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We are worried as nurses say they are not appropriatly staffed to constantly monitor him. When he was at home, he would always try to ‘escape’ his apt building. Now when in a wheelchair, he still tries to get out. He also yells at me to leave when I visit. It’s a nice facility, one of few that would accept him with his early stage dementia. We need him to stay. We are scheduled to have a meeting with the facility Dr., social worker and nurses Tuesday morning. Any advice to prepare for this meeting is appreciated.

More info would be helpful to give you guidance:

How long has he been in this facility? Is he in MC?

Is he currently on medications for his agitation/anxiety? If not, it is urgent to have his doctor get this to happen.

Has he been checked for a UTI?

How old is he?

What state are you in?

If he is a fall risk, his bed needs to be lowered all the way down, or he can get a concave mattress, or put his current mattress directly onto the floor.

For his wheelchair, I think what restraints they are legally able and willing to use will be discussed at the meeting. I think it varies by state.
Helpful Answer (5)
Reply to Geaton777
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Unfortunately it now sounds like he needs to be a bit more medicated to keep him calm and safe.
And since you seem to be a trigger for him right now, I would perhaps keep your visits to a bare minimum for a while, until the facility can get his medications adjusted accordingly.
Dementia sucks!!!
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Reply to funkygrandma59
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TxPonyGirl Oct 3, 2024
I think that is excellent advice! Maybe a short break from each other till things calm down.
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The doctor needs to be told of this behavior and your husband can be medicated to help with the anger, anxiety this should help with the outbursts that he has.
The medication can be tricky if he has LBD and not a Vascular dementia or Alzheimer's.
If he is trying to get out of the wheelchair request the doctor order a "Tilt back" wheelchair. The back can be tilted so that it makes it much more difficult to get out of and it also makes it more difficult to fall out of.
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Reply to Grandma1954
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If they were to attempt a discharge you would be the first to know, as this would require social workers, meeting with doctor, discharge planning.
Therefore it is important that the facility understand that hubby cannot return home.

What MAY more likely happen if this extreme agitation continues is a transfer to acute care either hospital or psychiatric facility where they can attempt to find a drug or drug cocktail that can provide hubby some relief without knocking him out. This takes some trial and error often enough.

You message to us is a bit confused and confusing and I think this awful circumstance has thrown you into a whirlwind of anxiety and fear. So I am going to advise you:
1. DEEP BREATHES. 10 of them in and out slowly. OFTEN.
2. Ask to speak to Social Worker or charge nurse of doctor who is appropriate to speak with at this particular facility.
Tell this person that:
A) Any thought of hubby coming back home is out of the question. You can no longer care for him.
B) Ask for what plan if any is afoot involving his care.
C) Tell them you are very anxious about all this, and must remain fully informed; as that you be contacted for any plans, any changes.

I am so sorry for these heartbreaking circumstances and I wish you the best of luck, hoping you will update us.
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Reply to AlvaDeer
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They can discharge him but it may be hard to do . Especially if he has good insurance they may want to keep him just for that reason . But if he is a risk to the hospital I would think they would want to discharge him to family or another more equipped facility
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Reply to Trixipie
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Your husband may need to be placed in Memory Care. Also, there are medications to calm him. Please inquire on anxiety medicine such as Lexapro. It takes a couple weeks for some medication to kick in, but the do work.
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Reply to Onlychild2024
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TouchMatters Oct 3, 2024
Thank you for your response. Gena
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As the brain deteriorates, the chemicals released into the body change, he loses the ability to process what is going on and to communicate his feelings. The body also is less able to rid of bacteria in the bladder which has side effects of confusion, frustration and other behavioral issues. All of these can be managed with supportive meds that allow him to feel less anxious and will clear up any infection from bacteria. When this happens, your husband will feel better physically and emotionally and those behaviors will lessen and possibly disappear.
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Reply to RetiredBrain
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Sounds like he needs to be medicated.
Talk to the physican on staff (not just the nurses or dept mgr).
Speak to the administrator and ask that person how they manage a resident / patient exhibiting these behaviors (i.e., when might they want to release him - and do they have the LEGAL right to do that ... if he has no where else to go?

Gena / Touch Matters
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Reply to TouchMatters
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The facility shd be trained in these cases -it’s not as if your fathers symptoms would be new to them
They don’t sound too great- maybe check out a couple others and ask them ( as the professionals) what plans they exercise for people with your fathers condition - I bet they’d offer some sound advice if they were any good
the facility also told you not staffed enough to monitor fully
the facility really doesn’t sound too great ?
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Reply to Jenny10
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corkycorkk: Perhaps he requires residence in an acute care facility as well medication adjustment.
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Reply to Llamalover47
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thank u all for advice & support-much appreciated! he is 87we r in nyc/ no health problems except for the dementia & gait /on seroquel /lexapro & depacote which nurse said may try to increase to try to calm him down from the screaming & trying ( often succeeding) @ crawling out of bed which as u suggested did lower to floor /also took all furniture -dressers chairs etc out of room as worried when crawls out might hit head/asked they test for uti & will check when go next week -hopefully some of these strategies might help as frankly just now future looks bleak/ nurse said screams when pple talk to him him & as mentioned @ me when sees me /when tried to give him kiss before left today (after less than hr “visit”)said loves me but doesn’t want me there /thanx again for letting me vent
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Reply to corkycorkk
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Sending thoughts of support your way.

My 2c to add;
* Falls Prevention stategies.
Keep discussing with staff what is working & what isn't.
Low laying bed - good.
Reduced furnitute to hit head on - good.
? Maybe the bed against one wall
? Maybe a spare mattress along the open side

While volunteering, I would be the extra eyes & hands to sit with *very high falls risk* people. One was a retired Doctor, a lovely man, that would forgot he couldn't really walk & would leap up from his wheelchair at random times.

Once calm, these people would be sat in a day room, so staff could supervise & hoepfully prevent falls.

*Communication.
As hard as it is to hear screaming & yelling, it may be how your Husband is able to communicate his feelings right now.

I hope things improve soon 🙏
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Reply to Beatty
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corkycorkk Oct 6, 2024
hi beatty /
many thanks! good insight -that screaming way for him to communicate/they have put rubber mats on both sides of bed & yes after breakfast they do put him in lounge in wheelchair but he tries to get out & go back to bed /why still don’t und is why seeing me triggers
outburst & screams @ me to “get out”
l
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