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Father is in MC, he is 66. Relatively speaking he is healthy for his age outside of his cognitive issues. He was moved into MC from the AL side due to his cognitive issues mainly wandering, which was to be expected. He has been on the MC side for around six months now, I have just recently started to visit again for four months. With permission I take my father to our local gym three days out the week. He use to be a competitive body building and seems to function well in that setting. He was unable to bring his free weights from the AL to MC for safety reasons.

Last week it was brought up that I might want to limit my visits and such extracurriculars like weight lifting since it appears the staff has noted concerns for his increasing strength, and if he has an outburst they will be hard pressed to restrain him. My father is a large man, and many of the staff happen to be female and on the smaller side. I understand the concerns, but it is wise of me to go against this suggestion because it is something we happen to enjoy together. It allows him to reminisce with others at the gym, share his stories and interact. He does not have many friends in MC, he does not enjoy traditional elderly activities.

I spoke to his friends about the possibly of having them go visit my father instead so I can try and keep his connection with the past intact to a certain degree. They are not too comfortable with that, and tbh nor I am. When they get together they do get rowdy and extremely crass. My father already expresses very inappropriate or non PC world views by himself that is only exemplified by his friends.

I am confused as to what I should do. Weight lifting has been a thing we have done together since I was a kid. Other kids had their father teach them how to ride a bike or throw a baseball, I was tought how to clean and jerk. I am not trying to downplay their fears either, my father is large and has questionable worldviews. While he has never been violent or aggressive as he progresses he could wind up confused and really hurt someone. Something minor could trigger him into a frenzy.

I just do not feel comfortable taking away one of the view remaining connections he has that he remembers fluidly. I am also afraid that if I ignore their wishes any minor infraction would result in his removal. I have spoken about the use of medication, I was told preemptive use of such mediations is not what they are used for. They are used to sooth the behavior that has been expressed, not prevent it from showing it all together in someone that has not expressed such behaviors.

My father's doctor was also baffled by the request to limit his exercise in fear of the staff. Though according the social worker it is a fairly common request since staff and resident safety is an absolute priority. It is a lovely place, I have no real complaints. They have worked with me, but I feel wrong taking one of the few joys he has left away from him. He is still so young. I have toyed with the idea of taking him home, but I know I cannot handle it.

Does anyone have any suggestion as to what I should do? I have lowered his weight, and reps but even still I cannot curb the concerns of the staff. Should I try to find a new placement? Should I try for AL in another place?

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If his friends are what fuels his more questionable views towards people, then in my opinion you have a duty to limit that interaction. No one should have to live or work in an environment where they have to deal with inappropriate behavior even if it is comes from someone who is ill. That is not excuse.

Also I do fall in the camp that is your duty to be flexible with your fathers care, if the staff fears for their safety you have a duty to mitigate their fears. They are doing what you are unable to do which is care for your father, which means you should be catering to their wishes that best allow them to care for your father. If you feel you can do better then take care of your father yourself.
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What's wrong with continuing what you're doing and taking it one day at a time? In another month or year, there may be a development or change in your father's behavior that moves the needle one way or another. At this time, facility staff has suggested that you limit the gym time with your dad. What if you don't? And if you do, does that guarantee any happy result for you or dad? I don't see that it does.

Sounds like you're doing the best you can. And sounds like you understand the concerns of the staff, and you understand some of the pros and cons of continuing to take your dad to the gym on the current schedule.

I'd have another place or two in mind as backup, just in case, and especially since the MC seems to have jumped the gun on behavior that isn't happening right now, and with no history of it, either.

I hope you can at least get the doc and care facility on the same page for an ongoing care plan.
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You can take Dad to the gym and give him time to visit, but limit the weight he is lifting.
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NYChrono Feb 2022
That does not solve their primary concern though, he would still be strong and if he did have an outburst someone would still get hurt.
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Are there other persons in the facility that are his size and weight?
My Husband was 6'4" and at his heaviest when I was caring for him was 285 give or take.
He did not "work out" but he was strong. (I do not have a single interior door in my house that locks. He broke every one just by trying to open a locked door. (Popped the lock on each and every one) It was one of the reasons that I said that if it no longer was safe for ME to care for him at home I would have had to place him. And if it was no longer safe for HIM for me to care for him at home I would have had to place him.
But as he declined he became weaker and he did lose body mass.
I would not worry about the what if's, might be's that may be in the future. Take it a bit at a time.
Also maybe change the work out to build flexibility, balance rather than muscle. It is important to keep the muscle but also to have the flexibility and balance. That will help him more in the months, years ahead.
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NYChrono Feb 2022
I think the next largest resident was around my height of 6'3 not exactly sure of the weight he was fairly lean. For clean and jerks we do focus on flexibility around the snatch. His routine is not solely strength based, but I will admit that is a focus he has always been a gym rat, and pushing PR's is a big thing for him. Which does fuel his drive to increase strength.

The MC ward is fairly small, I believe only 14 residents are on the floor. For the most part many of them are wheelchair bound and much older then my father. He is the youngest person on the floor. While on this forum, I have also been looking to adjust the routine and even looked into getting "dummy" weights to create the illusion of moving heavy weight but it is not the actual weight. I just feel wrong lying to him like that.
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As BurntCaregiver pointed out, it is not your job to make their job easier. Follow the care plan put in place by his doctor. If they feel this routine is beneficial then so be it.
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Obviously, you've never worked in a facility where
" non threatening" patients live. We had a patient much like your dad who was a body builder and was a strong person. This person had never been a threat until his dementia progressed. There were small signs, such as raising his voice to other patients that got in his way, including a chair that would not move for him so he tossed it to the side. This was all discussed with the family in denial, who poo-pooed the idea that he was a threat. Dr refused to prescribe anti depressants. So one day my friend and I was delivering snacks to our patients. He wanted cookies. Our snacks were various muffins, donut holes, juice and grapes on that particular day. The idea of being told there are no cookies four today's snacks, resulted in my sweet petite female Co worker being back handed which sent her down, hitting her head on the floor and corner of the closet wall, causing 23 stitches to her scalp and a concussion. After that, the Dr prescribed several medications to calm him down. The family felt the aide instigated the problem by telling him there were no cookies today. You've got to realize your dad's facility is not trying to be trouble makers. They've got to keep their patients safe but also their workers. Just because your dad has not exhibited violent tendencies, doesn't mean he won't. Dementia plays all kinds of tricks on a person.
The facilities see all kinds of patients in various progressions of dementia. They are there to provide a safe and healthy enviroment for ALL patients and workers, not just a few who think their family member is not capable of violence. If you can't live with the fact that your dad could turn on anyone at any time in the future, then i suggest you remove him from the facility, take him home with you. At some point then, it could be you as his victim. I'm sure you can come up with other ideas that your dad can enjoy. I suggest you find someone else to work out with. Good luck to you and your dad.
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NYChrono Feb 2022
No I have never worked in any healthcare provider position, this is correct. I do understand the progressive nature of the disease, and I have expressed these concerns to his doctor and even they are of the opinion that if he could be violate without proof of such behavior what right do they have to limit activities he enjoys.

Even if I limit it, this could cause aggression they are afraid of also. It seems like a raw deal. I have thought of taking him home, I just cannot afford to sustain two homes, and care for my father. My apartment is also far too small for two men.

I have thinking of things we can do, but tbh he does not have many hobbies that we share outside weight lifting. He is and always will be a gym rat.
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IMO, if memory care allows men, then they should at least have one male CNA. And they do have male CNAs my daughter has worked with them.

My GFs father was in his mid 80s and his exercise was walking. He was in an AL when he became violent. He threw the computer and other things. The staff locked themselves and residents in a room. Cops were called and he was taken to a Psychiatric hospital. What I am saying is the weakest little old man with a Dementia can summon up the strength to do harm. My daughter was punched in the head by a resident.

They are asking you to cut back, not out. Take him 2x a week. Now visiting, how is that a problem. Better ur there if he does become aggressive. (I think some assume ur a woman, I think ur a man) Now the things he inappropriately says, thats part of the Dementia. He has lost his filters and what comes into his head, goes out his mouth. Those people that he says these things to need to understand where its coming from and let it roll off their backs. Especially if staff. I don't know what they think you can do about it, its part of the desease! And if they do not realize that, there's a problem with the staff not being trained in how a Dementia works abd how to deal with it. And if there is staff that complains, maybe they should not be working in an MC.
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NYChrono Feb 2022
I am a male yes. When I do visit I do take my father out, when he was in AL I would stay in his apartment, but I personally find the MC part of the facility slightly depressing so I do take him out as much as I can. With work and school it is limited, I have been only able to do 1 additional day outside our routine 3 days, I do call often.
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If your father is still able to work out and enjoys this activity (that you do with him and don't expect MC staff to do) and his doctor says it's okay, then by all means continue.
The MC people need to be told that you are not going to stop working out with your father to make their jobs easier. No, your father should not have to grow weak and have his muscles atrophy because the MC staff prefer a patient who is weaker and less mobile.
All caregivers prefer it when someone with dementia is weak with low mobility. That doesn't mean we take actions to bring that about.
Good for your father expressing "inappropriate" world views and not being PC. I wish I was his caregiver because I would love him and his friends.
If he isn't violent or aggressive with the staff or other residents at the MC, then they have nothing to complain about. If he is then he will have to be medicated to stop that.
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NYChrono Feb 2022
That is what his doctor has told me, when I brought up medication. If he ever does become  violent or aggressive then we can explore medication, but not until then. His doctor expressed pretty much everyone one of your concerns. If I could afford the private help I would still have him in his home. I have even toyed around with the idea, I just do not make enough to support it.
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Limit his exercise by not letting him get any stronger. Tell his friends that he can't build anymore strength or he will lose his privileges and then he won't be allowed to go out and about. They need to help keep him safe.

His adjustment period of annoyance, as you put it, his verbal abuse of women and minorities all play a role in the potential for him doing harm. They are red flags for the trained professionals.

No, they can't be flexible. Can you imagine the chaos without rules and regulations in these places? They would not be a safe place for anyone.

Just stop letting him build strength and that should address their concerns, which are legitimate.

Just curious, why is he now building strength when he wasn't in AL? I would be concerned that this started after a transfer to MC. What's up with that?
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NYChrono Feb 2022
Oh he was in AL, this was part of the routine we had in AL, he even had free weights in his AL apartment, and I still took him to our local gym three times a week. This is not a new routine, just one that we started back up four months ago. He was unable to bring his free weights to his MC room, and I was asked to not visit for a month, then not take him off the grounds for another month. We just got back into training four months ago.

Part of the problem his he enjoys moving and lifting weight. So strength even at lower weights and higher reps would still net an increase or maintaining it. The safety concerns, he is safe. According to the staff he has never expressed any violate behavior nor has expressed any physical concern that would question his safety.

Which confuses me around the safety issue.
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I am baffled as well. If there has never been any evidence of violent acting out then there is unlikely to be in the future, and I cannot imagine them sitting about discussing what "might" happen.
I would just do a bit of explaining that these gym visits are really more about chit chat and a social outlet, and that were your Dad ever to evidence any outbursts in which someone were at risk you would of course not do this activity with Dad.
To be frank, with poor cognition my worry is more for DAD himself; weights can be VERY dangerous for those who are not fully cognizant; be certain there is good spotting work done here, and no overhead lifting without adequate support.
Just downplay your outings and stop a lot of conversing with the staff about where you go and what you do. I would think, if they "fear" him for some reason they would be relieved he is getting good energy outlift. But perhaps there's something I am missing here.
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NYChrono Feb 2022
I am just going based off what the social worker has told me. The staff is generally afraid of a what if situation regarding my father. Geaton77's posts does sum up nicely what the social worker has told me. It takes 1 incident to injure someone, and no one wants to be that person.

We have enough support around my father at the gym I never let him or any of his older friends lift alone. Everyone in the gym watches out for them. We love the old guard. I was also afraid of side stepping or just telling them I am doing x instead of y. I do not want to be dishonest with the those that are watching and providing care for my father majority of the time, but I do think avoiding direct conversations and say I will honor their wishes is the lesser of two evils.
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I personally would say that’s wrong taking away the one thing he really enjoys and feels like himself and that this is why family care will always outbeat any facility care, as we can tailor to their specific needs. Facilities will always run with procedures. It’s like when I was trying to organise someone to come tidy Mums room they said the staff would not walk up or down any stairs with the vacuum and that I’d have to be there to do that. I get it’s a OH&S and union rules but the help is kind of pointless if I have to be there to carry a stick vacuum and move any objects like chairs out of the way and then pay for it. May as well just do it myself, sigh.
my dad was and still does athletics (high jump),.. if he was to get memory problems later on, I definitely would not stop him from still doing athletics as it means the world to him. One thing I do question is, how severe is his cognitive decline if his still fully accepted by his friends and they have rowdy get togethers? MYbe his friends are jut really awesome but with my mum, the friends disappeared pretty much as soon as Mum started having a decline.
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NYChrono Feb 2022
His cognitive decline is not HORRIBLE, it is noticeable though. His buddies have been extremely supportive and awesome they have been friends since they were diapers. I do not see them ghosting on my father in the foreseeable future or at all. Anything is possible though.

Things might be awkward if I limit what they can do though. They do not enjoy normal elderly activities. They even make jokes about "fudds" despite being "fudds" themselves. It just makes it difficult, if my mom was still alive he would not have been placed, I could have supported the level of care he needed with the support of my mom present. It is not a handful or difficult, I just have a very busy life which makes home care impossible.
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Physical abuse by residents is a thing that happens, it's a valid concern born from experiences. It would only take 1 incident to injure someone, female or male. My mom is a retired RN who also working in a NH so I heard the stories. You will need to be flexible and do things with your dad and his friends either outside or inside the facility but it shouldn't be something that makes him a lot stronger. Healthier, yes. Stronger, no.

Also as his disease progresses, switching venues between inside and outside may increase his agitation, as they are less able to process the transitions and handle change.

My only other suggestion is that you offer to hire a male companion aid for him who hangs out with him in the facility (some people do this) but can't say if he can afford this or if the facility will allow it. If he has an incident and gets kicked out I think the incident goes into his medical records and the next facility will read it and probably say no thanks. Please try to find some other activity he can do with his buddies. Just the social exposure is helpful to him. You may need to "educate" his buddies to stay off of negative topics as this is very unhelpful to him now. They need to learn how to distract and divert. May you gain peace in your heart as you go on this journey with your father.
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NYChrono Feb 2022
That is one of my fears that I have expressed with the staff. If I take away a part of his routine it could lead him to become agitated and depressed. I have brought this up with his Doctor and as he told me to take away something that makes him happy and brings him enjoyment due to a perceived safety issues is unfair to him. I am 50/50 on that take, which is why I am torn.

His friends do not listen to me, they see me as the "woke" kid altering their behavior is 100% a lost cause. I let it go cause my father tends to have more of his lucid moments around them and it is nice to see that spark. He is more himself around them. I am also worried cause if he asks questions he might put two and two together and get why I am limiting his activities which might also cause issues.

The things they are asking me to do might cause more issues then solves, but I am not sure how to properly express this concern. I have tried, but has not worked. I understand I have to be more flexible, but on the same token shouldn't the same be for the staff?

His doctor is a lost cause also I tried to speak with him and he dismissed all over their concerns. Hand waved it as it is their job, if they are afraid of getting hurt they should find a new job.

I do not want to be the bad guy, I guess I am just scared of having to play the parent role. Forgot to mention they do allow one-to-ones but he cannot afford it, and I am already covering a portion of his placement costs. I cannot comfortably cover a one-to-one aid.
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Has he at any time shown any aggression to the staff or other residents?
If not I would say that their concern is a bit premature.
If he does begin to exhibit increased agitation, anxiety then you can address this.
I think exercise is good for him, keeping his current and future physical limitations in mind. Make sure that you monitor him. If he goes into a locker room to change I would suggest that you use a "family" room so that you can be with him and he is not apt to wander out of the locker room without you noticing.
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NYChrono Feb 2022
According to the staff and my knowledge he has never shown aggression towards the staff or residents. He was extremely annoyed during the two month adjustment phase but outside of that I have not been informed by any difficult physical behavior. I have gotten complaints about his comments made, especially towards females and people of color. He has never been physical with anyone.

They have told me that this is more premature, due to his size. They have told me they are afraid if he does choose to get physical it will be too late.

Yes, I am always by my father's side at all times when we are out. Thankfully he has no other issues outside of wandering which is why I have toyed around with the idea of taking him home. I am afraid they will alienate my father due to their fears.
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