Challenging behaviour

[Give me sunshine]

Hi everyone. We finally moved my dad into a specialist dementia unit in a nursing home on Monday. It was a very very difficult day, but he's in. I was chatting to some of the carers today about how he's getting on and they admitted he gets quite aggressive when they try to wash or change him. He's also not really sleeping much at night and spent the whole of last night just wandering.

It's very early days, of course, and all such a big change for him, but I'm concerned that all this will be considered 'challenging behaviour' and that they won't allow him to stay long term if things don't settle down soon.

How do care homes normally deal with this kind of behaviour? What happens if the can't handle him? I worry that if a specialist dementia unit can't deal with him, then who can and what are our options? Gosh, it's all such a worry. If anyone has any constructive thoughts/experience, do share them, I'd be very interested. Thank you in advance, this is such a brilliant and supportive community

 

[canary]

This sort of behaviour is par for the course with dementia and a decent care home specialising in dementia should take it in their stride. My mum did both of these things - in fact, when she first moved into her care home she hit one of the carers with her walking stick I was appalled, but they were totally unfazed.

They were the masters of persuasion - cajoling mum into washing/showering/bathing cant have been easy, yet they (with only a few exceptions) managed it.
They dint worry about mum wandering around at night, either. They would make her tea and toast and try and persuade her back to bed, but they didnt mind if she wouldnt go. There was usually a couple of people wandering round the corridors and a little group in the lounge chatting and the night cares would keep an eye on them and chat to them.

Unfortunately, there are some care homes who claim that they specialise in dementia, yet consider this sort of behaviour challenging and wont tolerate it. I would talk to the manager about your fears and you may well find that they are unfounded. If they start worrying about this sort of thing, start looking for another home.

 

[Give me sunshine]

This sort of behaviour is par for the course with dementia and a decent care home specialising in dementia should take it in their stride. My mum did both of these things - in fact, when she first moved into her care home she hit one of the carers with her walking stick I was appalled, but they were totally unfazed.

They were the masters of persuasion - cajoling mum into washing/showering/bathing cant have been easy, yet they (with only a few exceptions) managed it.
They dint worry about mum wandering around at night, either. They would make her tea and toast and try and persuade her back to bed, but they didnt mind if she wouldnt go. There was usually a couple of people wandering round the corridors and a little group in the lounge chatting and the night cares would keep an eye on them and chat to them.

Unfortunately, there are some care homes who claim that they specialise in dementia, yet consider this sort of behaviour challenging and wont tolerate it. I would talk to the manager about your fears and you may well find that they are unfounded. If they start worrying about this sort of thing, start looking for another home.

Thank you so much, this is enormously helpful. It all feels very daunting, but it's such early days still. Hopefully things will settle in some way. Thank you

 

[Grannie G]

Hello @Give me sunshine

The stress carers face when deciding on residential care for people with dementia with challenging behaviour is enormous.

When my husband was admitted I asked outright if the care home was aware of his challenging behaviour, understood it and were able to manage it. I stressed the last thing in the world I wanted was for them to decide they were unable to meet his needs and I would have to start a search again.

They reassured me and were true to their word.

They knew I had received help from the Mental Health Team who accompanied me when I took my husband into the care home. One Mental Health Worker was there for me and one for my husband.

I know things are different now but there is no harm in asking if you can be accompanied when taking a person with dementia into residential care if you feel it is too difficult to manage.

 

[update2020]

Hi everyone. We finally moved my dad into a specialist dementia unit in a nursing home on Monday. It was a very very difficult day, but he's in. I was chatting to some of the carers today about how he's getting on and they admitted he gets quite aggressive when they try to wash or change him. He's also not really sleeping much at night and spent the whole of last night just wandering.

It's very early days, of course, and all such a big change for him, but I'm concerned that all this will be considered 'challenging behaviour' and that they won't allow him to stay long term if things don't settle down soon.

How do care homes normally deal with this kind of behaviour? What happens if the can't handle him? I worry that if a specialist dementia unit can't deal with him, then who can and what are our options? Gosh, it's all such a worry. If anyone has any constructive thoughts/experience, do share them, I'd be very interested. Thank you in advance, this is such a brilliant and supportive community

I agree with all the above. Hopefully yours fears are unfounded and the management and carers can cope. The things you describe are quite common and they will have seen them before especially if they are a specialist dementia unit.

Other solutions if he doesn’t settle may be to change his medication which they can try to do within the home or by sectioning him to an NHS acute dementia unit. Hopefully this won’t be necessary but if it is they will guide and advise you along with specialists in the NHS both based in the community and in hospital as necessary. The home - again especially if it is a specialist dementia home - will be in regular contact with these.

 

[Moggymad]

My FIL moved to a dementia home a week ago from hospital. During the 12 weeks in hospital his behaviour changed & he became unsettled & a bit challenging. Since being in the care home he is a bit unsettled & like your dad doesn’t sleep much at night. Don’t know if he wanders but he is probably shouting out & trying to get out of bed which is what he was doing in hospital. He was also averse to personal care when at home although being in hospital that long he did relent a bit & allowed some help. Since being in the home he has had some incontinence so that is another downturn.. The manager suggested we didnt visit at first so left it 4 days then took his tv in for him. The senior nurse mentioned he has been very rude to the carers, I dread to think what he has said. He is normally a very quiet shy man who doesn’t say much. Again we were told not to visit to give them time to settle him a bit more. Had an email yesterday to say he has made friends with another man there & they sit together in the lounge & diningroom. This has helped him to settle a little more. My mum was the same very unsettled until she made a friend. The home know how to facilitate this. We stilll haven’t resumed visiting but all being well will go one day next week.
Hopefully the experience of the staff where your dad is will help him to settle soon. It can take a while though so bear with them & let them work their magic!

 

[MaNaAk]

My FIL moved to a dementia home a week ago from hospital. During the 12 weeks in hospital his behaviour changed & he became unsettled & a bit challenging. Since being in the care home he is a bit unsettled & like your dad doesn’t sleep much at night. Don’t know if he wanders but he is probably shouting out & trying to get out of bed which is what he was doing in hospital. He was also averse to personal care when at home although being in hospital that long he did relent a bit & allowed some help. Since being in the home he has had some incontinence so that is another downturn.. The manager suggested we didnt visit at first so left it 4 days then took his tv in for him. The senior nurse mentioned he has been very rude to the carers, I dread to think what he has said. He is normally a very quiet shy man who doesn’t say much. Again we were told not to visit to give them time to settle him a bit more. Had an email yesterday to say he has made friends with another man there & they sit together in the lounge & diningroom. This has helped him to settle a little more. My mum was the same very unsettled until she made a friend. The home know how to facilitate this. We stilll haven’t resumed visiting but all being well will go one day next week.
Hopefully the experience of the staff where your dad is will help him to settle soon. It can take a while though so bear with them & let them work their magic!

I had the same with dad when he went into a home but a few weeks later I was told that he had female admirers.

MaNaAk

 

[Give me sunshine]

Hello @Give me sunshine

The stress carers face when deciding on residential care for people with dementia with challenging behaviour is enormous.

When my husband was admitted I asked outright if the care home was aware of his challenging behaviour, understood it and were able to manage it. I stressed the last thing in the world I wanted was for them to decide they were unable to meet his needs and I would have to start a search again.

They reassured me and were true to their word.

They knew I had received help from the Mental Health Team who accompanied me when I took my husband into the care home. One Mental Health Worker was there for me and one for my husband.

I know things are different now but there is no harm in asking if you can be accompanied when taking a person with dementia into residential care if you feel

Hello @Give me sunshine

The stress carers face when deciding on residential care for people with dementia with challenging behaviour is enormous.

When my husband was admitted I asked outright if the care home was aware of his challenging behaviour, understood it and were able to manage it. I stressed the last thing in the world I wanted was for them to decide they were unable to meet his needs and I would have to start a search again.

They reassured me and were true to their word.

They knew I had received help from the Mental Health Team who accompanied me when I took my husband into the care home. One Mental Health Worker was there for me and one for my husband.

I know things are different now but there is no harm in asking if you can be accompanied when taking a person with dementia into residential care if you feel it is too difficult to manage.

Thank you. It's so reassuring to know that others have found a way through this.

 

[Give me sunshine]

My FIL moved to a dementia home a week ago from hospital. During the 12 weeks in hospital his behaviour changed & he became unsettled & a bit challenging. Since being in the care home he is a bit unsettled & like your dad doesn’t sleep much at night. Don’t know if he wanders but he is probably shouting out & trying to get out of bed which is what he was doing in hospital. He was also averse to personal care when at home although being in hospital that long he did relent a bit & allowed some help. Since being in the home he has had some incontinence so that is another downturn.. The manager suggested we didnt visit at first so left it 4 days then took his tv in for him. The senior nurse mentioned he has been very rude to the carers, I dread to think what he has said. He is normally a very quiet shy man who doesn’t say much. Again we were told not to visit to give them time to settle him a bit more. Had an email yesterday to say he has made friends with another man there & they sit together in the lounge & diningroom. This has helped him to settle a little more. My mum was the same very unsettled until she made a friend. The home know how to facilitate this. We stilll haven’t resumed visiting but all being well will go one day next week.
Hopefully the experience of the staff where your dad is will help him to settle soon. It can take a while though so bear with them & let them work their magic

I agree with all the above. Hopefully yours fears are unfounded and the management and carers can cope. The things you describe are quite common and they will have seen them before especially if they are a specialist dementia unit.

Other solutions if he doesn’t settle may be to change his medication which they can try to do within the home or by sectioning him to an NHS acute dementia unit. Hopefully this won’t be necessary but if it is they will guide and advise you along with specialists in the NHS both based in the community and in hospital as necessary. The home - again especially if it is a specialist dementia home - will be in regular contact with these.

Thank you for the reassuring words. I am hoping they will be able to manage him. I visited yesterday and they finally managed to give him a shower, shave him and brush his teeth! It's been a week of him quite aggressively refusing, but they've worked out the best time of day to try with him. I really hope he starts to trust and understand the carers and nurses. Thanks again for this extremely useful post and guidance.

 

[Give me sunshine]

My FIL moved to a dementia home a week ago from hospital. During the 12 weeks in hospital his behaviour changed & he became unsettled & a bit challenging. Since being in the care home he is a bit unsettled & like your dad doesn’t sleep much at night. Don’t know if he wanders but he is probably shouting out & trying to get out of bed which is what he was doing in hospital. He was also averse to personal care when at home although being in hospital that long he did relent a bit & allowed some help. Since being in the home he has had some incontinence so that is another downturn.. The manager suggested we didnt visit at first so left it 4 days then took his tv in for him. The senior nurse mentioned he has been very rude to the carers, I dread to think what he has said. He is normally a very quiet shy man who doesn’t say much. Again we were told not to visit to give them time to settle him a bit more. Had an email yesterday to say he has made friends with another man there & they sit together in the lounge & diningroom. This has helped him to settle a little more. My mum was the same very unsettled until she made a friend. The home know how to facilitate this. We stilll haven’t resumed visiting but all being well will go one day next week.
Hopefully the experience of the staff where your dad is will help him to settle soon. It can take a while though so bear with them & let them work their magic!

Than you. You are right. Very early days! Hopefully things will settle. I hope things settle for your FIL soon too - take care and bon courage all round!

 

[Moggymad]

Than you. You are right. Very early days! Hopefully things will settle. I hope things settle for your FIL soon too - take care and bon courage all round!

Thanks you too?
Unfortunately a fall last night has put him back in hospital. Seems he had a mild heart attack & the fall may have rebroken or dislocated the hip he broke during his recent hospital stay. Just when things were beginning to improve.
Anyway all the best for you & your dad x

 

[Shedrech]

Oh @Moggymad so sorry to hear that ... I hope the hospital can make your FIL comfortable so you get to visit him

 

[Moggymad]

Oh @Moggymad so sorry to hear that ... I hope the hospital can make your FIL comfortable so you get to visit him

Thankyou yes he is in resus & his children were allowed to go in to see him. He was sitting in bed with his foot turned out at an odd angle, wired up to heart monitor & drip plus a catheter, eating cornflakes & having a cup of tea ? Arn’t they amazing? Doc said he may look ok but there’s a lot going on so to be prepared. He has a uti which he came out of hospital with & pneumonia. GP had checked him over as a new resident only a couple days ago, none of this was evident then although I suspect the uti hadn’t cleared up & GP picked up a heart murmur that no one else had mentioned. So we‘ll have to see how things go. He is amazing considering what he’s going through. Best foot forward!

 

[update2020]

Thank you for the reassuring words. I am hoping they will be able to manage him. I visited yesterday and they finally managed to give him a shower, shave him and brush his teeth! It's been a week of him quite aggressively refusing, but they've worked out the best time of day to try with him. I really hope he starts to trust and understand the carers and nurses. Thanks again for this extremely useful post and guidance.

You are welcome.

I ought to add that I am not an expert except by experience. But when I was in a similar position I found the lack of understanding of what might happen next and how the care home might cope very worrying.

I really hope and feel fairly sure that the care home will cope with your Dad. x

 

[Izzy]

Aw @Moggymad I’m so sorry to hear this. Wishing you strength.

 

[Give me sunshine]

Thanks you too?
Unfortunately a fall last night has put him back in hospital. Seems he had a mild heart attack & the fall may have rebroken or dislocated the hip he broke during his recent hospital stay. Just when things were beginning to improve.
Anyway all the best for you & your dad x

Oh gosh, so sorry to hear this! Sending good wishes and strength your way. You are not alone, we all understand and are here to be as supportive as possible. Please let us know how he's getting on - and please feel free to off-load as much as you need to here. Take good care and I hope things start improving and settling again soon. x

 

[Give me sunshine]

You are welcome.

I ought to add that I am not an expert except by experience. But when I was in a similar position I found the lack of understanding of what might happen next and how the care home might cope very worrying.

I really hope and feel fairly sure that the care home will cope with your Dad. x

Thank you - you've summed it up perfectly ie the not knowing what will happen next and how the care home will cope is very stressful! I very much appreciate you sharing your experience with me, thank you. Take care x

 

[Moggymad]

Oh gosh, so sorry to hear this! Sending good wishes and strength your way. You are not alone, we all understand and are here to be as supportive as possible. Please let us know how he's getting on - and please feel free to off-load as much as you need to here. Take good care and I hope things start improving and settling again soon. x

Aw @Moggymad I’m so sorry to hear this. Wishing you strength.

Thankyou, he is on a ward now & BP improved with fluids. Was only 65 at one point?Good news is that the hip is not broken & doesn’t appear displaced but his pinned femur has taken a bit of a jolt so there is inflammation & swelling. Still not sure about the odd position of his foot so we are hoping they have xrayed his whole leg. Will perhaps get more info tomorrow. Anyway thankyou for your good wishes & sorry I didn’t intend to hijack your thread @Give me sunshine! I’ll continue to follow your dads progress.