Father in Law has been hospitalized three times now in the past couple months and each time he is stabilized and behaves very well and gets released. However every assisted living/memory care he has been placed in, despite medication for his agitation, he gets violent and trashes his room, threatens staff and other patients and gets kicked out on his first day there. Every time. I don't think we have any options left. We already had to move him to a different state as our home state had no more places that would accept him. We cannot have him in our home as it would not be safe for ourselves and especially our children. Feeling lost and unsure what to do or what comes next.

What happens when a parent keeps getting kicked out of facilities for violent behavior?

I have been there and done that with my sister. She had frontotemporal dementia, which began in her early 40’s. She was never violent and actually was not diagnosed until about age 48/49. She first went to assisted living. Whereas she was young and physically strong, everyone else was in their 70’s and beyond. She was pretty stable there for about a year, although during that time she went from having an entire apartment to one room with a bath. She was thrown out of there after about a year for pushing down another resident and breaking her arm. Next she went to another assisted living/memory care home and became increasingly violent to the point that we had to have a private caregiver in her room 24/7, so we were paying double for her to stay there. During this time, she trashed her room daily to the point that they removed everything in it that she could destroy. She was physically violent with everyone who entered her room, and she had to stay in her room while other residents were out and about. This stay lasted about a month or two, as when she was admitted, they told us it was only temporary until we could place her somewhere else. Her violence was not aimed at anyone in particular, but at anyone who stood in her way. With the help of social services, we finally were able to place her at a facility that specialized in violent behavior and with the help of a neuropsychiatrist, they were able to get her under control with drugs. She basically stayed in a zombie-like state and walked and walked and walked the halls, sometimes not sleeping for 3 days at a time. They still had trouble keeping her in her room or even getting her to sit still long enough to eat, but she was no longer violent. It was both with relief and sadness that we finally decided, after a bad fall and her refusal to eat or drink, it was time for hospice. She lives another 12 days and died at age 51. She had decided early on to donate her brain to science and her cause of death was Pick’s disease. I hope in telling her story that it will give you some insight as to what you are facing. It’s a matter of finding the right help for your FIL and the right place to put him. If this means a geriatric psychiatric facility, so be it, but you need to keep your family safe. We did not have to give up our POA to get the resources we needed, but she lived in Washington, DC, so we had excellent resources available. I wish you the best of luck in finding the care that your FIL needs. Keep your family safe.

Helpful Answer (12)

You said, "He absolutely can not be allowed to come to our home and it terrifies me that it could come to no other option but that". They cannot force you to take him into your home under any circumstances, so don't worry about, or even consider that.

If they threaten you saying it's either you take him or he ends up on the streets... point him to the nearest bridge to sleep under. This is a dangerous and violent individual.

If your husband insists he lives at your home, move out that day with the kids and file for divorce.

He needs to be made a ward of the state asap.

Helpful Answer (11)

I couldn't agree more. Unfortunately they are already POA and it isn't just a simple thing to resign POA once an individual is incompetent, but rather a court procedure. They should resign POA at once with the help of an attorney. He should be a ward of the state and never let into their home. The social system will lie, cheat and steal to try to get him placed with them. They need to learn the word NO fast.

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ZippyZee is right. You do not have to take him in for any reason. When he gets thrown out of enough facilities he will become a ward of the state and they will have to find him a place. What happens then is the state gives permission to drug him into oblivion the second he acts up in whatever facility he's palced in.
It's not your problem to deal with. You have a home and kids. Don't get involved. Let the state handle him.

Helpful Answer (10)

@Alva

You are mistaken. They can simply resign POA by going through APS and filing paperwork in the probate court.
No one needs a lawyer.
I know a few people who actually got themselves removed from being a POA by doing exactly this.
It's not that hard to get yourself removed as a POA. In fact, the easiest route to getting removed as a POA is to do it through the hospital while someone is admitted. Their social workers get that done fast.

Helpful Answer (9)

What the problem here is, that there "are not facilities" that take people suffering from this kind of problem unless you maybe live near a city. Assisted livings and Memory cares are privately owned and do not provide this type of care. So for a SW to say they do is in LaLa land. All Memory care is just a step up from an AL. More of a locked down unit with hopefully staff trained in Dementia. Most aides are women they would not be able to handle a angry male.

In my State the closest Phychiatric hospital is 2 hrs north of here. Thats where those showing violent tendencies are taken. But its not permanent. Once they find the right combination of drugs, then the person is released to a Memory care facility. What is needed for those suffering from violent behaviour and those suffering from sexual behaviour is a place where there is appropriate staff, like men aides. That there is a neurologist/psychiatrist on the staff. A PCP/GP should not be prescribing meds for people with these tendencies.

Again, in this situation, I would let the State take over FILs care. No, its not his fault but its not his families fault either. He needs care that that average person can't give.

Helpful Answer (9)

First, I’d have a few of questions. See if the hospital (perhaps the social worker there) can give any suggestion about WHY FIL’s behavior improved in the hospital? Did they give him different or more drugs? Did he get more visits, more company? WHY do they think his behavior would have deteriorated so quickly back in each facility? Any other guesses?

Then much the same questions for the facilities he has been chucked out of. Were they giving him the same drugs as the hospital? How quickly did he deteriorate (three times in a couple of months means it wasn’t instant). Did there seem to be any reason for him to go downhill?

Next, more details about how he is “violent and trashes his room, threatens staff and other patients”. In particular, what was the violence? What were the threats? Did he actually make physical contact with staff or other patients? Was he making demands, and if so what? Did the facility consider calling the police, rather than evicting him? And where did he go, if he didn’t go to your home? If it was to another facility, who found it for him?

If you are really running out of options, I’d suggest that the police do get called, and he goes into the law enforcement mental health system. But as you will be asked a lot of questions, I’d try to get answers to the points I’ve set out above.

Helpful Answer (8)

It almost seems like he is able to showtime in the hospital. He seems to have more respect for the environment and that there are more authoritative figures available in an instant. One of his requests when he gets agitated and wants to leave is for staff to call the police. In hospital they have called a security guard to talk to him and that works if their uniform is police-like enough. If police are not called immediately, he begins getting violently angry. He also experiences paranoia and he has no respect for women outside of a hospital and does not shy from hitting/hurting them. It can't just be the scrubs as those were worn in assisted living as well. When my husband would visit him in the hospital he would be sweet to the nurses/staff but then as. soon as they were gone he would turn to my husband and say they were horrible/keeping him against his will/paranoid conspiracy theories.

I think he associates hospital somehow as temporary and then he can go home, so I don't know how but manages to keep it cool there so he can leave. But he can't go home and he doesn't understand that. His confusion is too great at times to be alone and he was self harming. His violence too great to be with us. He is divorced from his wife for physical and verbal violence towards her and before he was hospitalized/302d for the first time in the past few months he had turned his paranoia on me, began stalking like behaviors, threatened to kill me and had a plan to do it (which he told me through phone messages and then called my husband and walked him through the plan and told him to keep it a secret...). He then vaguely threatened he could just kill himself, my husband and our kids so they could be together forever without me. He confuses me with his ex wives at times as well. We used to have a good (enough) relationship.

As for the violence in assisted living memory care, he has punched staff members in the face. He has broken glass and held pieces of it up to threaten with. He has set off fire alarms. He picked up a table and threw it through a window. He took off his belt and used it as a whip. In other facilities police and ems were called, and took him to hospital and then we are told the facility cannot handle him and he is not welcome back. He stays in the hospital until a new place is found by a team of social worker (new one each time), a placement specialist (same one each time) and my husband.

His most recent I do not know many details about yet but he was placed in a group home setting with what seemed like more experienced staff who understood his needs/triggers. The plan was to keep him more sedated for a few days while he got used to the place and slowly taper off to see if they could as the hospital only had him on low doses for anxiety. All I know is, again, first day there, and he woke up from a nap, got angry and began trashing his room. My husband had to go back and take him to a hospital again. I am awaiting more details, all I got yesterday was his room was destroyed and he had injured himself as well in the process of raging. I don't think he is able to understand the consequences of his raging out but he does seem to sort of understand that when he does, his son comes to get him (or meet him at the hospital) so it's all okay.

We're exhausted and confused. He seems to both understand/has "logical answers" for his behavior AND not understand what he is doing and just is going downhill so fast.

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Back to my first answer, the issue is that your FIL has become a violent criminal who is not sane. Instead, people want to treat him as an elder with dementia, who needs the right sort of care.

No need to repeat all the ‘violent criminal’ symptoms you have already set out, no need to say that insanity is not his ‘fault’. We all know that. No sense in trying over and over again to work out ‘why’, failing every time. The point is that our community deals with many such people in appropriate facilities, which are NOT mainstream aged care facilities. Many of them also have grieving families. Shift the focus.

Helpful Answer (8)

I just want to clarify that I don't personally care where he is placed as long as it's not my home. At this point I don't feel concerned for his comfort (though I do feel guilty about my "lack" of feeling there). I was worried it would come to a point where that was his only option left if no other AL/memory care would accept him. The places he has been put in, have been at the recommendation of hospital social workers and an elder care placement specialist who all keep saying memory care is what he needs and they'll be equipped to handle him. He keeps proving that they can't.

I absolutely worry about him being around other people, but he is able to be charming in the hospital for the most part so the cycle keeps repeating.

I just wanted to know/prepare for what comes next because it seems it's going to keep happening until they run out of places to put him and that is going to happen fast. I appreciate all of your advice and those who let me know about ward of the state, etc. Lots of great advice and knowledge here and I am reading it all even if I don't respond individually. Thank you!

Helpful Answer (8)

Your situation is a nightmare...my husband is not (yet) violent except for a couple of times before doc got his Seroquil dose and times worked out by experimenting. In those several times he did things like throw a chair at me -- became incredibly strong even though he looked frail. I worked out a "protection scheme" for myself -- his bedroom has an inside lock, so I will lock myself in there if it happens again and perhaps call the police. I had a lock put on the door to the garage, which was his workshop. I don't want him coming after me with a hammer. I have been puzzling over what to do if his behavior eventually becomes uncontrollable and facilities send him home. Given some of the suggestions here it sounds as though surrendering POA to the state and letting them deal with it (I assume in somewhat the same way they would deal with the violently mentally ill) might be a good one. Otherwise...you truly do have the priority of protecting yourself and family, no matter who might think you are being unkind to FIL.
I have a friend whose MIL keeps getting sent home because she tears off her colostomy bag and sprays everyone and everything with the contents! I don't know if they still use strait jackets but this sounds like a situation where that might be necessary...

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DCorelle, I was thinking again about your FIL and the problems. Here is a guess, that might be worth considering.

You hit the right answers yourself, first in your post of April 1st, and second in your answer of April 2nd. FIL “has been completely obsessed with (your husband) his whole life (honestly to the point where if it could be just him and his dad, other family out of the picture, his dad would be thrilled...hence the death threats) and he is very much the only child on a pedestal”. FIL was violent to his ex-wife, and has no respect for women, including you and the largely female staff at any age care facility.

Peggy Sue said that her in-laws “loved, absolutely loved, being admitted to the hospital. The family visits, the flowers, the concern from staff”. For your FIL, add in more and longer visits from his son, and the female nurses appearing subservient to male doctors. That’s why he calmed down in hospital, not medication.

If this is still the problem, there could be a couple of useful ways to make it clear:
1) Next time FIL goes to hospital, your DH doesn’t visit. See if FIL calms down. If he doesn’t, they won’t send him back to a facility.
2) If FIL is in a facility, get your DH to take time off work to spend around the clock with him, meet female staff at the door to his room. See if FIL calms down. If he does, this also shows that it’s an obsession about his son and women, and it’s a mental illness issue which is not treatable in a normal facility.

I would still suggest that the best way to get FIL to somewhere capable of his care, is to call the police and charge him when he is violent and threatening. That will get him out of the age-care roundabout, and into somewhere set up for this behavior.

Sympathy and best wishes, Margaret

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PS It's the only thing I can think of that is actually under the control of you and DH.

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It may be possible that your FIL is doing well in the hospital because he likes the attention he receives while there. Nurses in and out of the room many times of the day, doctor visit each day, meals brought to him on a tray, someone coming to retrieve the tray after meals, housekeeping coming in to clean each day, etc. Then when he returns to a residential facility those frequent human interactions decrease dramatically.

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What happens when a parent keeps getting kicked out of facilities for violent behavior?

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