How do staff handle dementia patients who are inappropriate touching and wanting hugs from other residents?

Thank you for your input. This morning the maintenance man was called to the Nurses Station by a supervisor. As he passed Mother's apartment he was inappropriately singing very old romantic love songs very loudly. When he was walking back past Mother's apartment we talked. He said he was at the apartment in the morning before I got there, not at night. Mother does not have dementia to the extent that she would have got that mixed up. Further she likes Yogurt at night not in the morning. Giving him the benefit of doubt here, he said he fixed the TV and Mother's alarm clock. That was not true. He fixed the TV the week before. I didn't argue with him but his assertions have not reassured me. I told him I was uncomfortable about 2 weeks prior to this how he came to Mother's door and suggestively asked her if there was anything she wanted to talk about. That was too familiar. The facility has staff, that is not his position to be asking her such an open ended personal question. Since I brought my concerns up to management, he has not been around. Mother is regaining her strength, she has not mentioned: 1.) being afraid when I am not there, 2.) being afraid of a man in the closet with his hand on the door, and she has not been sleeping every moment except for meal times. Mom is slowly appearing at activities and she enjoyed life to the fullest today with the great great grandchildren and family at a holiday party on the premises. Not that anything is solved. Does anyone have experience with this? What steps are recommended to keep a loved one out of harms way? I have asked him to stay away from her apartment. Another maintenance person can do anything that needs done in her apartment.

pamstegma: I totally agree with you! Their thought processes have been altered due to aging and ill brains. If asked if a bank robber or a staff member gave my mother a yogurt or a piece of candy, the answer would be the same and she would say "yes" to both!

Be careful when you ask a patient questions. Often they say "yes" to anything in order to please you. So ask "Who brought you the yogurt?" because that needs more than just a "yes". I could ask my sister if Santa came down the chimney and she would just say "yes".

Daughterlu, I think all of us understood the question to be about inappropriate touching by a resident with dementia and our answers reflect that. Even those with dementia should never be allowed to cross that line where they cause physical harm or mental anguish to another resident, if a member of staff is speaking or acting that way they have absolutely NO excuse.

Mt Mother was having thoughts that a man was in the closet in her bedroom in Personal Care and that his had was on the edge of the door. She was frightened. She didn't want me to leave at night and would ask me what time would I be there in the morning? She was frightened of something. Two weeks prior to this behavior a maintenance man in the building stepped into her room and said to her in a familiar and flirtatious manner, "(her name) is there anything you want to talk about?" He didn't see me. I popped into view and asked him, excuse me why are you here." He left without answering. I was a volunteer at a rape crises center and this scenario is very similar to when a child is having nightmares after someone the know crosses a line. Last week, I left Mother's apartment after I got her ready for bed and she usually goes right to sleep. She sleeps alot, she is near 100 years old. The next day I noticed her alarm clock was fixed. She told me a friend of hers fixed it last night. I asked, oh, is that the maintenance man. She said yes. There was also an empty small yogurt on her nightstand. She couldn't have gotten it herself. I asked if he got the yogurt for her. She said yes. I talked to her telling her he should not be in her room at night for any reason. We talked. She opened up. I complained to the staff that it was inappropriate for the maintenance man to be in her room at night. My directions as her daughter and her POA of Health Care is that her door should not be left open, that only authorized staff such as the RN's, Nurses Aids, med tech, etc. are allowed in her room and that need to be vigilant that this does not happen again. I leave at 8:00 pm and arrive at 8:00 am. Whether it is another resident, staff or anyone who comes into the facility, for any reason,I don't want my Mother to be victimized. The elderly deserve the same rights and protections as a child has. Since I made a big fuss to staff and administration Mother is finally doing better today. She was as close to comatose as I have ever seen her sleeping all day except for meal times. Today she got up for an activity. She has not been as fearful. Listen to your loved ones in these facilities. Answers to the question posted are full of acceptance. I say, "NO," protect your loved on as if they were your child. Can anyone recommend what other steps could be taken to make sure the facility informs you and also what steps can they take to protect your loved one when you are not there.

Johnjoe: Wow! Good story. Yes, I will classify dementia "as a sad state of affairs for one's brain," but then again all of us logical-thinking persons already know this.

Some years ago I attended a work's Christmas Party 5-hours late since these things start way too early. When I arrived Danny the Stores Man was drunk as a pig and He was sitting between two Girls, with His arms over Both of Them, and Let's say His behaviour was unbecoming of a Gentleman. I called Him a Taxi but He would not leave. Then I asked the Bars Mam what Danny was drinking, and He said Brandy & Ginger Ale. I said no more brandy, just ginger ale, but the more Danny drank the drunker He became...the point I'm making is " Danny's behaviour was dispickible, but He had lost all reason. He had no idea what He was doing due to over intoxication. Demensia Sufferers are very similar, but Demensia is a disease of the Brain, where by the Sufferer looses all grasp of rational thinking, and it is not their fault.

IsntEasy: The recipient of the kiss told the Pastor of the church in no uncertain terms that it was VERY INAPPROPRIATE! Of course, I said the "kisser' is a woman with a severe case of arrested development, e.g, she is a woman of 59 going on 11. I totally disagree with your statement!

Regardless of nationality, people who strive to emulate Christ may have some self-examination to do if they are offended by an affectionate greeting. I hope the pastor gently encouraged the recipient of the kiss to do some personal development of her own.
As for the kisser, some folks are just very generous with hugs and kisses. Mighty Christian of them, I'd say.

cwillie: The woman who gave the inappropriate kiss is an American. She just has a severe case of arrested development.

I don't know Lama, many cultures think a kiss on the cheek, or both cheeks, is an appropriate greeting.

Let me give you an example of inappropriate touching/actions. There is a woman who attends my church who has a severe case of arrested development. One night this woman kissed another lady on the cheek, whom she had JUST MET. The lady who was kissed informed the pastor. Similar situation...just a different setting. VERY INAPPROPRIATE!

Just had this with Mom. A man from her AL was also in rehab the same time she was. This man is a local in our town and is known to be "a dirty old man". Mom didn't like him before her Dementia and still doesn't like him. I requested in rehab that he not be allowed near her. I was told he has rights to go where he wants within the facility. Explained that I understood that so...move Mom if he gets close. He had taken a liking to her in AL. Felt he was her caretaker. I mean, this man is sleezy. The aides at rehab and the AL agree. Problem, u tell one shift but they don't tell the next shift. This man was being seen caressing a woman's cheek who wasn't verbally able to speak for herself. This is not right. I understand that Dementia patients become like children and not to much you can do about that. TG this man stayed on one side of the common room and Mom was on the other. See, Mom is with it enough to warn "don't" then she will hit and this has nothing to do with the Dementia. I warned that rehab staff and told them I wouldn't be paying for his glasses if she knocked them off. No one should be exposed to anything they r uncomfortable with. TG her AL has only 39 residents so thy can be watched better.

I think the staff's response will depend on the response of the one being touched or hugged. If the recipient of the affection responds in a positive way, no action will be required. On the other hand, if the recipient's response is negative, then the staff will take action to distract or redirect the dementia resident. If by "inappropriate touching" you mean touching that is sexual in nature, the families of the residents involved will be notified and a plan of care will be initiated. Separation may be required. My grandmother had dementia and lived in a convalescent hospital. She had a friend who also had dementia and who believed that my grandmother was her husband. The two of them often walked through the facility hand in hand and often patted each other in an affectionate way (but not sexually). My mother and I were consulted by the staff and questioned as to whether or not we had objections or were concerned about the relationship. We didn't. We were just pleased that grandma had a friend and that she appeared to take pleasure and comfort from that relationship.

I think that all humans need affection and benefit from the touch of another. I believe that touch affirms that we are alive, valued and cared for. A person can waste away emotionally from lack of touch. Is it common for a dementia patient to touch and hug others? In my experience, it is not uncommon and most dementia residents respond positively to being hugged or lightly touched. Some residents seek or desire more intimate touches. This is less common, I think, but, after all, dementia residents are human beings even though their mental capacities are diminished. They have the same needs and desires as does all of us.

In light of hugemom's post, I must add to that. My foster dad also had mental issues as he declined. Before he deteriorated, he had me on his joint bank account and I made sure the bills were paid. He got more than me so he was helping me. I said his bills up for online auto bill pay from our end. I never did anything he never authorize but he had the nerve to forget our conversations and what we discussed and he later complained there was money missing from his account and thought I stole it when really I didn't. Each time I had to remind him of what we discussed and what he said versus what he thought until he eventually started remembering. This happened repeatedly. That wasn't all. There were times he would send me out on an errand for our supper. Everything was fine and dandy and going very well when I left. By time I got back and I actually showed up with our supper, he became a whole different person because he totally forgot everything. This was actually very frustrating each and every time I had to go through this with him, and many times I actually felt like a broken record which was more frustrating.
We must sometime realize that what's going on in their heads is not what's going on in reality, because what's really going on is really opposite of what they think is going on when really what they think is not really true. It can be hard to realizes that there's some strange reason why they would accuse you of stealing something they rightfully gave you. Another odd thing is when they give you something, they later or should I say very shortly after forget all about it once you've taken it home. Let's say it's a handbag and they later ask you where you got it. This is when you remind them that they got it for you but don't remember ever seeing it. This can also be frustrating. This is why some people are just not cut out to deal with these types of difficult cases because not everyone has the training and the knowledge to be able to do so.
It took me quite a while after dad started deteriorating to realize what was really going on, and who knows what he told the bank regarding the joint account. The bank worker doesn't have to deal with him so they don't know what's really going on like I did because I had to deal with him and I knew what was really going on versus what he may have said behind my back. He never should've been living alone at this stage in his life when he was mentally declining and no longer able to function like he did before he declined. Of course I couldn't just leave him to himself or who knows what may have happened to him. However though, what was I to do, step back and watch something bad happen to him knowing there was no blood relative around to call or just leave him alone altogether? Either way I just couldn't win because my hands were tied and there was little I could do especially not having much money to file for guardianship. I didn't even know there was such a thing as an APS until someone finally told me of their existence. It took me a long time to finally find out about the resources I needed all along but just didn't know they existed. Not even the veterans affairs could do anything but thank God someone told me about the APS or who knows how long what I was dealing with would've still been going on and maybe poor old dad may have even been hit by a car. What would it have taken for the right people to finally come forward had I not had the resources I so badly needed? Would it have taken him being hit by a car running around town all alone and me not having a car to take him anywhere or would it have meant him having a heart attack alone in that apartment and me walking in one day to find him? What would it have taken had someone not told me about the APS? I wish I would've known sooner but I just didn't. I guess sometimes it's better late than never. Had I known what the guardian was really up to when she severed me and dad's bond, I never would've given her any information. Me and another person were discussing this very thing recently and even they said no wonder people have trust issues when the system uses and abuses you which is what happened in this particular case. Sometimes people who take guardianship will overstep their bounds and do stuff they have no right doing. The very people who are going to answer for it are the abusive guardians who did what they had no right doing, not the people who were wrongfully ripped apart by someone they were supposed to trust they were supposed to trust but they were betrayed by that person. Whenever anyone files for guardianship of someone, this should be done very carefully by the right person because some guardians are abusive and they will use their power in abusive ways. The case of my foster dad is not the only case I ever saw, there was a lady who took guardianship of three down syndromes that she secretly abused very badly. The lady since died and the girls are free

My mom claimed she was inappropriately touched the first few days after she was admitted to her facility. Even though security cameras in the facility showed nothing, the administration was still required to file a report with the state. It may seem as though the facility isn't doing anything, but in fact there is a lot that goes on behind the scenes when an incident like that happens. If no one is injured, if the incident is minor, a good staff understands that people with dementia will often act out this way. In my mom's case as time went on, it was very apparent that these incidents were occurring in "her world", but no one else's. The staff watched her, but did not stalk her.

Unless it is serious touching staff will do nothing.

My foster dad was definitely a hugger but he would never put his hands weren't supposed to be. It's one thing to want to hug people, it's another to touch someone where you're not supposed to. If you really think about it, a person with dementia has a mind that's returning to childhood. Anyone who knows about children it's will know that children have a need to share natural affection, something that I've been noticing most adults don't. Exactly what's wrong with this world is lack of natural affection. I think the demented person knows something about their own eventual end, and I think for that reason they have a child-like desire for comfort through natural affection. However, I'm not sure whether or not they know the line not to cross where not to put your hands but then again others may know, my foster dad did. He was always wanting to be close to me and sit with me on the couch and anytime I was leaving for the night or sometimes when I was coming in, I always got a hug, especially as he deteriorated. Any time he sat on the couch beside me it was very normal for him to place his hand on my leg, just like any other person would in an innocent way to either comfort that person or if they're seeking comfort and normal human closeness and bonding, especially in his old age. He may not of shared any details with me, but I'm starting to wonder if he may have secretly known he was deteriorating and didn't want to scare me.
I think somehow he apparently knew enough to be as close to me as absolutely possible because eventually happened to separate us though neither one of us saw what could've been coming. I would definitely take very good notes and pay particular play close attention to his increased desire to want and need natural affection because apparently the person you're talking about knows something, something inside is telling him to be as close to others as possible because something down the road is coming. You may want to watch the person where inappropriate touching is involved but definitely try to fill in the gap where he's lacking natural affection. Trust me when I say they know something but they can't tell you because all they know is that they're supposed to start expressing love for others while they have a chance because there's no guarantee you'll get to do it later when something separates you from those people. I'm assuming you're dealing with a gentleman, right? If so, remember that elderly men in particular often want the affection of younger women. Some people may call them dirty old men, but it's not necessarily true in all cases. I've noticed that if they don't have any family that cares about them, they will seek out other people with whom they can relate and build a relationship. One thing to be wary of if this happens is that someone can easily take advantage of them in ways that are common to take advantage of our elders and rob them blind. Been very wary if this happens to be a situation where the older person is building a relationship with a much younger person, they could very easily take advantage of the patient in unspeakable ways when really the patient is really not competent to make competent decisions. In some such cases, the incompetent person can be steered to make decisions to benefit the person taking advantage of them

Pretty common. In many communities, the staff would try to redirect the behavior if the resident on the receiving end is uncomfortable with it and they'd try to encourage friendships where both parties are OK with it. I know a couple of ladies who lie in bed side by side for at least an hour a day, reading magazines and chatting like teenagers, and other residents who greet with a hug, even if you see them a dozen times a day. It's actually quite pleasant if you let down your own guard a bit : ) As Ferris mentioned, touching and hugging are good things, it's only the frequency and lack of filtering that can make them troubling in people with dementia.
Of course, if the touching is inappropriate or aggressive, that's another story and another set of tactics to handle it.

Yes, yes, yes. Dementia in a lot of brains activates the sexual desire buttons (laymen's terms) and people will want to engage in a natural activity. What makes you think touching and hugging are bad? Granted, when the party receiving it might not like it, but it is usually harmless, and remember, dementia patients are not responsible for their actions.

The first response is to tell them NO very firmly. A care plan might say "eyes on at all times". Medication for OCD can be prescribed. In the worst cases the patient is sent to a psychiatric care facility, but that is a last resort.

It is not uncommon although not all those with dementia behave this way. What exactly do you mean by inappropriate touching? Obviously anything that veers off into the realm of sexual assault need to be stopped, but hugging, touching and hand holding is mostly tolerated unless it leads to confrontations.