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Splendor Asked July 2019

My dad’s gotten violent- striking his aides. He’s on his 2nd facility. Where do we go next? Are there places that specialize in this?

He was in a larger memory care unit for a year and a half. As his dementia progressed he started displaying combative and other disruptive behavior. They suggested he needed a smaller facility with more one on one care. We moved him to an 8 person home-based place. He’s gotten worse. More violent. He’s on several mood calming drugs but unless he’s sedated 24-7 he still hits. If this facility decides he’s too much, where would he go next? Most Alzheimer:memory care places I see say they won’t accept people with aggressive behavior” which unfortunately can is a common trait during certain stages of the disease. Short of an uncaring, cold, psych hospital where can he live and get the help he needs and deserves. He’s a former veteran and outstanding husband and loving father that deserves dignity despite the toll the disease has taken on him. VA was no help because he didn’t meet their criteria (serving during war time, etc). Im desperate for a solution. Are there places that truly specialize in this and can handle aggressive behavior?

SofiaAmirpoor Aug 2019
This is a hard one. In my area there used to be a nursing facility that only took Alzheimer's patients, but they did not take medicaid. It was a great program, but they unfortunately they closed down years ago. There are psych nursing homes, but they are few and far between. I wish I had a magic wand for you....I don't.

CaregiverL Aug 2019
My mother gets combative & violent too. Dementia. Hide any guns & knives. Seroquel might help. SNF have patients with this problem. Hugs 🤗

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Countrymouse Jul 2019
Splendor, I've no personal knowledge of this but there are other posters on the forum, I'm sure, who would suggest you ask for a review of your father's diagnosis. A referral to a psych unit - not an uncaring, cold one, preferably! - for a thorough workup might not be a bad idea anyway. How satisfied were you with your father's original diagnosis, and how confident are you about the treatment he's received to date?

Challenging behaviours, including aggression, are indeed common in dementia but the specialists have been trying to move on from chemical control alone; moreover pinning down exactly what sort of dementia he has is crucial to getting the drugs right. Moreover, you've seen for yourself that in reasonable doses the approach so far is simply not working for him. Are you in touch with an older age psychiatrist, or if not who has been leading his medical care team?

NYDaughterInLaw Jul 2019
In my opinion, sedation is the kindest and safest solution to your problem. He can seriously hurt himself and others during an episode of violence. Sedation can be part of the help he needs and deserves. Sedation is not necessarily permanent; however, it will allow for the care he needs now. An 8 person home-based place sounds ideal.

anonymous912123 Jul 2019
To me, he is in the fight or flight stage. Although we do not know what is going on in his brain, my husband started to get aggressive at the end of his life, sometimes in his mind he was leading his troops out of the rice fields in Korea, under combat, he was saving 125 men's lives, and actually.. he did that.. only it was some 40 years earlier. Thankful, he died before it got any worse, he had been battling cancer for 12 years. Had he lived longer, he was going to be placed in a psychiatric hospital, affiliated with the Veteran's. The Veterans have a name for this, I do not remember what it is, it is not PTSD, evidently, many who have been in combat for an extended period of time have suffered from this.

Ahmijoy Jul 2019
Has the facility actually told you they want him out?

Unfortunately, because of his past issues, his only option may be a psychiatric hospital. It’s not ideal, but you can’t take the chance that he may injure another resident. I understand that he was a great guy who deserves respect and kindness, as do all our Veterans. However, sadly, he’s in need of more care than they can provide in regular facilities. If there is a social services office at his current facility speak with them and ask for help.

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