happy about them taking the drug route to deal with the problem, especially when dad was prescribed an antipsychotic drug too, Risperidone, but unfortunately there seems little else they can do. It’s certainly not the pathway to end you dad’s life though, so don’t think that.

The drugs have helped calm my dad and because his new care home can deal with his aggressive behaviour better they only have to give him the Lorazepam occasionally now when he gets really bad, most of time they just know how to deal with him, distract him or be more flexible with his care. You would be surprised how much of a difference a more suitable care home can make.

I hope you manage to find a suitable solution.

Elle x

 

[Bonniejax]

Many thanks for all your replies. I could not respond before as my computer was playing up. I had another meeting today with the care workers and the caseworker. The care workers made a very strong case for giving him sedatives, because yesterday he tried to take another resident's walking frame away. Apparently because my POA does not include Health and Well being the social services now make the decisions regarding his health. Game set and match to them I think. My only possible recourse could be the court of protection, but it is another government dept and I am not that confident of any success.I have a four week window before the next review and the sedative decision.

 

[Bonniejax]

Just found out that care home managers receive a commission for new residents entering their care home. Was anyone else aware of this? I certainly was not.

 

[love.dad.but..]

Just found out that care home managers receive a commission for new residents entering their care home. Was anyone else aware of this? I certainly was not.

I would think with privately owned part of a national chain care or nursing homes the manager's salary would include bonus if full occupancy or targets are met when settings are profit driven.

My dad strongly resisted personal care and would be possessive with other residents' walking sticks in particular and both these aspects are very common in dementia. However whilst not always successful they mostly used their experience and well tried strategies to handle difficulties and re visited the problem as often dad would be different 10 mins or half an hour later. Sedatives were never suggested and actually as dad became a falls risks I would have been very concerned.