My father is basically the nicest guy but about once a month he gets stubborn and hits his caretakers. He has been dismissed from 3 nursing homes in the area for hitting. He has been baker acted and is currently at a mental facility to adjust his medication. Between hospitals for a UTI and rehab nursing homes he has been in 7 different places in 6 weeks. He can return to assisted living only if he has 24 hr private aid. That costs around 400 per day, who can afford that? What are caretakers supposed to do with an aggresive patient? I know with alzheimers this is not unusual but people treat you like it is. I do not know what to do. I am trying to get him qualified for medicare. If I put him in another nursing home this will probably happen again. Thanks for any advise you have!
I'm afraid a lot of this depends on where you live (their ability to cope with behaviors). A nursing home is the most likely place for him, so keep working on getting him in to one. They are probably more able to cope with these behaviors than assisted living. Either way, his assets will get depleted if they already aren't so eventually he'll qualify for Medicaid. Maybe in a nursing home, they can cope.
Good luck - we are with you in spirit.
Carol
Just like you, I was told that 24 hour private care was a non-negotiable condition of her re-admittance to her care facility. I understood this, since she was very much a danger to others as well as herself, and no care facility is staffed to deal with this sort of a problem. Unlike many, I was fortunate that her estate, which I already managed, had sufficient funds to deal with the horrendous expense of nearly $15,000 a month. At least for a while.
The two things really helped me out, besides the Depakote. The first was that as a 7th stage dementia patient, she qualified for Hospice. Hospice didn’t pay for the private care, but they provided a great deal of her care while being paid entirely by Medicare. That cut down on some of her other costs, and allowed me to decline life-prolonging procedures for my beloved mother whom I know would rather be dead than like this, if she had the choice. The second big help was the willingness of her care facility to reassess her situation regularly, so that when the violent episodes decreased to a level that the in-house staff could handle to some degree, I could cut down the private care hours a little at a time.
Right now, episodic violence in dementia patients is either uncommon enough to remain unaddressed on a large scale, or it is under-reported due to shame, embarrassment, or the desire of some care facilities to deal with it as they see fit without oversight. Since the incidence of dementia is on a rapid rise, I believe we will see more cases of this episodic violence, and as we do, measures will eventually be put in place to deal with situations such as ours. Right now, unfortunately, you and I are on the forefront. It’s up to us to break new ground and see to it that our loved ones are treated well and appropriately, and that the costs for such issues can be dealt with by normal, non-rich people.
One final thought on this: I’ve run into much resistance from the medical practitioners to the simple solution of sedating her to the point that the behavior stops. There appears to be a perceived ethical conflict in that doctors are not supposed to sedate their patients for their own convenience. I suggest that this otherwise excellent rule should be reexamined in the light of end-stage dementia. Patients such as my mother, who has not known me for months and requires total assistance for all life functions, whose brain has literally melted, turning her into something closer to a veterinary patient than a human one, cannot be considered to be deprived of anything valuable by sedation. In cases where there is depression and despair, anti-anxiety sedatives such as Lorazepam, Valium, and so on should be considered humane rather than unethical. I’ve pushed hard on this issue with my mother’s doctors, and they’ve reconsidered their views on the matter to some extent. Maybe you can do the same.
Sending you positive thoughts!
Luvmom
Luvmom
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