My mom is in a nursing home with dementia and paranoia. Last night she punched one of the workers.

...cont....( and trust me there is a difference between taking care of a senior 24/7 at home privately then placing them in a "paid for care center/facility." Such as I myself, I am experiencing my mothers Dementia, her Dementia (each individual suffering from Dementia can have different Dementia symptoms, some are typical and recognizable of the disease, some are not) is making it difficult for my own family dynamics, but by no means and in zero ways does that mean when I place her again for the betterment of everyone involved, including her, will my expectations of quality of care be less than what I expect of myself simply because of our private scenario at the moment. Also, I do know from which I speak. She has been in 4 extended care facilities and one senior care assisted living in her senior past.)

... I am reading over and over again from what must be people in the care industry itself defending the "job, and stating to this poster that violence is common practice in dementia, that aids or others are subjected to violence as a usual part of the job. I say (and do excuse) bs, because Dementia is not full of violence, some violence can and does occur depending on what direction the disease has taken per individual and also depending on what surroundings the individual is subjected to, but it is not "typical, no it is not. If an individual is expressing violently, that individual needs genuine immediate attention (and should have had long before the outburst.) Meaning their communication skills need assessed (is their communication compromised? Can they express themselves, their needs, their wants, their fears, etc freely and well?)..Then, their medication (usually over medicated) situation needs assessed and then actually addressed and I do mean actually addressed (such as my mother was prescribed 13 medications before I reentered the family to take on her care, she is now down to one medication. That feat in itself had taken me over one year and 3 physicians fired to get that accomplished.) To Aids, CNA's Nurses and all staff, curators included; As another has said on here, are often "understaffed, so what, you handle it, you deal with it well, carefully and maturely. You (meaning all within the industry) are paid an hourly (or salary) wage by either private persons like myself, or the state (thru all of our taxes).. So learn the job, be good at what you do, be of actual help and of actual service, or leave the job before you harm (meaning before you loose your patience and harm someone because the industry of elderly care may not be for you) or, before you become harmed (by a non communicating, or non listened to or over medicated (both body and verbal language) resident out of your own inabilities or your own inexperience .. because if an individual is being genuinely "listened to and genuinely cared for you can almost predict an outburst through "watching and listening to their agitation, their dissatisfied expressions, movements, sounds, etc. If you are good at what you do, you can at I do mean most times completely change the environment to a safe and more reasonable one for the resident. (remember, they are the ones you are caring for not other aids or teh facility, but the individuals themselves). Here's a little hint and suggestion if elderly care-giving is even a road to take or one to leave; If you are a genuine deeply good (very subjective here, but very meaningful) person who genuinely "cares for other humans" (and only you can answer that yourself) decides to be an elderly care employee, you will learn intuitiveness, how to watch, how to decompress situations before they escalate, how to relax and cause a healthy more calm environment, you will notice issues of lacking, issues of need, and you will be "in-tune" to what real care means, and what it takes to accomplish making a person, "happy, "relaxed "safe and "self assured. If that is you, then you usually remain and become an excellent care giver within the industry. (Alertness, intuitive deep genuine cognitive care and kindness is missing in elderly care across the board, across the nation) ..An impatient, control hungry, power seeking, belittling person, selfish person, one of possibly a narcissist attitude, will be a harmful care giver employee (and I've seen many of the later in the industry, to be quite frank, I've seen more the later than the more preferred) ... So to you industry workers commenting, ask yourselves which type are you, and should you be in the industry at all. You are not in a war here, you should not be just out to get through your day, you are being paid to care" to care for" and to care "about our parents and grandparents in our absence, do you understand.

Yes, it's very common. The goal is to do everything with elders in their care, to keep them calm. But, hitting [sometimes with their assistive devices], biting, scratching, deliberately tripping-up others, yelling, crying, screaming, etc., can make it sound like Bedlam, and cause injuries for staff, the elder themselves, and sometimes to other elders.
Elders may APPEAR weak because of age and infirmity, but Adrenaline can still fuel even the weakest-appearing elder, to be able to rip skin off, even break bones, of someone they get ahold of; they spit [spreading germs], knock syringes askew or grabbing them and stabbing the nurse with them, etc.
Injuries happen, despite everything staff can try, to keep things as calm and orderly as possible. Thankfully, bad injuries don't happen too often; lower-levels of harm can be more common.
When someone cannot communicate in any other way, fear is still in the mind, and drives them to resort to whatever means they can, to express themselves.
Many really desperately hate being in a facility; it represents the ultimate loss of freedom, and loss of their faculties; somewhere inside every demented mind, they know things aren't the way they should be.
Basic survival instincts in most, are very strong, so they fight, when they cannot communicate in better ways.
It's worse if staff workloads are too heavy [even with basically adequate staff, loads can easily, suddenly, get too heavy], or if certain staff are unexperienced with the individual's care needs, or if there are other factors happening that upset the elder. And there can be some not-so-good staff; usually, those do not last long, working in facilities.
It's a moving target, trying to keep everything calm and running properly, in elder-care facilities, which usually run on far to slim a budget, or, are badly managed. Staff on the "front lines" of any company, be it health care, banking, hardware, or whatever, are usually the 1st to get laid-off, leaving those remaining, short-staffed.
Nursing staff has ALWAYS been chronically 'kept to-the-bone'...which guarantees that if anything staff-intensive happens, all work loads must be triaged into what absolutely must be done, and what can be put off for later....everything can easily go off the rails, if those on duty, are not at the top of their game.
It's a cognitive dissonance of sorts, between staff pushed hard to get things done on-time during their shifts, where so much can derail best efforts, and elders who seriously need more time to get their stuff done.
Slim numbers of staff per patient population in facility, is sometimes bad insurance and administrative cost-cutting, betting nothing goes haywire that can hinder staff getting their necessary tasks done...which can result in half-baked job of things, or, doing things out-of-order to what is normally done.

Cetude, I was shocked that you used the term "inmates"; I think clients, residents, or patients would be more appropriate. The term "inmates" has a negative connotation. I hope you haven't heard staff members refer to their residents in this manner. If that is the case, it should be reported and staff members need "retraining".

It is not uncommon for persons with Alzheimer's to become combative during some caring tasks. We need to think about their needs and dignity as we do so. I care for my mom in my home...she does occasionally hit, kick and spit. We look for the trigger and work to find ways to do these things more appropriately. Showering and hair washing is tough for her too. She does not like the water running on her. We give her a sponge bath about twice a week on the bedside commode and a full shower about once a week. We use a shower chair and a hand held sprayer. That way she can be soaped, then rinsed and water doesn't continually flow over her. Find out if the nursing home uses Teepa Snow or Naomi Feil techniques. Perhaps you could suggest they look into those. I am not opposed to ever using medication for agitation, but feel it is often way over used and would try other methods first. It is good that you are advocating for your mom.

Is your Mom in a specified Memory Care or Dementia Care section of the nursing home? If so, the staff should be specially trained to deal with these types of issues. Residents should be listened to. It is common for those with dementia to refuse many things....because it comes down to them wanting some kind of control over themselves. Diversion should be well taught to caregivers. Let them say 'NO" right now. and reapproach with the request in 10-15 minutes again, and ASK....not order.... there are clear techniques that work generally. BUT, in the case of the fresh hairdo....this does seem like miscommunication or perhaps, staff who just do not wish to be flexible. If a woman has a fresh hairdo, what is wrong with doing the shower but not the hair for one time? We need people who can think past their noses in these positions but often they are not there!! Someone suggested that you find out the shower days, and then plan the hairdresser AFTER or in between the shower days, or somehow, make it clear to the director and staff supervisor what you want done in this kind of situation. Finally, I do agree with NOT going for medication for this situation. Medication should come when there is a pattern of agitation or aggressive behaviors....not an isolated or occasional episode. Staff should be trained in diversion, redirection and other techniques to get a memory impaired resident past this agitation. We had a big problem with this behavior with my Dad when he was first admitted to Memory Care, because he was a male who was used to being in control and making his own decisions and he detested, in his normal memory situation, other people TELLING him what to do without explantions and discussions with him. Even after he got settled, and became calmer, he always referred to his caregivers as 'the bosses' because some of them just didn't have the right approach. They didn't give acceptable choices so that Dad could be 'in charge' of simple things. He became more compliant and everyone loved him, but he still had problems with those who treated him like a 'thing', rather than like a 'person'....and he knew it enough to talk about it regardless of his memory problems. So listen to your relative's concerns; be there often and different times; make friends with the coworkers who are treated your loved one and others with respect; ask at mother's nursing home about the training staff get, REGULARLY, about working with those who are memory impaired....and make sure the executive director and whomever is in charge, ultimately, of all the caregivers, get to know you, and know that you going to be there....and you want the best for your mother. You can do all this with love and sweetness and innocently asking questions about this or that.....but it has been proven that the ones who do get the best care, are the ones where it's well known that they have family and friends who are going to be showing up regularly....so be sure you are on that list!!

My mom has dementia and she hasn't had major personality changes as of yet, other than an increased level of pre-existing OCD but I think that's probably more about trying to control something in a world where she no longer controls anything. She has had personality changes only when she's having a UTI- so I think that for sure should be explored. She has her full wits about her but has physical impairments that led to first being in the rehabilitation wing and now a permanent resident by her choice, she knew I couldn't care for her at home. I say all this to confirm that my presence in and out all the time makes a huge difference. We are lucky to live just 4 miles away and work only 1 mile away. I've been a compliance officer for the agency that accredits hospitals and nursing homes for 10 years and I thank God for that as I know it helps the type of care she gets. But, I've had several nurses there say that unfortunately the ones who have the "over involved" daughter are rare, some have no visitors at all. I do ask for a copy of her MAR and notes regularly so I can see if anything is escalating, like a roommate situation and also because my mom doesn't remember everything accurately and it helps her to trust the staff more because she knows I check in all the time.

The nurse at the facility I worked at got a black eye from a resident, the day before her daughter's wedding. Another CNA had her collar bone broken from a resident. I have scars on my arm from a female resident swinging her wheelchair alarm at me and the metal clip hitting me. Yes it hurt. Six months of classroom training along with six months Clinical, I forget the total hours. Miss one class or one clinical, we were out of the program. NJ state law. Everyone thinks the job is easy. I'm lucky the clip didn't get me in the eye. We take the abuse and go on with the shift, after doing an Incident Report.

Human beings, whether they have dementia or not, often lash out when they are frightened, cornered, or threatened in some way, or perceive that they are. I am friends with nurses who worked in emergency rooms who told me that people coming in from car accidents would hit the attending nurses, not even realizing what they were doing, or pull out their IV's without having any clue they had done so. There was nothing "wrong" with their brains, nothing demented about them. .But their bodies were in state of medical shock, some had lost blood or they were otherwise medically compromised.

Elderly people are often medically compromised due to their advanced age, loss of physical mobility, and inability to communicate their basic needs to those that care for them (such as hunger, thirst, physical discomfort, whether they are wet, bedsores, etc).

When I worked in a nursing home I recall that when patients were groomed this was done while the patient sat in a wheelchair. Wheelchairs present a problem that non-wheelchair users rarely consider. I know this since a person very close to me used a wheelchair and I was aware of the problems and implications of being in a wheelchair and not being physically able to get out. What happens?

Well, if you are seated in a wheelchair, unless the arms are removed, you cannot get out. Basically you are left vulnerable and must trust the person caring for you. What if the person is not so trustworthy? Even one bad experience can leave a person terrified.

Imagine being cornered on three sides, unable to get out, and a threatening person approaches you. From the point of view of a person with bad intentions, say, a sexual predator, this is an ideal setup as the victim cannot escape and most likely will not be believed should he or she squeal later on. Other types of threats or assaults might be a person coming to take blood and doing so forcefully, getting bathed without regard to body privacy, or various degrees of shoving and verbal abuse such as scolding or even demeaning judgments with religious overtones.

Even if those doing her hair were very kind and had totally good intentions and communicated well, anything in her past may have scared her so much that she might have felt threatened being approached at that very moment.

This is one of those things that health care workers should be aware of. It's a hazard of the job. They are dealing with vulnerable people who are medically compromised. No way should these folks nor their families be blamed.

I love that id "goodgravy123" - I have found that with my mom since she has lost her communication skills, the only thing she can do is lash out. An infant cries, screams, thrashes about because that's all they know how to do to get attention. Same is true in adults who have lost their communication skills, they will hit, swear, yell and scream, etc when they are upset with what is going on to them or around them. I do not have any first hand experience with nursing homes, just what I hear. I agree with Hugemom above in that you should do some investigating before passing blame. Although, I'm not a big believer in blame, I believe in getting to the root of the problem and fixing it. With this disease, that can be near impossible, but still worth the effort because you always come up with an idea or two or three. I find I have to "think outside the box" a lot which has come with practice. You know your mom, she is still in there, do what you feel she would want you to do. Stay in there with her, visit as often and at different times of the day if you suspect she is not getting the care she needs. Follow your gut instincts, you can't go wrong when you do. My daily goal is to get my mom to smile at least once a day, some days that is a pretty tall order! But I do what I have to do and I usually succeed. A smile is priceless, the feel mom gets from that smile is also priceless. Stay in there, your mom's need you.

I heard of another situation where there was another lady I currently know of who took care of her husband at home. I don't know if he stayed home to the very end or not, but rumor had it that he used to beat the crap out of her. I personally as an abuse survivor would've been out the door and gone the first time someone raised a hand to me! I don't know how the pros handle this kind of behavior but I've noticed they have some clever way of keeping violence under control but again, I just don't know how they do it but they do get things done

I agree with Tiredof14 as well as susanesmith. Even though people with dementia have trouble expressing their feelings, you should investigate why by asking the head nurse. She probably didn't feel right about specific CNA. I would believe in my mother than the CNA. Can your mother speak ? If so, ask her if anyone is treated her good or not. She'd be bluntly honest with you even if some are not accurate.

...to "Daughterlu"... Call an immediate meeting with the curator of the facility, and include all involved in your mothers financial and move abilities, her power of attorney, etc etc. Look into either having the other resident transferred or ultimately moving your mother if they drag their feet about the other resident. Your mother does not nor should not "feel afraid in a place she will be for the remainder of her life.

As for the lady coming to the apartment, is it possible that she really did used to live in that particular apartment before she moved or maybe she was moved? Depending on how long she's stayed there versus how long the current resident has lived in that particular apartment, it can point to a strong possibility that maybe this other lady really did live in that particular apartment. Now my foster dad who is now in a nursing home would most likely come right back to his old house from where he was taken because he lived there for so long and to him it was home. Anytime you're single and living alone with no family, you can actually dread ever having to move from that place for fear of having nowhere to go, especially if you're on fixed income and normally broke by the end of the month

Believe it! My husband tried to hit me last night because he was angry I took his shaver away (I needed to charge it), and I think a person with dementia just gets so frustrated they will lash out at anyone nearby. I've been hit as a nurse working in nursing homes with seniors, so it is just part of the job. Get used to it. You knew your mother when she would not do things like that, but now she is someone else. Accept that she is going to have behaviors that are not nice.

What worries me about violent behavior is that Mom is in Personal Care and a sweet looking woman is violent and has come into Mother's apartment saying she used to live there and has refused to leave asking where is her furniture. It took a nurse and two nurses aids to get her out. She was kicking and hitting the staff. I started locking the door. She came back the next week and was hitting and kicking the door. No staff was on the floor. I got her away from the door myself. On a Sunday morning after breakfast after I was leaving Mother she was sitting in the hallway telling me that Mother is evil. She said at nighttime the evil one comes into my Mom and consumes her. She says she knows Mother is mean. I told her that Mother is sweet and loving. It worries me that apartment doors are not locked. I have seen pictures of residents of nursing homes in dementia centers where they have awful bruises that look like they were beat up but passed off as "a fall." Mother does not have dementia but if beat up she could become disoriented. After a fall she deteriorated and it took her 2 months until she got back to where she was. Mom is a prisoner in her facility.

It isn't uncommon for dementia sufferers to become violent and agitated. I've been punched, kicked, bitten and had a chunk of hair pulled out.

It's possible that your mom's hair was not "freshly done" -- to her, it was just done, but it could have been a week earlier. My mom hates bathing and refuses to let staff bathe her. I am able to gently get her cooperation so I am the one who bathes her once a week. We have a little routine now that seems comfortable for her, but would be too time-consuming for staff. Yet every time, mom tells me she "just showered this morning" so she doesn't "need another shower." I am fortunate that I can be there for her, because she is quick to be verbally combative with staff over anything she perceives as "telling her what to do." And I have full confidence in the caregivers at her AL - they are wonderful.

.... I want to explain something if I may, and yes in regards to this post. Lets look at the existence of care facilities and then what our parents must experience in them. ....When we have no other place that "fits our parents needs (or ours) be it full or part time, then care facilities are (most times) our only options. Care facilities (be them any name you wish to call them) must actually "care for the persons residing. They are paid to do that very act because either we, or each state, are willing to "pay the facilities staff members" to be nothing more than courteous, patient, intelligent, reliable, alert, helpful and kind. Is that not our hope? Those are our requests that we have for our parents, yes? Indeed it is. Now the reality is this; we are not there 24/7 to watch over them. Much can and does take place each and every hour of every passing day within these "facilities. Some good, some bad. We have learned that the industry within its workforce seems to attract either the very kind or the very unkind, and then you have the ones in-between, the "its my job for 8 hours a day until I clock out." its an industry of incredibly high turnover rates in quits, fires and rehires of employees, for a reason. ...Yet, our parents live every single day in this industry. The poster mentioned her mother has paranoia, well without knowing all details, I imagine we all would have "paranoia to some degree when in these places. I imagine paranoia is only one thing they feel. I mean look at the reality; They go from independence, to dependence, and it most likely wasn't their choice. They are forced to live with having many different people come to their "space" every day. They have strangers approaching them, directing them to do this or that. They are forced to trust actual medication being handed to them and being told to "take this" They are now forced to having complete strangers bathing them (let that one sink in.)... They are now forced to be "social. They are forced to "put up with and learn staffs personalities & temperaments. They are told what they will be eating, even if its written with a smiley face on a chalk board in the "dining room" as if a "special of the day" is to be glorified. They are actually unprotected, unless they feel safe because someone has taken them under their wing or someone, a staff member, has taken a 'liking to them. They are now expected to live by rules and schedules. So the "paranoia, that many are "diagnosed with" in these facilities, may be factual, or just may be a true and (should be) a reaction to the actual environment they are now expected to "enjoy." and not complain. Facilities that are "pretty, or a smiling face that greats us as we visit, all of that may make us "feel like we made a good choice" for our parent/s .. and perhaps we have, but we dont live there, do we... they do. So if a parent is at risk, or vulnerable to being subjected to less than expected care (even an unexpected hair washing, I mean think of what actually had to take place to wash her hair when she didnt want to have it washed) and if they cannot or will not (for fear of raising problems) protect themselves when things occur (I'm talking anywhere from abuse to even a snooty or attitudinal Aid, or a grumpy nurse, etc) then someone being their voice, their advocate, their "eyes and ears and their power to do something when things go wrong, or if/when things look fishy, or strange, is very important. So take a little time and check things out for her. Thanks.

Oh yes, I should add that I strongly agree that unqualified workers to agitate these patients are only making matters worse by worsening the situation. I don't blame her if she struck out oh yes, I should add that I strongly agree that unqualified workers who agitate these patients are only making matters worse by worsening the situation. I don't blame her if she struck out at them for messing up her newly styled hair, I don't blame her because I would also be very upset if my hair was newly styled and someone came along and undid the hard work done by a beautician

The only people I really know about are the ones I have personally dealt with to a point. Now my foster dad who was put in to a nursing home in the dementia ward became combative but I know how long ago he became that way. I don't know if everyone with advanced dementia or Alzheimer's becomes combative but I've heard they do so maybe this is normal for them at a certain stage. I currently know someone who took care of her pop until he died and by time he died he didn't know anything, nada. Not sure what she dealt with, she didn't say

It is not unusual for a resident with dementia to hit a staff member. However, when a resident is getting agitated and they are not a danger to themselves or others, the staff person should just leave them alone and let them calm down. Many times when residents lash out it is because a staff person is trying to force their will on them. If your mom did not want her hair washed, they should have honored that wish (especially since it had just been done.) Bathes are the number 1 refused treatment in nursing homes. Residents refuse to take a bath more than medication, therapy, and diet. Bathing can be a very stressful experience for a resident with dementia. If this is the case then maybe a consult with his/her doctor so that an anti anxiety medication can be given before bathing.

Yes, unfortunately that sometimes happens with Alzheimer's. My uncle, a very mild mannered soul all his life, became violent because of Alzheimer's and had to be sedated in the nursing home. Yet his two sisters, also with Alzheimer's did not become violent. So, not everyone but some do. It's my belief that getting alzheimer's patients into a care situation, earlier rather than later, so that they can adjust, and have a positive experience, rather than be forced when it's late in the disease, makes a big difference. Just my experience.

This is normal behavior.They cannot help it.I have dealt with personality changes that would shock anyone not in the medical field.Perhaps she is in pain as well. Might have a UTI as well.They just do not understand what someone (employee) is trying to do to them so they strike out.Talk to the doctor,staff and try to come up with a medical solutionI\(change in meds for example) test for a UTI another example..Why was her newly styled hair being washed to begin with anyway? Of course she was upset I would be too.Explore all avenues..good luck and God bless.

...cont. Thoughts; If your mother has option of setting hair appointments within the facility and she does that from time to time, then they must know, they must be aware, that regardless her bouts of dementia, they are aware that she has some cognitive clarity .. So the event of her hair being washed soon after a hair appointment, is an event that will most likely be the facilities fault. And as Ive said above, staff are notorious for ignoring residents needs, wants and demands. Some on this thread have responded that no staff ever should be hit struck or other, I am not one of those persons ..Not when and if you've kept close attention of the care facility's (the industry itself) track records across the nation. Never forget that these people (the staff) are paid to "care for" residents .. they are not paid to mistreat, ignore, hurt, insult, etc, etc any human being within their care. The hair deal, again as also said above, is serious enough to evaluate a bit more thorough, because if your mother was simply defending an action she was not happy with, and if this "hit or strike" is solely left up to the facility to report on (meaning if you dont check out what went down) that report could very easily set your mother up on a road to diagnosis and "treatment" and medical reports being filed that can be to her serious detriment as time goes on.

I agree with Tired1of14. Should residents be drugged in order to be more submissive? Medicating your mother after one incident is wrong! How hard did your mother punch the aide? Women in this age group, and I'm assuming she's in her 80's at the minimum, aren't very strong so it probably wasn't much of a punch. Ask your mother about the incident. Also meet with the administrator of the facility to see why her freshly styled hair was being washed again to begin with. It sounds like your mother's logical requests are being ignored, and that she's being forced to comply with unreasonable demands.

It is not uncommon for people with dementia to lose their inhibitions and exhibit behaviors such as hitting, swearing, and other things they NEVER would have done when well. Before assigning blame to any staff member, speak with the liaison at the home, or even the social worker. Do some research and find out if this was a one time thing or if the staff has seen her behavior escalating. It may be time for a Care Conference meeting with the staff. Most facilities have them scheduled for every few months. I'd also like to mention that sometimes, if a resident has an infection like a urinary tract infection, it changes their entire behavior. Nursing homes don't test regularly for UTIs but they are more common than you'd think.

...first of all "Cetude" you need to not call care residents "inmates"... now about the question; Id be very serious about finding out why her hair was washed. If she's not being listened-to and staff are doing what "they want" over listening to or not picking up on signs of her distress or unhappiness that your mother (or anyone) are expressing, then a punch or strike may have been the only way your mom determined she could stop them. Staff are notorious for abuse, and yes that includes ignoring, belittling, condensending, acting as if the residents are valueless regarding their own self decisions,demands, cares and thoughts... and as many have mentioned here, I personally would not be so quick to medicate. I'd look a bit closer to the event and the entire setting, and I do mean entire, In which your mother is forced to live day after day in before any medication is requested (remember, it's allot easier to get meds prescribed, then to get them unprecribed, so be smart and think of her, not you, not the staff.)

Nursing homes go by schedules due to multiple inmates to care for, so they have no choice about when to get bathed, fed, or other activities. Sometimes the CNA will leave the tray and the inmate will forget to eat so they pick up the tray untouched, so they can end up malnourished or dehydrated. I think many of them know they are not home and strangers are caring for them and do not have a choice, and striking out can be a moment of frustration. Nursing homes are horrible places, which is why lawyers say family has to visit extremely often and at different times so staff knows they are being monitored. The stress of impounding a loved one does not end there. Now the nursing home doctor or nurse practitioners is probably pumping your loved one up full of drugs so her behavior will be better managed, which puts them at higher risk of falling and being malnourished. If that fails they will put them in a psychiatric center, which case the home may or may not take them back.

This kind of thing is terribly difficult. Obviously it is not okay for a member of staff to get hit, for any reason. But then you hear what led up to it, and how can you not think "well that was an incredibly stupid thing to do"?

Physically lashing out is, however, very common in dementia - not least because verbal communication has become so much harder. A good facility will have trained its staff how to preempt the frustration that might cause it, how to spot the warning signs before a meaningless, unprovoked slap or punch and dodge it, and how to calm and appropriately restrain the cared-for person. All the same, sometimes it's going to happen. Express regret that it did happen, but don't apologise because it's not your fault and it's not your mother's fault either.