Hi all (sorry, this is quite a lengthy post but I want to give you the full picture), It has been a day and a half - in fact its been a month and a half... My husband, 3 teenage children and I care for my MIL who has AD and have done for the last 4 years. Up until 2 months ago were getting along fabulously, routines in place and whilst there was a slow decline in her awareness, we could handle it and all still maintain our day to day lives happily together. Then 8 weeks ago MIL had a sudden seizure one Saturday morning, falling onto her shoulder. After getting her into hospital, it was then discovered she also had a fractured spine. This is where our problems really began. The pain of the injuries, the fear of the hospital and the strange people around her and the general confusion of the situation has had a huge impact on not only her AD but also her behaviour (I am not sure if the seizure has also impacted on her brain) As I worked at the hospital, I would go up to give her a wash in the morning and change her, back up to give her lunch and then after work to give her tea and sit with her for a while - mainly to try to keep MIL calm but also to help the nursing staff as she refused to wear the back brace supplied to help the fracture (if it hadn't been for the dementia, it would of been an immediate operation) or the sling for her broken arm which needs a whole new ball and socket but again as she will not keep it still they cannot risk operating as she will lose full use if not kept in place. Her behaviour became progressively more volatile and mildly violent, with the staff having to call security on more than one occasion to prevent her from leaving the ward and causing any further serious damage to herself. It was eventually decided after 4 weeks in hospital that a stay in a care home with a 24 hour carer would be the best solution and hopefully return MIL to her former self. Sadly this is not the case, in fact her behaviour has become even more aggressive and agitated, she even refuses to allow me to assist her, which caused me particular distress as we have always had such a close relationship - she will not accept personal hygiene, screaming hysterically and sometimes physically assaulting the staff, she will not take her medication, refuses to wear the back brace, and often refusing to eat or drink. She is sleeping very little, pacing up and down and around the home to a point of sheer exhaustion but is extremely unstable on her feet. This is causing a huge concern to the staff as she is so unstable and is at risk of falling and last night accumulated in a call from the staff at the care home to say that she had stumbled and banged her broken arm - she was screaming with pain but would not let anyone near her, the GP was called but she refused to allow him near her so all he could do was ask the staff to monitor her and continue with the pain relief - the pain relief she often refuses to take. The care home called me after the visit to tell me that MIL had fallen asleep and after following the call up this morning, I was told that she had actually slept for 5 hours last night (the first time in 3 weeks) and that she had in fact eaten her tea last night and taken her medication this morning but is still in extreme pain and pacing around the care home. A CPN is now involved along with social services as the care home are extremely concerned about the fall risk due to the spinal and arm injury and are suggesting either a 24 hour carer with us in the home or an alternative care home, possibly nursing (am really unsure of where she will be allocated if not in the home). I have spoken to the CPN and asked to be involved in the meeting but here is my dilemma - What do I do ?? Do I run the risk of bringing the aggression and possible violence home along with the refusals to medicate or wash (albeit with a carer in place), or do I take the option of alternative care? I am so torn, I can cope with absolutely anything but I cannot cope with the the behavioural difficulties and I am so, so worried about the effect it will have on us all, in particular the children, if we have to deal with this on a daily basis. However, I am also concerned that MIL might actually be better in the home setting than elsewhere and if I do not give her the chance, I could be contributing to her continued decline? The care home are requesting that the meeting be rushed through after the incident last night so will probably be held by next week and whilst I don't know what the options for me are going to be, her fractured and broken bones are still causing untold difficulties and her care needs are far greater than even when she was in hospital ? How do I make the right decision for everybody and will I ever get over the guilt and continual sick feeling I get when considering it, if I make the wrong one? What do I do ? Any advice however small, would be so appreciated right now - I can honestly say, even after reading the posts regularly, that I did not ever anticipate ever having to make this decision or indeed, how enormously difficult it would be. Thank you for taking the time to read my post.