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When my Dad checked into the VA hospital for subacute rehab, he was recovering from a flu and an earlier bout of sepsis, both of which increased his delusions to the point where several times he got angry enough to scare people. He's been staying the locked facility for several weeks without showing any more aggression, and the people he is sharing space with are not sociable, most never see reality, and he is very alone there and out of place. We want to place him in a retirement home that is closer to home, and has adequate 24-hr care, but not in an environment where all fellow patients are delusional and dangerous. Lately my Dad has been calm and easily re-directed. The doctor notes will reflect his delusional incidents and they will consider him a risk, but for how long? We feel he is improving every day.

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Facilities cannot be too careful. In Lakewood, Colorado there was an incident where a man with dementia killed his roommate with dementia. If I remember correctly it was because of a missing watch.:-(
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In reading your followup posts, to me you describe someone who has had incidents of instability. And who has violent tendencies. Yes, I know that you say he only wants to attack someone if they are harming his family, but in his mind, any other patient or staff member could be attacking him. Delusions are not uncommon with Vascular Dementia. And with vascular dementia, which you say he has been diagnosed with, I would think that it would take awhile to determine if he is indeed stable and not an undue risk. I'm no expert, but I would discuss it with the doctors and get their input. When he was diagnosed with Vascular Dementia did the doctors explain what that means? There must be some reasons they gave for prescribing that he be in a locked facility.

To me, I would be more concerned with the consequences of the risks for right now. You say you want to place him in a retirement home...I would investigate and thoroughly consider if that is a proper fit for him, keeping in mind the progression of dementia. Can they adequately monitor him and provide him with care as his condition declines? Do they have a Memory Care unit on premises that he could be relocated to easily if that were needed?

I'd discuss all of this and his prognosis with his doctors. I realize your goal is for him to be as happy as possible.
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It sounds like they have his mood swings under control. Let it be for now, taking him out too soon would be disastrous. One step at a time.
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Can't edit post for some reason - alcohol problems about 40 years ago.
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My Dad has NPH, which has some cognitive issues that never presented a problem to anyone but himself. We've always wondered if he had some anxiety issues since he does have a temper problem, but he never hurt anyone, never struck out, except to spank a child which we NOW know you shouldn't do. His only problem really was the delusions, it made him fearful that we all were in danger, and when we didn't believe him, he felt he needed to be aggressive in order to save us. (we had to protect the oxygen supply and by golly nobody was going to get in his way.... and I just stared him down!!! and said "are you going to hit your own daughter?" But - had a stranger let the challenge stand, it would have been pushing and shoving. Come to think of it, he had an alcohol problem about 0 years ago and there were a few very minor physical altercations. So in short, he has no history of violence, but he can look menacing and thinks maybe he should beat people up, but never out of mean or selfishness. Just an overactive sense of I'm right sometimes. Yes he has been diagnosed with vascular dementia.
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Did your dad have mental health issues before? Was his problem only due to being in the hospital? Was his only problem delusions? Does he have dementia?
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Here's the problem: he is docile in a controlled environment. Taking a patient out of that and moving them to an unfamiliar facility creates anxiety and anxiety leads to outbursts. From a lockup, he would need a half-way move if VA has cottages like that available. If he functions well at the half-way mark, he may be recommended for a group home or senior's apartment. It won't happen in weeks, but maybe in months. Took my sister a year to progress from lock up to group home.
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I would think it will always be on his medical record. If another condition develops that very likely will, and will likely cause aggression. Though some facilities may consider him it will be difficult.
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