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My mom is in danger of losing her placement in an assisted living memory care facility if we can't get her aggression under control to the point that she is not hurting staff members. She is currently in the behavior support geriatric unit at the local hospital, but they have been very UNhelpful thus far.

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I would say to see a neuropsychiatrist for an evaluation to see if any medications are available to help in these situations.

Best wishes to you.
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There should be a medication or combination of meds that calm this behavior. Talk to her hospital caregivers about what is being done on this.
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What is happening? Is Mom in pain? Can be a factor (arthritis is a beast). Fear? A huge one.

I was told yesterday "now all you kids have grown up & it's time you MOVED OUT! This is MY house & I don't need you here". (I am an assistant on staff on the orthopeadic ward of the local hospital).

So we backed off. This lady needed space. She can swear, hit out. Tried for a grab of my hair (but I'm a good dodger).

Tell me about about your Mom.

Aggression is communication: Unmet needs.
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ecmcellen May 2021
Mom is currently on the geriatric behavior support unit at the hospital due to her aggression. She was biting, hitting, etc. This was her second time--she was back at assisted living less than a month. Turns out, they figured out she had some pretty serious the last time she was in, and did NOTHING! No meds, nothing. Needless to say, I was shocked that they would do this. She is now getting some tylenol 3x day and Voltaren gel. Since they discharged her prematurely this last time and didn't address the probable underlying cause for the aggression, the assisted living place, which I have been very pleased with over the years, has agreed to give her one more chance. And I have learned I need to be a MUCH more assertive advocate and force them to communicate with me at the hospital.
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Speak with your mom's Dr, Usually the Dr can prescribe something to calm her down
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When my uncle became aggressive at one facility they moved him to another which was better able to handle him. Maybe there is a better place for your Mom.
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Our dad became this way as his dementia progressed and he too was going to be placed in Geriatric hospital but there was no openings at the time so he was on a waiting list. In the meantime, we got his doctor involved and he placed dad on Depakote. It really helped. Other things we found out was that the NH staff was not adequately trained on how to handle situations like this with residents. Several would gang up on dad and that only increased the aggression. We had a Frank talk with the director of nursing and told her about the Teepa Snow videos online to use for handling residents with dementia. She was grateful and was going to use them for in service training. How she hadn’t heard of them before is astounding to me. Also, I want to ask if your mom would be better in MC at this stage?
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My mother was violent and combative (she screamed and hit my father for 3 days and finally eyed up the kitchen knives and said that she would happily slit our throats if she didn't think there would be consequences). I called the Elder Abuse Hotline who referred me to the right person at Social Services (same dept as child abuse). Once sectioned, she was medicated with Seroquel (anti psychotic) and later combined with an anti depressant. Huge improvement and no aggression, she's not a zombie either. She's at home with me and I've been able to bring the dosage down too. Hang in there.
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NeedHelpWithMom May 2021
You handled the situation quite well. Glad that you were able to calm her down. No one should live in fear of others.
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Speak with her doctor, and if necessary, get a specialist in elder medicine who can prescribe medications to calm her. Finding the right medication can be trial and error, balancing side effects, dosages etc. Be observant as you try medications to make sure they are working for her.
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She needs an evaluation and possibly change of medication, although she has a placement, it remains your responsibility to see to her being able to be a good fit, or she places others at risk to include staff, it sounds like she is not on medications for her aggression and if so, need another evaluation. Cognitive changes are not always due to dementia some people have decline as they have lived, some people are sweet, mild mannered and docile, ask about their previous character and you will hear similar. However, despite what we see as truth, these issues tend to become more apparent with people who were not at all easy to deal with, and for some reason we expect more of them as they decline. They are usually the combatants, bullies, and this is exactly why placement does not work. You might need to address reality of who she was prior to all of these changes, my experience is that truly these are not new, and at times intentional to get attention from staff and bully other residents. I recall a lady who was placed on pedestal reportedly by her late spouse, she gave staff and others grief to act as if he was alive, coming to get her, and adult children called repeatedly for her actions that were temper tantrums. Knew spouse was dead, but her actions were, "I am the queen here pay attention to me." Staff has no way to give this type of attention, so yes if not calmed down, they do not need her to stay there, possibly hot a waiting list., must do something or you will be attending a discharge meeting and will need private care from your home. Sorry, so many things none of us are prepared for until too late, and then we still try to see they are in control, they are not, when they call you to get her, you will see that you are Responsible for her now. Hope you have siblings and an alternative plan of care.
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Mom is in seroquel and helped with combative issues
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It sounds like she may need to have a new needs assessment and placement in a facility that is a higher level of care.

I hope that they find something that helps her calm down. Imagine how scared someone is to act like this.
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ecmcellen,

Please follow Bernermom’s advice. She handled her situation with aggressive behavior properly. No one should have to live in fear of someone that they are caring for, even if the one that they are caring for can’t help it. Both of you need help before it gets worse.

Once I was helping out a neighbor whose son has severe autism. He was a non verbal very large and strong teenager at the time. I am very small, always have been.

I had sat with him since he was a toddler and while he had temper tantrums, he wasn’t ever violent with me.

Well, he became aggressive with me. I did the same thing as Bernermom, I reported the incident. I was black and blue after his attack. He was so strong that there was no way that I could defend myself. Plus, he was over six feet and 200 plus pounds. I am five feet and just over 100 pounds.

His mom confessed that he frequently attacked her and his grandmother! Unfortunately, meds didn’t work for him because my neighbor had been a nurse at one time and thought that she knew best and would adjust his meds without consulting his psychiatrist.

Poor kid was probably going through withdrawals because of her haphazard ways. As much as I felt badly for her, I stopped sitting with him. It was terrifying to be attacked by him.

I felt badly for my neighbor as a single mom who never had time for herself so I used to help her out when needed. This poor woman does everything for her son, wipes him after going to the bathroom, bathes him, shaves his face, brushes his teeth, etc. He can feed himself. Her daughter and my daughter were friends at school.

I was glad when she moved out of our neighborhood because I couldn’t stand seeing her covered in bruises. Last time I heard, he’s in his late 20’s and still beating up his mom. She has tried to kill herself twice due to the stress.

Please don’t accept any abuse. You could end up in a very dark place if you continue to remain in a vicious cycle. There is help out there. Reach out. No one deserves to be abused.

Best wishes to you and your family.
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My mom had the same issues. It was scary and the meds offered (anti-psychotics) made her worse as she experienced what is termed a paradoxical effect. I turned to cannabis. I started with pure CBD at different levels and I tried topicals and tinctures. I kept upping the dosages until I saw improvement. I used 30:1 and 20:1. Currently mom is taking a 18:1 soft gel made by Care By Design. We have had zero violent episodes and aggressive language is all but absent. She is NOT stoned, can walk and functioning better than I've seen since her diagnosis.
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Maryjann Jun 2021
What dosage did you use to start? Do you give it daily?
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Just a simple answer..... she is in the wrong place.
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Aside from the usual answers of getting proper medication, distractions when they explode, other placement, etc. I go one step further. I know what is wrong with them and have been terribly harmed by them but it also taught me things along the way. First, try the kind, patient way to solve things - it won't work, believe me. Then I get very tough and literally threaten them with severe consequences if they don't stop (no, I would not hurt a flea but they don't know that). I stand very firm and tough that I will not under any circumstances tolerate their behavior and will tell them some terrible consequences if they don't stop at once. First they rebel but when they see I am serious, they get scared and they will stop. End result achieved. It works, believe me.
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NeedHelpWithMom May 2021
Not always. Not in every circumstance. If a person is out of control, it doesn’t matter if you are patient and kind or if you threaten them. They are past the point of no return and will violently hurt others.

It’s an extremely challenging situation. As harsh as it sounds, these people need to be in facilities, instead of being near others. I think it’s best to let professionals handle extreme cases of violence.

Some of these people have super strength when their adrenaline is high.
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Sounds just like my moms dementia. The caregiver in care home was frequently bruised by my combative mom. Despite constant pleas to her Geriatrician & Kaiser social worker, Dr was hesitant to adjust the meds..this went on for years. I finally started taking my mom to the ER every single time ( at least once a week) she was combative & was trying to "go home". ER ran the usual labs, (no UTI, etc) but couldn't do anything for her behavior. After a few rounds of hospital stays for observation and conversations with another Geriatrician that current meds were no longer working, mom's cocktail of meds were adjusted. I did all I could to get Kaiser to step up to help my mom & support the caregiver.
Wishing you strength 💪.
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Debstarr53 Jun 2021
The operative word here is KAISER. They don't care ABOUT ANYBODY. It was a good day when I dropped that nasty, self-serving mess of a company. The doctors are told to give minimal care. I have AARP United Healthcare now and get to pick my own doctor. Best healthcare I have ever had. Same for my mom who has dementia, I got her on the same plan. The medication that has helped her nasty behavior is Buspirone.
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Imho, no carer should be in fear for their life by an out-of-control, aggresive patient. Your mother will require medication(s). Use BernerMom's advice as suggested by NeedHelpWithMom.
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Often, we see abnormal aggression in our parents with dementia. Under healthy circumstances, they were never this mean. But dementia takes them to a whole new level. And that’s when medication is greatly needed. Sometimes it takes a series of different medications to get them calm. My mom is just as you described your mom. She can curse, grab, hit, scratch. Now, her hits and kicks are not harmful as she’s barely able to do it. But the cursing and fingernail scratches are real. Sometimes I really don’t think she’s my mom. My mom was a funny, loving mother. This new mom is mean. Ugghhh.
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