Use of restraints has been proposed !

Vegpatch

Registered User
Nov 3, 2016
24
Hi all

Does anyone have experience in use of restraints in a ch ?

I was called into a meeting at the ch on friday to tell me that the gp couldn't do anything more for dad & he'd been discharged from dementia crisis team support as there was nothing more they could do. Ch are struggling to deal with him during personal care, even on EMI nursing unit.

He becomes very aggressive during personal care - hitting, spitting, kicking - he's a danger to himself (bruising, skin tears etc) & others.
His teeth and nails are disgusting as no one can get near them & he cant do them.
1 carer can sometimes give him a bit of a shave, but hair cant be done either.
He's doubly incontinent, so obviously needs some level of cleaning and changing each day.

The home are now saying they cant deal with him any longer - he needs a home who use restraints, or to be sectioned.

I'm in bits. While I understand we need some way of cleaning him...surely restraints will only increase his fear and aggression ??

Please help !
 

Avis

Registered User
Nov 2, 2019
105
Speak to you doctor about sedating your father, not to the point of chemical restraint but so that his anxiety and fear are alleviated. You can buy small electric fingernail cutters that don't look like scissors and are quite soothing if you can get him to let you hold his hand for a few minutes. It may be that he can be sedated enough that he can be bathed and groomed every 2nd day to make him more comfortable. Discuss this with his doctor and case worker.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
70,390
Kent
Hello @Vegpatch

The decision should not be left to you. There are medical and psychiatric professionals who have experience in dealing with such challenging behaviours.

Your dad sounds frightened and confused and I`m unhappy restraint is still an option.

I`d get the dementia crisis team back and ask for more constructive help. You do not have the experience to be forced to make such a decision. I think someone is not taking their responsibilities on board.
 

canary

Registered User
Feb 25, 2014
11,344
South coast
It sounds to me as though the care home is just trying to get you to find another place for him (Im not sure that any care home uses restraints now). I would be inclined to tell the care home to get him sectioned. I suspect that they are trying to use it as a threat, but actually, if it happens he would be more likely to get the help he needs.
 

TNJJ

Registered User
May 7, 2019
1,054
cornwall
Hi all

Does anyone have experience in use of restraints in a ch ?

I was called into a meeting at the ch on friday to tell me that the gp couldn't do anything more for dad & he'd been discharged from dementia crisis team support as there was nothing more they could do. Ch are struggling to deal with him during personal care, even on EMI nursing unit.

He becomes very aggressive during personal care - hitting, spitting, kicking - he's a danger to himself (bruising, skin tears etc) & others.
His teeth and nails are disgusting as no one can get near them & he cant do them.
1 carer can sometimes give him a bit of a shave, but hair cant be done either.
He's doubly incontinent, so obviously needs some level of cleaning and changing each day.

The home are now saying they cant deal with him any longer - he needs a home who use restraints, or to be sectioned.

I'm in bits. While I understand we need some way of cleaning him...surely restraints will only increase his fear and aggression ??

Please help !
Hi. Yes I do. But it is not chains etc which is what I think you might mean.
I used to be a paid carer (now care for the parents)and have worked in homes. What it means is that there could be 3 or 4carers to help with personal care. Sometimes it will be I person either side of the PWD and either 1doing all the personal or 2 depending on the circumstance. Believe me it is very hard to do personal care whenPWD are either spitting at you,kicking you or pulling your hair amongst things. They will explain and talk to the PWD as they are doing it. But they have Duty of Care so PWD cannot be left. Sometimes they might not use it depending on the PWD mood but it will be written in the PWD care plan.Majority of times it is only used in personal care and it will be for the shortest time.. Not all PWD can take extra meds and the medication can take weeks to get into the system which is where (MAYBO)comes in as it is immediate.My care company called it MAYBO.I hope this helps.
 

Vegpatch

Registered User
Nov 3, 2016
24
Speak to you doctor about sedating your father, not to the point of chemical restraint but so that his anxiety and fear are alleviated. You can buy small electric fingernail cutters that don't look like scissors and are quite soothing if you can get him to let you hold his hand for a few minutes. It may be that he can be sedated enough that he can be bathed and groomed every 2nd day to make him more comfortable. Discuss this with his doctor and case worker.
They’ve tried sedation, but it doesn’t seem to be working . I may need to speak to his GP as i’ve Only heard this from the home re GP can’t do anything more for him...
 

Vegpatch

Registered User
Nov 3, 2016
24
Hello @Vegpatch

The decision should not be left to you. There are medical and psychiatric professionals who have experience in dealing with such challenging behaviours.

Your dad sounds frightened and confused and I`m unhappy restraint is still an option.

I`d get the dementia crisis team back and ask for more constructive help. You do not have the experience to be forced to make such a decision. I think someone is not taking their responsibilities on board.
Totally agree ! To be honest I was really ill on Friday when they called me into the meeting....so I couldn’t ask too many questions.
We don’t have a case or social worker at the moment as self funding - I hope that we’ll get one based on current situation. CH have been talking to CHC team, so hoping for an update tomorrow.
I’ll also try to get the number for the dementia crisis team and talk to them.

I live 90 mins away, and can only visit once a week, so getting to see or speak to anyone is a nightmare. I don’t feel as though the ch have been keeping me informed at all !
 

Vegpatch

Registered User
Nov 3, 2016
24
It sounds to me as though the care home is just trying to get you to find another place for him (Im not sure that any care home uses restraints now). I would be inclined to tell the care home to get him sectioned. I suspect that they are trying to use it as a threat, but actually, if it happens he would be more likely to get the help he needs.
Hmm..yes, that was my first thought. New manager started 10 days ago...first time he talks to me is about chucking dad out !
They mentioned sectioning, but last time he was in hospital with a UTI it was horrendous (mainly due to the uti i’m Sure,, but continuous change of beds and people meant he felt more frightened than usual, therefore more violent)

If sectioned, what is the situation ? chemically sedated in a hospital bed for a month ?!
 

Vegpatch

Registered User
Nov 3, 2016
24
Hi. Yes I do. But it is not chains etc which is what I think you might mean.
I used to be a paid carer (now care for the parents)and have worked in homes. What it means is that there could be 3 or 4carers to help with personal care. Sometimes it will be I person either side of the PWD and either 1doing all the personal or 2 depending on the circumstance. Believe me it is very hard to do personal care whenPWD are either spitting at you,kicking you or pulling your hair amongst things. They will explain and talk to the PWD as they are doing it. But they have Duty of Care so PWD cannot be left. Sometimes they might not use it depending on the PWD mood but it will be written in the PWD care plan.Majority of times it is only used in personal care and it will be for the shortest time.. Not all PWD can take extra meds and the medication can take weeks to get into the system which is where (MAYBO)comes in as it is immediate.My care company called it MAYBO.I hope this helps.
they’ve been using 2 - 3 carers so far, but obviously no physical restraint. Even so, he injures himself daily, and others regularly too
 

canary

Registered User
Feb 25, 2014
11,344
South coast
If sectioned, what is the situation ? chemically sedated in a hospital bed for a month ?!
No, he would be in a special unit where he would be assessed and they would try and sort out his medication so that he was calmer, but not zombie-like. The doctors would have more experience with challenging behaviour than the GP.
I dont have personal experience of this, but I know many people on here have found it ultimately a positive experience.
 

Bunpoots

Volunteer Host
Apr 1, 2016
3,810
Nottinghamshire
Hi @Vegpatch

My dad was sectioned (not because of violence but because he wouldn't have been safe to go home alone) and he had no idea it had happened to him. I can honestly say it was the best thing to have happened as it got him to a place where he was safe and properly cared for.
 

Weasell

Registered User
Oct 21, 2019
53
I would get him sectioned.
The drugs that effectively sedate people have side effects, one obvious one is the effect on the respiration. Imagine you are a GP, would you dispense at the level/strength required ? I would not.
He needs to go somewhere where a team can plan his care and medication needs, perhaps using strong medication to start with.He needs to be shown that having personal care need not be traumatic. If that happens the medication can be reduced.
If I had a choice between being restrained, with my dementia ravaged brain, possibly hallucinating, perhaps with the tidal syndrome between normality and delusion, or a very high level of medication that kept me calm , give it to me any day.
Wishing you well.
 
Last edited by a moderator:

Vegpatch

Registered User
Nov 3, 2016
24
I think we're starting to think about the sectioning route. Need to try to get a social worker assigned I guess.
Chc wont even do an assessment as the ch cant meet his needs, so they wont assess him ! It all seems topsy turvy to me !
 

Abbey82

Registered User
Jun 12, 2018
78
Hi There,

we’ve been down the sectioning route, twice now and it was the best option for my Dad, in fact your dad sounds very familiar.

My Dad has issues with personal care and one day can be compliant but most days can be agressive and have to be physically held whilst being washed/cared for, he is also doubly incontinent and 61 years of age. Not many drugs work on day but he does have Lorazepam periodically throughout the day to maintain a level of sedation so that he’s manageable and not on the go all day (for his own safety and benefit)

It’s a real rollercoaster but he was sectioned in total for around 3.5 months and it really was our last option before being told this time that he would need to go into residential care, but it had to be secure and nursing care. We found one that deals with complex behaviours and where a lot of residents struggle with personal care, so whilst not ideal they are used to it.

I hope it gets better for you all
Thankyou for your info everyone.
Baby steps...
 

Vegpatch

Registered User
Nov 3, 2016
24
Thankyou abbey82

We've identified a new care home and are waiting for them to assess him to see if they think they can cope with him. They are listed as a 'higher level' dementia home...so I'm hopeful. He def needs higher level care as his behaviour is so erratic and agressive....but then he's lovely at other times !

If they cant take him, we'll be back to square one to see what options are. Social worker we've been assigned seems amazing...so fingers crossed. X