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An elderly relative has been staying at a home for elderly for the past one and a half years. I used to take her out in my car to take some fresh air. She likes to go near playgrounds to hear children playing or to watch flowers and trees (with her limited eyesight).


Since last May, the doctor in charge of the home said that she will not be allowed to go out any more except to go to hospital because of her incontinence and because when she returns back she is aggressive. However, the nurses insist that when she goes out she returns back calmer!


Is his doctor's decision justified? Can a dementia patient be locked inside for good until he/she dies? The home does not have access to a garden and the only window she can look out of is in the dining room and it overlooks a main road with cars passing by.


I worry a lot because I feel that this treatment is unfair. Has anyone passed through this experience before? Do any alternative solutions exist in such situation? I appreciate your comments because I am wasting sleepless nights worrying in vane about her inhumane 'therapy'!

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Conflict within the family has everything to do with it. And it sounds as if this may be the case with yours. Resident experiences significant agitation after being out. Expresses that agitation on other residents or staff upon return. Family charged with being responsible make the decision it is better for her not to go out. You are ticked off that doctor told you this. Imagine how much more angry you would be if it was this family member that told you of the new rule.

Instead of getting angry yourself, accept this change and visit her there when you can. Be cooperative in her care and you will be less stressed as will the resident and staff.

From, a member of a dysfunctional family.
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The doctor justifies his instructions on the grounds that the trips outside are agitating the patient.

But the nursing staff say that the trips, far from agitating the patient, improve her mood?

And there has been a handover of curatorship, from whom to whom? Do you have any relationship with either person? Is it a good relationship?

The reason it matters if there is family conflict over your relative's care is that when there is conflict then the best interests of the relative can get rather lost in the ding-dong of family arguments. It becomes less a question of whether the relative really benefits from the outings, and more a question of whether Family Member 1 can boss Family Member 2 around or not, and this is bad news both for the relative herself and for the staff charged with her care.

But I'd be happy to hear that no such thing is going on with your family. If so, then you want to return to the doctor and the manager and ask them to explain the apparent discrepancy between their understanding of your relative's state and that of the nursing staff.
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I would start by talking to the Social Worker.

If there is family conflict, I can well understand why the doctor feels the need to play "bad guy".
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Following your message, I fixed an appointment with my relative's new curator. I will ask her about any worries regading safety which the home did not tell me about
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It may be that she has increased confusion and disorientation upon return which often causes behavior issues. That is very difficult for the resident and staff alike. Is this the case? Aggression is a danger to herself and others.

I understand your concern. If these outings are causing problems, it could be that the doctor is playing the bad guy especially if there are conflict issues between family members.
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patt0015 Dec 2018
There has just been a change in the curator appointed by court. why should conflict issues between family members affect the doctor's decision and conclude that she cannot even go out for 1 hour!?
And if she is disorientated on her return, why do carers urge me to take her out?
Why would the doctor need to play the bad guy?
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Who informed you of this decision? The patient? The staff? Which staff?
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patt0015 Dec 2018
both the manager and the doctor himself who is a resident doctor appointed by the home for elderly. But I do not understand why and from whom to seek assistance
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It is, as you obviously think, a lousy solution which would win that doctor no plaudits at all from any dementia care organisations.

But. I suspect that what the doctor, or more accurately the facility as a whole, has a problem with is not fresh air and sensory stimulation but the person's safety in the hands of an untrained caregiver. Were your trips to the playgrounds bringing you into conflict with the staff or with another family member?

It is very far from satisfactory that this home provides no access to the outdoors for its residents. If you look at common designs for new-build memory care units, they are often arranged around an enclosed atrium so that residents can walk around safely without leaving the premises.

Who is actually responsible for your relative's care? Have you talked to this person about your concerns?
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