"Chemical Restraints"

[Anonymous]

Anonymous wrote:Chemical restraints are against the law. I'm asking what that means. Does it mean over-medicating or sedating residents?

It means using medication to control behavior. Doesn’t have to be overmedicating. Doesn’t have to be sedating.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

Medication is usually part of person centered care. It’s not anti-medication at all.

[Anonymous]

Anonymous wrote:My dad was actually very gentle until he got Alzheimer’s. In a nursing home he hit a nurse and at that point he was heavily drugged. We moved him to a place that had a special unit for dementia patients but he never spoke after the heavy medication. He died two months later. It’s such a terrible disease in the end. I understand why the first place did what they did, but it made me so sad for him.

I’m so sorry. Your dad sounds like he was a lovely man.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

What about the roommate? Do they get person centered care too, or do they have to be assaulted and die on the altar of not medicating dementia patients?

This. Anyone who criticizes using medication to manage abusive behavior even if it means heavy sedation, needs to go spend the day with the most challenging patients when they are UNMEDICATED.

And you need to research how standards of care have evolved. This situation never should have happened. Most patients don’t need to be sedated into semi consciousness and thus level of violence did not erupt out of nowhere. The patient who acted violently probably never received appropriate treatment, the facility knew his condition, and he shouldn’t have been with a roommate.

Learn. Advocate. Find better facilities.
I started helping my mother take care of elders long ago when those barbaric treatments were the standard of care. I’m so thankful for the advances over the late 20ish years.

And you know isn’t thankful the standards of care changed- the low paid workers who are getting assaulted on a regular basis. It is horrific what is happening to them and no one seems to care.

The majority of workers in nursing homes have been hit, scratched, bit, groped, etc.

Many have been punched in the face, had shoulder dislocations, concussions, etc.

It is ridiculous you cant put up a bed rail to make sure a dementia patient who can’t independently walk but doesn’t remember that cant get out of bed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

What about the roommate? Do they get person centered care too, or do they have to be assaulted and die on the altar of not medicating dementia patients?

This. Anyone who criticizes using medication to manage abusive behavior even if it means heavy sedation, needs to go spend the day with the most challenging patients when they are UNMEDICATED.

And you need to research how standards of care have evolved. This situation never should have happened. Most patients don’t need to be sedated into semi consciousness and thus level of violence did not erupt out of nowhere. The patient who acted violently probably never received appropriate treatment, the facility knew his condition, and he shouldn’t have been with a roommate.

Learn. Advocate. Find better facilities.
I started helping my mother take care of elders long ago when those barbaric treatments were the standard of care. I’m so thankful for the advances over the late 20ish years.

And you know isn’t thankful the standards of care changed- the low paid workers who are getting assaulted on a regular basis. It is horrific what is happening to them and no one seems to care.

The majority of workers in nursing homes have been hit, scratched, bit, groped, etc.

Many have been punched in the face, had shoulder dislocations, concussions, etc.

It is ridiculous you cant put up a bed rail to make sure a dementia patient who can’t independently walk but doesn’t remember that cant get out of bed.

Staff in person centered care facilities report much greater job satisfaction and less stress. I don’t think you understand that most dementia patients can be safe and safe to be around without being medicated into a stupor.

The US pays healthcare workers shamefully low wages, including most of the staff at elder care facilities. I agree with you about that. It’s terrible and unlikely to improve anytime soon.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

Asking that they leave is fine. That's not using chemical restraint. Chemical restraint is illegal in Maryland. That's what I'm asking about. In my parent's facility they sedate residents who continually want to go outside on a nice day or who don't want to come back in or who don't want to be picked up and moved from a chair to a wheelchair because the person doing the moving is mean -- or because they are short staffed and it's easier to move 15 zombies in wheelchairs at one time than it is to move 15 alert elderly residents. I think that's illegal. It's also very sad to see people who used to have lively personalities just sitting upright in a wheelchair with their eyes closed all day long, or slumping forward with their forehead resting on the tabletop.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

And people should stop being upset about their aggressive relatives being medicated!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

Asking that they leave is fine. That's not using chemical restraint. Chemical restraint is illegal in Maryland. That's what I'm asking about. In my parent's facility they sedate residents who continually want to go outside on a nice day or who don't want to come back in or who don't want to be picked up and moved from a chair to a wheelchair because the person doing the moving is mean -- or because they are short staffed and it's easier to move 15 zombies in wheelchairs at one time than it is to move 15 alert elderly residents. I think that's illegal. It's also very sad to see people who used to have lively personalities just sitting upright in a wheelchair with their eyes closed all day long, or slumping forward with their forehead resting on the tabletop.

Sadly, it is what it is. Or you have to take them home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

Asking that they leave is fine. That's not using chemical restraint. Chemical restraint is illegal in Maryland. That's what I'm asking about. In my parent's facility they sedate residents who continually want to go outside on a nice day or who don't want to come back in or who don't want to be picked up and moved from a chair to a wheelchair because the person doing the moving is mean -- or because they are short staffed and it's easier to move 15 zombies in wheelchairs at one time than it is to move 15 alert elderly residents. I think that's illegal. It's also very sad to see people who used to have lively personalities just sitting upright in a wheelchair with their eyes closed all day long, or slumping forward with their forehead resting on the tabletop.

I think it’s illegal in MD as well. The problem for you is that any intervention and enforcement is going to be very slow and probably won’t benefit your LO. I would move LO and then report.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew a man with dementia who almost killed his roommate in confusion and caused thousands of dollars in damage pulling fixtures out of the walls of memory care. Sedating him was the only way to keep him and those around him safe.

It probably wasn’t. The idea that dementia patients must be sedated to a zombie like state is no longer the standard of care. Psychiatric medication is often part of the plan, but that’s it. Google person centered care.

But even in person-centered care, the nursing home reserves the right to say the resident must leave, if they are threatening the well-being of staff and other residents. They can’t accommodate actively aggressive residents, especially those who might be mobile in a memory care unit. And it’s often hard to find an alternate placement. I witnessed this myself when I worked in a memory care - a resident gave an aide a black eye and pushed someone who was very fragile. It’s such difficult situation. Sometimes medication is the only way to keep someone in a placement.

And people should stop being upset about their aggressive relatives being medicated!

No one wants patients that are violent endangering other patients or staff. Medicating people into zombies is no longer the standard of care. Most aggression is not “just the disease,” it’s a response to environment and stimuli that is complicated by the disease. Medication is usually part of a dementia patient’s plan, and ignoring aggression is not. It’s amazing how hostile some people are to the incredible advancements in care that greatly enhance QOL.