Nursing home kicked out my FIL

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Imagine your loved one in a nursing home, and a violent person wanders into your loved one's room, in the middle of the night. When staff tries to protect your loved one by removing the violent man, he assaults them, sending one to the ER.

Would you be ok with this violent person remaining in the same facility as your loved one?

I see what you’re trying to do, but where are people like him supposed to go? Take him home, wait until he wanders off because it’s impossible to monitor someone by yourself 24/7, and he does cold and shirtless in a ditch? He is ill. He is not a “violent person”. He should never have been able to wander in the middle of the night unsupervised if the appropriate safety measures were in place, but this facility refused to do anything extra and was dragging their feet on getting him moved somewhere more suitable.

DP. Unless you are paying for 1:1 care or restraints have been approved, there is no way to have eyes on him all the time. And he was not permitted to wander. Staff found him and attempted to get him where he belonged.

Facilities cannot magically make placements appear. If something was available and they didn’t move him, that would be a different story but that’s isn’t what OP conveyed.

And whether he is ill or not, he is violent just like people who have a mental illness are sometimes violent. And, by entering the rooms of vulnerable people, he is a danger to others. As I said upthread, what happens to violent people is commitment to psych facilities, including violent people with dementia.

Depending on the state they do not allow restraints.

Which states don't allow restraints for a violent individual in a hospital? I'm familiar with ones who have pretty strict regulations, but I wasn't aware of any states where it wasn't allowed at all.

Maryland does not allow it. This behavior can be normal in dementia even if the person was not violent before. They have no mind left and no clue what is going on and are scared and react.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Imagine your loved one in a nursing home, and a violent person wanders into your loved one's room, in the middle of the night. When staff tries to protect your loved one by removing the violent man, he assaults them, sending one to the ER.

Would you be ok with this violent person remaining in the same facility as your loved one?

I see what you’re trying to do, but where are people like him supposed to go? Take him home, wait until he wanders off because it’s impossible to monitor someone by yourself 24/7, and he does cold and shirtless in a ditch? He is ill. He is not a “violent person”. He should never have been able to wander in the middle of the night unsupervised if the appropriate safety measures were in place, but this facility refused to do anything extra and was dragging their feet on getting him moved somewhere more suitable.

He sent someone to the emergency room with his violence. He is, by definition, a violent person.

He’s violet due to the dementia which can be common

So? He’s violent.

He's not violent to be violent and he needs to be medicated to reduce the agitation, etc.

[Anonymous]

The fact that violence is out of character is even more reason to have him tested for a UTI. My father went through the same thing and the default at his facility for new violent behavior was a UTI screening because it is so common.

Also, hard to think about, but I'd take him off all medication but for pain or behavioral control.

[Anonymous]

Anonymous wrote:FIL has fairly advanced dementia. Still verbal but always confused and doesn’t know anyone anymore. Frequently agitated. He was in a rehab/nursing facility that had been facilitating his transfer to another nursing home, but that has not happened yet for reasons I don’t know. His medical needs seem to be too advanced for most memory care facilities in his area, as far as we have seen. He is on several waitlists at other nursing homes.

He woke up in the middle of the night (regular occurrence), got confused, and grew violent after wandering into another patient’s room thinking it was his, after staff tried to reorient him to his room. He ended up knocking down two of the staff, one of whom apparently went to the ER (which is likely the small, rural 24/7 ambulatory care place next door not a trauma center!). The next day, the nursing home called one of his local children to take him home. No notice, just, come pick him up. And now apparently the other facility won’t take him either….. They have been trying for months to find a suitable place for him as he cannot be cared for at home anymore. His youngest child has been caring for him but is in well over his head. They are now in crisis management mode, again, after thinking they had found a safe place for him.

Medication management is clearly a challenge and may be a contributing factor. No memory patient safety measures in the facility exist. But how can a nursing home just basically dump a patient on the street?

I’m calling the local ombudsman tomorrow to see if they can help, at my SO’s request, but this is crazy, right? What recourse or path forward does the family have? An elder care attorney is already involved.

They didn't dump him on the street. He was picked up by a family member.

While I sympathize, OP, you admit that the facility isn't equipped to provide the kind of care he requires, he got violent (in another patient's room!), and a staff member required medical care. Why on earth do you think they would, or should, let him stay?

[Anonymous]

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Why is that their responsibility, and not the family's?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Imagine your loved one in a nursing home, and a violent person wanders into your loved one's room, in the middle of the night. When staff tries to protect your loved one by removing the violent man, he assaults them, sending one to the ER.

Would you be ok with this violent person remaining in the same facility as your loved one?

I see what you’re trying to do, but where are people like him supposed to go? Take him home, wait until he wanders off because it’s impossible to monitor someone by yourself 24/7, and he does cold and shirtless in a ditch? He is ill. He is not a “violent person”. He should never have been able to wander in the middle of the night unsupervised if the appropriate safety measures were in place, but this facility refused to do anything extra and was dragging their feet on getting him moved somewhere more suitable.

Of course he is. Do0n't be ridiculous.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Why is that their responsibility, and not the family's?

They are a licensed care facility and are responsible for caring for him until another more suitable placement can be found. There are options like putting an alarm on his door or adjusting medications that can be used until he can be relocated to a more appropriate facility. (Though he should also be evaluated to see if this outburst was caused by medicine or illness and can be treated.)

The facility presumably has 24/7 staff who are accountable for care of the residents. This is far, far more resources than any family has available. If he's not safe in a fully staffed facility, then there is no way it's safe for him to be sent home. And the facility knows this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:FIL has fairly advanced dementia. Still verbal but always confused and doesn’t know anyone anymore. Frequently agitated. He was in a rehab/nursing facility that had been facilitating his transfer to another nursing home, but that has not happened yet for reasons I don’t know. His medical needs seem to be too advanced for most memory care facilities in his area, as far as we have seen. He is on several waitlists at other nursing homes.

He woke up in the middle of the night (regular occurrence), got confused, and grew violent after wandering into another patient’s room thinking it was his, after staff tried to reorient him to his room. He ended up knocking down two of the staff, one of whom apparently went to the ER (which is likely the small, rural 24/7 ambulatory care place next door not a trauma center!). The next day, the nursing home called one of his local children to take him home. No notice, just, come pick him up. And now apparently the other facility won’t take him either….. They have been trying for months to find a suitable place for him as he cannot be cared for at home anymore. His youngest child has been caring for him but is in well over his head. They are now in crisis management mode, again, after thinking they had found a safe place for him.

Medication management is clearly a challenge and may be a contributing factor. No memory patient safety measures in the facility exist. But how can a nursing home just basically dump a patient on the street?

I’m calling the local ombudsman tomorrow to see if they can help, at my SO’s request, but this is crazy, right? What recourse or path forward does the family have? An elder care attorney is already involved.

They didn't dump him on the street. He was picked up by a family member.

While I sympathize, OP, you admit that the facility isn't equipped to provide the kind of care he requires, he got violent (in another patient's room!), and a staff member required medical care. Why on earth do you think they would, or should, let him stay?

It sounds pretty negligent that he was allowed to wander into another patient's room. He should have been stopped before that ever happened.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:FIL has fairly advanced dementia. Still verbal but always confused and doesn’t know anyone anymore. Frequently agitated. He was in a rehab/nursing facility that had been facilitating his transfer to another nursing home, but that has not happened yet for reasons I don’t know. His medical needs seem to be too advanced for most memory care facilities in his area, as far as we have seen. He is on several waitlists at other nursing homes.

He woke up in the middle of the night (regular occurrence), got confused, and grew violent after wandering into another patient’s room thinking it was his, after staff tried to reorient him to his room. He ended up knocking down two of the staff, one of whom apparently went to the ER (which is likely the small, rural 24/7 ambulatory care place next door not a trauma center!). The next day, the nursing home called one of his local children to take him home. No notice, just, come pick him up. And now apparently the other facility won’t take him either….. They have been trying for months to find a suitable place for him as he cannot be cared for at home anymore. His youngest child has been caring for him but is in well over his head. They are now in crisis management mode, again, after thinking they had found a safe place for him.

Medication management is clearly a challenge and may be a contributing factor. No memory patient safety measures in the facility exist. But how can a nursing home just basically dump a patient on the street?

I’m calling the local ombudsman tomorrow to see if they can help, at my SO’s request, but this is crazy, right? What recourse or path forward does the family have? An elder care attorney is already involved.

They didn't dump him on the street. He was picked up by a family member.

While I sympathize, OP, you admit that the facility isn't equipped to provide the kind of care he requires, he got violent (in another patient's room!), and a staff member required medical care. Why on earth do you think they would, or should, let him stay?

It sounds pretty negligent that he was allowed to wander into another patient's room. He should have been stopped before that ever happened.

How do you expect them to do that beyond restraining and/or locking people in their rooms? Most places barely have enough staff to operate, let alone keep their eye on every patient at all times.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:FIL has fairly advanced dementia. Still verbal but always confused and doesn’t know anyone anymore. Frequently agitated. He was in a rehab/nursing facility that had been facilitating his transfer to another nursing home, but that has not happened yet for reasons I don’t know. His medical needs seem to be too advanced for most memory care facilities in his area, as far as we have seen. He is on several waitlists at other nursing homes.

He woke up in the middle of the night (regular occurrence), got confused, and grew violent after wandering into another patient’s room thinking it was his, after staff tried to reorient him to his room. He ended up knocking down two of the staff, one of whom apparently went to the ER (which is likely the small, rural 24/7 ambulatory care place next door not a trauma center!). The next day, the nursing home called one of his local children to take him home. No notice, just, come pick him up. And now apparently the other facility won’t take him either….. They have been trying for months to find a suitable place for him as he cannot be cared for at home anymore. His youngest child has been caring for him but is in well over his head. They are now in crisis management mode, again, after thinking they had found a safe place for him.

Medication management is clearly a challenge and may be a contributing factor. No memory patient safety measures in the facility exist. But how can a nursing home just basically dump a patient on the street?

I’m calling the local ombudsman tomorrow to see if they can help, at my SO’s request, but this is crazy, right? What recourse or path forward does the family have? An elder care attorney is already involved.

They didn't dump him on the street. He was picked up by a family member.

While I sympathize, OP, you admit that the facility isn't equipped to provide the kind of care he requires, he got violent (in another patient's room!), and a staff member required medical care. Why on earth do you think they would, or should, let him stay?

It sounds pretty negligent that he was allowed to wander into another patient's room. He should have been stopped before that ever happened.

It sounds like this wasn't the right kind of facility for him at all. OP placement will be harder now with this incident. While violence is common with infections and dementia, it is probably best he is out of there. Did anyone try the hospital social worker?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Imagine your loved one in a nursing home, and a violent person wanders into your loved one's room, in the middle of the night. When staff tries to protect your loved one by removing the violent man, he assaults them, sending one to the ER.

Would you be ok with this violent person remaining in the same facility as your loved one?

I see what you’re trying to do, but where are people like him supposed to go? Take him home, wait until he wanders off because it’s impossible to monitor someone by yourself 24/7, and he does cold and shirtless in a ditch? He is ill. He is not a “violent person”. He should never have been able to wander in the middle of the night unsupervised if the appropriate safety measures were in place, but this facility refused to do anything extra and was dragging their feet on getting him moved somewhere more suitable.

He sent someone to the emergency room with his violence. He is, by definition, a violent person.

He’s violet due to the dementia which can be common

So? He’s violent.

He's not violent to be violent and he needs to be medicated to reduce the agitation, etc.

If your loved one is injured by a violent person, you really won't care WHY that person was violent. What you will care about is that the facility KNEW he was violent, that he already had a history of being violent, and yet the facility still allowed him to remain and continue the violence.
Do you really think it's ok?

"This man just beat my mother!!!! Oh, wait. What's that you say? He's not violent to be violent? Oh! Well, that changes, everything!
Please sir, continue. Carry on with beating my mother. It's fine--after all, I know you aren't violent to be violent."

[Anonymous]

Do your best to find a psychiatrist and primary care doctor specializing in geriatric medicine. I agree the violence could be caused by dementia. He likely needs to be in assisted living in a memory care unit, but if he's on Medicaid then a nursing home may be the only option.

I agree also with consulting with hospice. If his mind is gone and his quality of life is miserable, then prolonging the misery can be cruel. Does he have a living will? This situation shows why having one is so important. If he's surviving because of medication treating serious medical conditions, but has a living will stating that he would not want to continue living in this condition, then a family member with medical power of attorney could work with a hospice to consider whether there are options to discontinue treatment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The nursing home did the right thing as it has a duty to protect its patients/residents and workers from violence.

No they didn't. That was just the easiest thing for them. They needed to find an alternative placement. He can't be home. That's not safe for him or his family.

Imagine your loved one in a nursing home, and a violent person wanders into your loved one's room, in the middle of the night. When staff tries to protect your loved one by removing the violent man, he assaults them, sending one to the ER.

Would you be ok with this violent person remaining in the same facility as your loved one?

I see what you’re trying to do, but where are people like him supposed to go? Take him home, wait until he wanders off because it’s impossible to monitor someone by yourself 24/7, and he does cold and shirtless in a ditch? He is ill. He is not a “violent person”. He should never have been able to wander in the middle of the night unsupervised if the appropriate safety measures were in place, but this facility refused to do anything extra and was dragging their feet on getting him moved somewhere more suitable.

He sent someone to the emergency room with his violence. He is, by definition, a violent person.

Um, this is literally why people with dementia are often sedated - just like PP said, medicated to reduce agitation. PP didn't say let the violence continue.

He’s violet due to the dementia which can be common

So? He’s violent.

He's not violent to be violent and he needs to be medicated to reduce the agitation, etc.

If your loved one is injured by a violent person, you really won't care WHY that person was violent. What you will care about is that the facility KNEW he was violent, that he already had a history of being violent, and yet the facility still allowed him to remain and continue the violence.
Do you really think it's ok?

"This man just beat my mother!!!! Oh, wait. What's that you say? He's not violent to be violent? Oh! Well, that changes, everything!
Please sir, continue. Carry on with beating my mother. It's fine--after all, I know you aren't violent to be violent."

[Anonymous]

Facilities like Sunrise are businesses with aggressive marketing. They will absolutely accept your loved one with mild dementia to fill a spot, then kick them out when they become too much. Unfortunately, if you have a loved one with dementia or Alzheimer's you have no way of knowing how the disease progression will go. It is different for everyone. Your loved one could have lived there for years, then have challenging behaviors and then be kicked out.

FWIW I have a relative in memory care. She has hit other residents and been violent before. They have a geripsych on staff who worked to adjust her medications to help with this. They also moved her so she wasn't around a particular resident who she butt heads with. There were many other challenging behaviors that have happened in the course of her illness. If you hire a geriatric care manager, it can save you time and money because they will help you find the right facility.

Often, facilities like Sunrise will show families how great the food is and how many activities are offered. But you really need to ask hard questions like "have you ever kicked out residents with dementia?" "what happens if my loved one is violent/agitated/wanders" "do you have a geriatric psychiatrist who visits" "what is the staff ratio in the evenings when sundowning occurs" "what did your most challenging resident do and how did you handle it?" etc.

Also, in memory care the facility is locked. Residents wander all over the place. They will go in each other's rooms. They have no sense of time and place. Obviously this would not be okay in a normal nursing home. That's why they need to be in memory care specifically.

[Anonymous]

ER. Now. This is a common reason for admission. Say he has altered mental status and also needs placement.

-MD