Crisis Point after 9 days in a care home

Elle3

Registered User
Jun 30, 2016
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Apologies for the lengthy post, but I don't know what to do.

After just 9 nine days in a Care Home, the home have called to say they have reached crisis point and they cannot cope with my dad and he needs to leave.

My dad has Advanced Dementia and was living alone in his own home, the Social worker and myself agreed that he was no longer safe to live at home, due to an escalating number of issues; mainly going out at all times of day or night in any weather, waiting for the bank to open, burning his leg on an electric fire, fusing lights by screwing in the wrong bulbs into light fittings. Burning his kettle and releasing toxic fumes in his home, not going to bed, not being able to prepare simple meals (teabags on 2 slices of bread was a sandwich and drinks: cold water with milk in it). Constantly hiding things and believing there are people in his home, not able to recognise his own reflection and thinking the man is spying on him from next door and getting abusive and violent because of it. I could go on.

So I found a care home that dealt specifically with dementia sufferers, it was in the town where he lives and it was only small with 31 residents. A place became available and I took him and he moved in there on Friday 13th April.

On the first Saturday evening he was reported to safeguarding due to an incident with another male resident he got verbally abusive and attempted to get hold of his arm. So he was reported.

Then things settled down apart from him wandering around the home, trying doors and windows trying to get out.

I visited him on Wednesday 18th April, he had no recollection that it was me that took him there, because he kept asking how did I know he was there. He said he liked it and he had made friends, not once did he ask to go home, the only thing he asked to do was to go and get some money.

Saturday 21st April, I visited him again with my husband, again he asked how did I know he was there, did his dad tell me. When I asked him if he was liking living there, he said he had lived here for years and it was good. Later he asked me how my dad was.

Saturday evening around 10.20pm I get a phone call from the home, dad has escaped by climbing out of a window. Now I have had conflicting information that the window lock was faulty, but I've also been told he broke it. They found him about 11.10pm quite a distance from the home, not heading home or to the bank. But their biggest worry is that the home backs onto a canal walk, which is very dark and they were worried he might have headed that way and could potentially have fallen into the canal and drowned. Luckily he hadn't but the risk is there.

I spoke to the home the next morning and he settled fine once he was back in the home.

Sunday 22nd April I get a phone call at 8.15pm dad has his coat on and is trying to get out of the home again and they currently are having to give him one to one attention, can I come down and settle him and be with him, so they can get other residents to bed. So off I go, when I arrive dad greets me saying "oh good she can take me now". I find out he wants to get some money from the bank. (This is his obsession). It took me about 30 mins to convince him there was no money, the bank was shut, it was dark and it was bed time and to take his coat off. He accepts that the home is now where he Iives and he likes it, but still feels the need to get out. I finally left him around 10.15pm happy to get ready for bed.

This morning, I got a call from the manager of the home, she said due to the issues over the weekend they feel they cannot give dad the one to one support that he needs and they have reached crisis point and want him removed. She said she had spoken to the Social worker and I have to call her.

I have spoken to the Social worker and she is at a loss for what to do. I have said dad cannot return to his home, that is not an option. She has gone away to seek advice and hopefully a solution.

This is a nightmare.

Elle x
 
Last edited:

Bunpoots

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Apr 1, 2016
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Oh Elle, I'm sorry to read this when things seemed to be settling so nicely. You must be feeling devastated. I hope someone can find a solution quickly. I'm keeping my fingers crossed for you.
 

Elle3

Registered User
Jun 30, 2016
710
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Oh Elle, I'm sorry to read this when things seemed to be settling so nicely. You must be feeling devastated. I hope someone can find a solution quickly. I'm keeping my fingers crossed for you.

Thank you Bunpoots, this is just an awful situation and I'm worried about the outcome. For most of the time dad is the loveliest man, very quiet and happy within himself. But this obsession of going to get money for his job, is getting to breaking point and something I hoped could be broken by being in a care home. But it's just escalating the problem and making it worse. If only we could stop this one thing everything would be just fine. Elle x
 

love.dad.but..

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Jan 16, 2014
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Kent
I am sorry I don't have any ideas to offer but this compulsive wanting to leave by trying windows and doors of always needing to be somewhere is common. Dad whilst not the that extent of climbing out of a window was similar. I have left a longer post on your other thread
 

Jessbow

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Mar 1, 2013
5,735
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Midlands
Hang on in there, let the SW sort it out, Dont whatever you do agree to have him home.

The current home cant just turf him out until SW has found a solution, so just refer the home to him/her and keep your head down!!
 

Elle3

Registered User
Jun 30, 2016
710
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Hang on in there, let the SW sort it out, Dont whatever you do agree to have him home.

The current home cant just turf him out until SW has found a solution, so just refer the home to him/her and keep your head down!!

Thank you, I think that is what I'm going to do. I was going to visit dad today, but I decided it is probably best to stay away until I know for certain what is going to happen.
 

margherita

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May 30, 2017
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Italy, Milan and Acqui Terme
Thank you, I think that is what I'm going to do. I was going to visit dad today, but I decided it is probably best to stay away until I know for certain what is going to happen.
You have made the right decision.
I wonder if your dad could be prescribed some medication to decrease his pathological restlessness
 

Sirena

Registered User
Feb 27, 2018
2,332
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I just saw your update on the other thread Elle. I am so sorry to hear this.

I agree with Jessbow, of course he cannot go home, and it is up to the SW to find another CH which can deal with this behaviour, so just hang on in there until she comes up with some alternative CHs (your dad is not self funding is he?)

Frankly it does not sound as if they have a secure environment, or can cope with challenging behaviour, which is what your dad needs. At my mum's CH all doors and windows are secure, and there is no way anyone could break a window as it's double glazed and they'd need a heavy implement! I remember another member saying that some CHs say they accept dementia patients but they only want easy, placid folk and at the first sign of problems they want them gone. At one I visited (charity run, inexpensive) it was clear they were not prepared to accept anyone remotely challenging, the manager said he had to 'let go' a resident within their first week who paced in the evening. I mean - really??

I am sorry this hasn't worked out but there will be a CH which suits your dad better.
 

Elle3

Registered User
Jun 30, 2016
710
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You have made the right decision.
I wonder if your dad could be prescribed some medication to decrease his pathological restlessness

That has been suggested. At present he is on no medication at all.
 

Elle3

Registered User
Jun 30, 2016
710
0
I just saw your update on the other thread Elle. I am so sorry to hear this.

I agree with Jessbow, of course he cannot go home, and it is up to the SW to find another CH which can deal with this behaviour, so just hang on in there until she comes up with some alternative CHs (your dad is not self funding is he?)

Frankly it does not sound as if they have a secure environment, or can cope with challenging behaviour, which is what your dad needs. At my mum's CH all doors and windows are secure, and there is no way anyone could break a window as it's double glazed and they'd need a heavy implement! I remember another member saying that some CHs say they accept dementia patients but they only want easy, placid folk and at the first sign of problems they want them gone. At one I visited (charity run, inexpensive) it was clear they were not prepared to accept anyone remotely challenging, the manager said he had to 'let go' a resident within their first week who paced in the evening. I mean - really??

I am sorry this hasn't worked out but there will be a CH which suits your dad better.

Thanks Sirena, yes he is self funding, does that make a difference?

I supposedly chose the care home as it was purpose built and designed for dementia sufferers and they said they had experience and understanding of dealing with all their needs. Obviously not.

I also chose this home as it was local to my dad and easy for me to get to and visit, all the other homes were just too far away for me to visit often and if dad ever managed to get out of one of them he would be totally lost and confused. He's actually accepted the home very well, it's just this compulsive behaviour he has of wanting to get out to get money, that we can't seem to get him to forget and they can't cope with. Other residents try to get out and open doors and set alarms off etc. but no other resident has actually succeeded in getting out before, which is why it reached crisis point so quickly and they don't seem willing to try to deal with it. I witnessed one lady resident get very agitated and aggressive last night demanding to go home and she struck the carer but that seemed acceptable.

It's all very disappointing and I really don't know what to do, apart from bury my head in the sand, but I know that's not the answer.
 

NancySpain

Registered User
Dec 27, 2016
19
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Is it literally about getting some money? Is this a specific reference to something in his previous life? I’m wondering if there’s something about trying to work out what’s making him feel so frantic. Eg could you have a couple of wallets each with £20 and they’re handed to him when he first starts wanting money. Or is there something from his life about paying bills. So could he be headed off before he gets so anxious with “oh it’s ok we have that on a direct debit now”

My dad has been worried about money during some hospital stays. In his case it was that he thought someone was going to come with a bill at any moment and he wanted to be ready.
 

hrh

Registered User
Sep 16, 2017
76
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Thanks Sirena, yes he is self funding, does that make a difference?

I supposedly chose the care home as it was purpose built and designed for dementia sufferers and they said they had experience and understanding of dealing with all their needs. Obviously not.

I also chose this home as it was local to my dad and easy for me to get to and visit, all the other homes were just too far away for me to visit often and if dad ever managed to get out of one of them he would be totally lost and confused. He's actually accepted the home very well, it's just this compulsive behaviour he has of wanting to get out to get money, that we can't seem to get him to forget and they can't cope with. Other residents try to get out and open doors and set alarms off etc. but no other resident has actually succeeded in getting out before, which is why it reached crisis point so quickly and they don't seem willing to try to deal with it. I witnessed one lady resident get very agitated and aggressive last night demanding to go home and she struck the carer but that seemed acceptable.

It's all very disappointing and I really don't know what to do, apart from bury my head in the sand, but I know that's not the answer.


Maybe the answer would be to look at why he needs to get money, he may have dementia but he hasn't lost his reasoning. Maybe he feels the need to get some money, so why not discuss with the home manager, for him to visit the office where they can dispense a small amount of money to him either daily or whenever your dad wants it. Your dad should feel more contented that he has received the money, they can even walk him out to the back way, lead him to the office through the front. Your dad is only showing a need, not being difficult. Best of luck.
 

Sirena

Registered User
Feb 27, 2018
2,332
0
Thanks Sirena, yes he is self funding, does that make a difference?

I supposedly chose the care home as it was purpose built and designed for dementia sufferers and they said they had experience and understanding of dealing with all their needs. Obviously not.

I also chose this home as it was local to my dad and easy for me to get to and visit, all the other homes were just too far away for me to visit often and if dad ever managed to get out of one of them he would be totally lost and confused. He's actually accepted the home very well, it's just this compulsive behaviour he has of wanting to get out to get money, that we can't seem to get him to forget and they can't cope with. Other residents try to get out and open doors and set alarms off etc. but no other resident has actually succeeded in getting out before, which is why it reached crisis point so quickly and they don't seem willing to try to deal with it. I witnessed one lady resident get very agitated and aggressive last night demanding to go home and she struck the carer but that seemed acceptable.

It's all very disappointing and I really don't know what to do, apart from bury my head in the sand, but I know that's not the answer.

As you say it is odd they don't seem able to deal with your dad when they are dealing with other challenging behaviours, and very upsetting for you.

As he is self-funding, you shouldn't need input from the social worker. Obviously if she is helpful that is great, but from what you've said she doesn't sound a lot of use. I researched CHs online, called up to see how they sounded, and went to visit. If you call a few to describe your dad's type of 'challenging behaviour', they should be able to tell you right away whether they can deal with it, and if so you can visit and go from there.

Re your dad going to a home in a different area, I don't think that is too important (except in that it is further for you to travel which is obviously not ideal). If the CH is secure, he won't be able to get out.
 

jugglingmum

Registered User
Jan 5, 2014
7,111
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Chester
but he hasn't lost his reasoning.

In my experience of my mum she lost her reasoning skills long before she had serious memory issues.

One of the many aspects of dementia is logic and understanding have long since gone out the room, so trying to reason with a PWD is normally fruitless, and where compassionate communication comes into it.

Having said that your suggestion might work but given the issues arise in the evening it is likely linked to sunddowning.

Based on what I've read on TP many homes that say they deal with dementia only take the less challenging. EMI homes should be able to deal with this sort of challenging behaviour but in some parts of the country they are few and far between.

As @Sirena says, it may be worth trying to find somewhere as the SW won't be too bothered about where he goes as long as they move him from where he is so you will be able to choose a best fit if you can find somewhere.
 

hrh

Registered User
Sep 16, 2017
76
0
There is a misconception that a person with DM has no reasoning, that is different to a person having no factual pictures in their memory to recall, this doesn't mean a person with DM won't still search for reasoning to a question or a problem they are today confronted with. We have to try and work out for them what it is they are trying to find in their picture memory and reconcile it for them. We cannot use what we see as common sense into a world that no longer make sense for a person with DM, the 'Sun Downing' phenomenon is really only a consequence of problems building up earlier in the day, that hadn't been picked up by a staff member and dealt with at that time, there is always a reason as to why someone 'apparently becomes unreasonable' or unmanageable, it is what leads up to that point that counts and more vigilance must be paid by the staff to spot what the problem is earlier. X
 

Marcelle123

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Nov 9, 2015
4,865
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Yorkshire
My mother's behaviour was nothing like your father's. All the same, she was about to be asked to leave the first non-dementia home we tried, and the second one, a dementia home, in the first few days she was behaving aggressively, waving her stick at people, shouting out, and scuffling with other residents. She had been on no medication - they called in the mental health team and Mum was put on memantine. It had an immediate calming effect and there was no more aggression. Mum seemed depressed so some weeks later, she was put on an anti-depressant. After that, she was much more contented and settled in.

I was terrified that Mum would be asked to leave her second home, so I can imagine what you are feeling. I do hope that a solution is found - either a more suitable home, or some medication that will help.

Very best wishes. xx
 

Amy in the US

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Feb 28, 2015
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USA
I also wonder if there is medication that could be tried.

This is just my experience: My mother lost her ability to reason and think logically and execute a task, as well as insight, (cognitive abilities and executive function, plus anosognosia) long before she had any significant memory issues.

I do think someone with dementia may have, or seek, a reason or explanation, for things, but most types of dementia destroy the person's "logic board" and their ability to break down and think or reason through a task. Of course it depends on the type of dementia and what/how much brain damage it has caused, and of course everyone is different. But generally speaking, there is not much to be gained, and everything to be lost, from trying to have rational, reasonable conversations with PWDs, especially when anosognosia is involved, as it so often is.

Elle, I am so sorry this is happening.
 

Elle3

Registered User
Jun 30, 2016
710
0
Is it literally about getting some money? Is this a specific reference to something in his previous life? I’m wondering if there’s something about trying to work out what’s making him feel so frantic. Eg could you have a couple of wallets each with £20 and they’re handed to him when he first starts wanting money. Or is there something from his life about paying bills. So could he be headed off before he gets so anxious with “oh it’s ok we have that on a direct debit now”

My dad has been worried about money during some hospital stays. In his case it was that he thought someone was going to come with a bill at any moment and he wanted to be ready.

I'm afraid dad hasn't had any concept of bills now for over a year, but before that he did feel the need to pay them immediately. Now he wont part with any money, even when I used to take him out to buy groceries, I couldn't get him to pay for it, he always said he didn't need it, so I would have to use my bank card or cash.

I think what it is, is that dad is living within the 60's when he had to work to earn money. He now see's whatever he does as a way to earn money and the more he has in his wallet the better he feels.

He used to go on the trains every day and for some reason he has confabulated a story that he was getting paid to work on the trains and help people, this was not the case at all. Once we stopped him going on the trains, he then started to visit his local bank a couple of times a week to withdraw money, this then became his job but he didn't understand that the money in the bank he was withdrawing was his own money, the money was the banks and they were giving it to him for his work for just turning up there.

He then started to visit the bank daily, I had put a limit on how much he could withdraw, but as he wasn't spending any money, the money would start to mount up. Sometimes he would then either lose or hide or give away the money and think it had been stolen. He even burnt about £400's worth of £20 notes once, why I've no idea, he said it wasn't him that did it.

I have tried for a long time to stop this obsession and I've spoken to the bank about it, but when the bank tells him there is no money, he causes quite a fuss and refuses to leave or keeps revisiting them, so it is easier for them just to give him £10 to keep him quiet and send him home. He would also get very upset and angry when he would turn up in the middle of the night or at the weekend and they weren't there to pay him, they were very bad people then.

It has been suggested to the home about giving him some money, but they do not want to do this and they are adamant they want him to leave asap.
 

Elle3

Registered User
Jun 30, 2016
710
0
In my experience of my mum she lost her reasoning skills long before she had serious memory issues.

One of the many aspects of dementia is logic and understanding have long since gone out the room, so trying to reason with a PWD is normally fruitless, and where compassionate communication comes into it.

Having said that your suggestion might work but given the issues arise in the evening it is likely linked to sunddowning.

Based on what I've read on TP many homes that say they deal with dementia only take the less challenging. EMI homes should be able to deal with this sort of challenging behaviour but in some parts of the country they are few and far between.

As @Sirena says, it may be worth trying to find somewhere as the SW won't be too bothered about where he goes as long as they move him from where he is so you will be able to choose a best fit if you can find somewhere.

Yes dad lost all logic and understanding well over a year ago. So it has been a constant battle with him, especially regarding money and visiting the bank at all times of day and night. It has been a constant worry for me this obsession and now seems to be the cause of him having to leave a lovely care home.
 

Elle3

Registered User
Jun 30, 2016
710
0
I also wonder if there is medication that could be tried.

This is just my experience: My mother lost her ability to reason and think logically and execute a task, as well as insight, (cognitive abilities and executive function, plus anosognosia) long before she had any significant memory issues.

I do think someone with dementia may have, or seek, a reason or explanation, for things, but most types of dementia destroy the person's "logic board" and their ability to break down and think or reason through a task. Of course it depends on the type of dementia and what/how much brain damage it has caused, and of course everyone is different. But generally speaking, there is not much to be gained, and everything to be lost, from trying to have rational, reasonable conversations with PWDs, especially when anosognosia is involved, as it so often is.

Elle, I am so sorry this is happening.

Thank you Amy, I've long since given up trying to have a rational conversation with dad, he has no understanding and never answers a direct question. I often say his brain is like a dot to dot and most of the time the dots get connected wrongly so he makes up his own stories and theories for things happening. Most of the time now I just go along with whatever he tells me and I don't try to contradict him.
 

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