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Magir64 Asked December 23, 2023

My husband is in the hospital for aggression. Everyone is scared with him and things are getting worse. Can anyone give me any suggestions?

It's already a month for him with 4-point restraints. As a dementia patient, it's common to have sundowner every night, but there is a time no one needs to be scared about. The people in the hospital are so scared and they don't lose him even for a second. This is making him more aggressive in addition his cognitive behavior declining faster for being contained on the bed too long. I requested transfer but the doctor can't even explain the reason of why he needs transfer. So, of course the other hospital declined for insufficient reason of transfer. Most of the people are not professional and there is not even a specialist on site. Different doctors are seeing him every day with an inconsistent medication plan. When I raise questions or request explanation of change of medication, they get very hostile and put a note on his record that wife refused this and that. One day doctor made a plan what I agreed with was not followed, and they told me I refused this change! They won't release him for who knows another month. And they started telling me he needs to be totally sedated to avoid harming everyone. We are totally trapped in this situation, and my husband's limited time is being just destroyed by these people. How can I get them to take his restrain off so that he can properly move to a spomemory care place where they know how to handle my husband? Any suggestion is very much appreciated.

AnnReid Dec 24, 2023
There are specialized GERIATRIC BEHAVIORAL PSYCHIATRIC PRACTITIONERS who deal with this sort of situation and can help with developing modifications, medications, and management techniques.

Do a Google search and see if you can find one in your area. If not, contact a psychiatric facility and ask if they can recommend someone who specializes in these areas for a referral.

If there is a social services team in his present situation, ask them to help in your research too.

The sedation and confinement may be the only TEMPORARY SOLUTIONS his present setting can offer, and although it is obviously torment for you, they may be the best that you, or ANYONE, can do for him.

Contact “the other hospital” and ask for THEIR requirements for transferring him there, AND ask if THEY can suggest specialists in dealing with Geriatric psychiatric behavioral management.

Try (this is VERY hard, I know) to keep your focus on getting the best help you can find, rather than the injustice of what’s happening right now. The current restraints MAY be for keeping HIM safe, as well as protecting the caregivers who are dealing with him.

TAKE CARE OF YOURSELF! Your welfare is IMPORTANT. Try to get some rest, a good meal, and a few moments of comfort and distraction EVERY DAY.
Magir64 Dec 24, 2023
HI, Ann. I never thought of Geriatric psychiatrist. It sounds they are far better than the regular psychiatrist. They may have more experience with dementia induced psychosis.
I will check this direction as well. And thank you for all your advice. Among too many things to deal with, I need to keep my focus on how to get out of this situation.
Grandma1954 Dec 24, 2023
LBD is a whole 'nuther thing when it comes to dementia.
Have you talked to a Neurologist?
Many medications that would typically be given to a patient with dementia that is being aggressive can NOT be given to a person with LBD
If you are not getting anywhere with your requests I would contact :
The Hospital has to have a Patient Advocate that you can talk to.
Talk to another Neurologist better yet if there is a Neuropsychologist consult with him or her.

One of the "problems" you might have in moving him to a Memory Care facility is the aggression. Most facilities will want a patient/resident to be non violent for a period of time typically 60 to 90 days.

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Scampie1 Dec 23, 2023
I was placed in a home care situation with a client who became physically aggressive with me. This woman blocked me on her basement step and refused to let me leave her home. My cell phone was on zero, and I was just finishing up her laundry when her broken brain made the decision to block me with her walker. She had turned off the basement lights, and I couldn't see how to get to the stairwell since I wasn't too familiar with the setup of her house; especially, the basement. It was a horrible five minutes to spend with someone like this. Even though I've been trained in dementia care, nothing prepared me for this type of behavior.

I left that case and didn't go back into home health care until a few years later. I don't know if she would have benefited from any type of medication regimen since she was only being seen by a regular physician who I gathered was not knowledgeable about the treatment of people with dementia.

A psych hospital would be your best choice where they can get your husband on the correct medication cocktail for his treatment to calm the aggression. You may have to get an Ombusman in your area to work on your behalf.
Magir64 Dec 23, 2023
Hello, Scampie1. Thank you for sharing your experience.
I had one time he was physically aggressive towards me. He grabbed me and pulled my hair and told me he will break every piece of my bone. This never happened before. All I could do was to run out of the house without my phone. Since then, my phone is always nearby and available. But your experience is telling us the correct treatment can still save everyone including him and the surrounding people.
I just don't know how I can make this unprofessional hospitalist to be able to professionally explain another hospital (psych) the needs of transfer so they accept him. The hospital denied his request because he didnt even give them a diagnosis nor the medical needs of transfer. Should I request to change him to someone else only for the purpose to make my husband transferred properly?
BarbBrooklyn Dec 23, 2023
Alva, the husband has Lewy Body dementia. Haldol can make the symptoms of psychosis worse, from what I understand.

BarbBrooklyn Dec 23, 2023
Have you spoken to the patient advocate office at the hospital?

And Elder Law attorney is one option for getting someone who can advocate for your husband.

Magir64 Dec 23, 2023
HI, everyone.
I am so amazed everyone respond this quick.
He is in a general hospital with no specialist on site.
Psych hospital may be an option but I am so scared to send him there when they don't know anything but just a regular psych patients. Dementia patients react different to the medication thannother regular patients with psychosis. They almost prescribed him Haldol, which can kill him if they are not careful enough.
He has been seen with remote psych doctors who are not always specialized with treating dementia patients.
Yes. He cannot go to memory care with this aggression but my wish is the doctor who knows what he is dealing will find a right cocktail so he gets calm enough.... then he can move on to memory unit.
At this moment, this hospital cannot even transfer him to the right hospital because of the lack of knowledge what they are dealing with and they can't even explain the needs to the other.
AlvaDeer Dec 23, 2023
You say Haldol can kill him. In all truth it is the drug of choice here, and would death honestly be worse than four point restraints? For me it would not. That's for sure. I am so sorry, but yes, he does need the right drug cocktail and the best place to assess that is neuro psych where he will be more free than in any setting he can be in now.
So very sorry this is going on for you.
AlvaDeer Dec 23, 2023
I don't know of any state on earth currently allowing four point restraints?
Where is this?
What kind of facility is this?
What is happening may well be against the law.
You of course need to speak not with a Forum of strangers now, but with the medical team caring for hubby.
I am so very sorry.
Magir64 Dec 23, 2023
I've been fighting with them from the day one.
And looking for all the options. I am even thinking of hiring a lawyer for his right.
I don't want to disclose too much because many people in this hospital is already hostile with me. And I don't want anything happen to him.
MeDolly Dec 23, 2023
They do not get paid enough to try and handle someone like your husband and put their own well-being at risk. He is unstable, they are not doing this to him, it is his broken brain.

Memory care will not deal with a person like him, he needs meds to calm him down, at this point nothing else will help him.

If he is not in a psychiatric hospital that is where he needs to be.

Do you hold his DPOA?

strugglinson Dec 23, 2023
Is this a general/ regular hospital ? or psychiatric hospital?

Nacagi Dec 23, 2023
Out of curiosity how does he act out his aggression? Verbal, cursing, throwing things and/ or bodily fluids, hitting, spitting or a combo?

JoAnn29 Dec 23, 2023
I agree, he needs a psychic facility that will work on getting him the correct cocktail of Meds. Can u get your PCP involved or your Neurologist would be better?

A MC will not except your husband while he is aggressive. They have to consider other residents. MC is justva step up from AL. They may have more aides and more knowledge about Dementia and how it works, but they are not equipped to handle an aggressive resident.

Nacagi Dec 23, 2023
Everyone is scared of him in the hospital, He's probably scared being there, with
the noise, different smells and constant interruptions to name a few, Poor guy
JoAnn29 Dec 23, 2023
People who suffer from Dementia/ALZ can become violent and hurt someone. Seems this hospital has no idea how to handle this man.
cwillie Dec 23, 2023
He needs to be transferred to a specialized psych unit, a general hospital ward is no place for even non aggressive seniors.

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