Anonymous wrote:Aggression, agitation, violence that were not previously there are SYMPTOMS of an illness or SIDE EFFECTS of a medication.

The home should not have called to have him picked up. He should have been taken to the ER for stabilization and family called.

I am sorry this happened.


Geriatric medical care is terrible most places.

I agree, but the top priority is to ensure the safety of the people in the nursing home, staff and patients, and this is what they did. Violent behavior is always extremely problematic to manage. I feel sorry for OP's in-laws, of course.

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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.

Agitation, aggression, anxiety are all signs of dementia. Having been through this, I don't know what happens to people who are abandoned at the ER but I wouldn't wish that on someone I loved. Best case, they will have someone sit with them providing 1:1 care, use a video monitor, etc. Worst case if they are understaffed they can and will restrain dementia patients (strapping them to a bed), drug them with Haldol, not feed him because they don't have the staff or resources to spoon feed, etc. They aren't equipped to deal with these patients.

If I were you I would start with taking him back to the ER for a full evaluation. Something could be wrong medically. Aggression and violence could be due to pain or discomfort. Something like constipation alone could cause this.

While in the ER, ask for a hospice referral. If FIL is eligible for hospice, they could try to help with placement. Or at the very least, you can get respite care (two weeks) in an acute hospice facility to buy time to plan next steps. He sounds like he could be eligible for hospice. They don't provide custodial care. You will still need to find a place, but they can help with managing behaviors. Their goal is to provide comfort so they will work to reduce pain or get him in a comfortable state. Goodwin House is the best in the DMV.

Of course, you have to look at finances ASAP. Ultimately, next steps always end up about finances. Sure, you could rent him an apartment with 1:1 24/7 care but that would cost a fortune. Is he a veteran? Does he have long term care insurance?

I would find a geriatric care manager to help ASAP. Here's a DMV one: https://caringconsiderations.com/

If assets are there, don't look at nursing homes like Sunrise. You need a place that only does memory care or has a memory care unit. He will keep getting kicked out if he is in a nursing home where he is comingled with residents who just need physical help. What your describing is 100% normal for advanced Alzheimer's/dementia. The staff is trained for this and will help get him on appropriate medications to help manage behavior. The best place in this area is Silverado, but it's expensive ($16k a month). They have separate floors, so someone advanced would be in the advanced unit where they would be skilled at managing advanced behaviors and he would be allowed to wander around. You may have to look outside of where he is living now if it is rural. Be willing to move him if his needs can't be met locally.

Anonymous wrote:

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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.

He wasn’t in a hospital. He was in a nursing home.

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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.

As a nurse who received a broken nose and orbital fracture from an elderly patient with dementia (I work in a hospital), the nursing home handled this so wrong. If this was completely out of character for him, he should have been brought to the ED to see if something was going on. They very, very clearly just wanted him gone and this was a perfect reason. I've seen it before. Some nursing homes are horrible.

I agree that the ED is probably the best course of action at this point, but like another PP said, it doesn't come without its challenges. He could be there for months. He will likely end up in restraints at some point, both physical and chemical. There's a good chance he could pick up something else while in the hospital (UTI/Pneumonia are the most common) and take a turn for the worst. Its not an appropriate setting. There is no routine. There are a lot of disturbances. If he is violent at the hospital, the search becomes even harder. I think the longest we had a patient was a year and a half.
I'm not saying don't do it, he's in crisis mode right now and he and your family need help. But I think everyone also needs to be prepared for the fact that this option has some pretty dark realities as well.

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.

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

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.

Anonymous wrote:The mistake was actually picking him up from the nursing home. If you had refused to pick him up they would have found another place.

This, you never get him. We used legal aid to fight a Medicaid discharge. They need to properly medicate and supervise him. Get an attorney and return him. Don’t sign anything or agree to anything.

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.

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Anonymous wrote:A couple of things. It isn’t a dump if the family picked him up.

The family needs to cast a wider net when looking for a facility. It is going to be a nightmare to find a facility to take him now that he has a record of going into vulnerable people’s rooms in an agitated state during the night and add to that the violence toward staff with two not being able to contain him. This will all be disclosed to anywhere you consider.

An ER is an option but it’s not the panacea that PP makes it sound. A placement isn’t going to magically appear because he’s in the ER. If they have to keep him, the care will suck. He won’t get a hospital room - he’ll be stick in an ER bed, which depending on the facility is just a bed behind a curtain with irregular meals and no routine. His confusion will go off the wall and if he gets agitated he could be restrained and medicated with heavy duty psych meds and could end up involuntarily committed in a psych placement. Plus someone has to pay for that so if there is money it might be better spent in other ways.

An attorney and adult protective services are good resources.

Last thing. You are rather dismissive of the staffs’ injuries. Your FIL sent a staff member to the ER. That’s serious and it’s pretty shocking that your reaction doesn’t recognize that he hurt someone and those injuries could have long term affects.

Apologies if it seemed that way—just providing context in case the nursing home could have been overstating the seriousness of the situation to bully my sibling-in-law.

They are probably not overstating. They are not the appropriate placement for him at this point, as evidenced by not being able to keep anyone safe - not the staff, not other residents and not him.

Not all facilities have the infrastructure and/or staffing to handle all levels of care. That’s why you need a wider net.

If he is private pay, you could try to find someplace where they would allow you to bring in your own 1:1.

Your situation is really tough (and could get worse depending on politics, but that’s for another post). When people are a danger to self or others, usually the result is psych placement. Had you all not gone to get your FIL that may be where he ended up. Hard as your situation is, it might be the best available at the moment.

I hope you find something soon.

Aggression, agitation, violence that were not previously there are SYMPTOMS of an illness or SIDE EFFECTS of a medication.

The home should not have called to have him picked up. He should have been taken to the ER for stabilization and family called.

I am sorry this happened.


Geriatric medical care is terrible most places.

Anonymous wrote:What meds is he on? He might need different ones

I don’t know everything he’s on but the nursing home changed something recently and we worry that triggered the violent outburst.

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.