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 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 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 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 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 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 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?

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 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 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 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.

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.

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:

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.

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

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.