My wife is starting to show aggressive behavior. Staff at the memory care unit has asked me to come in twice to calm her down, comments?

Phogan,

I would request a Test for UTI. If that is negative then I would request a psych consult.

Mom’s Nursing Home had a contract with a Psychological and Psychiatric Service that visited with the residents as needed.

My Mom would become combative, was anxious, etc. When Mom was in this state she was miserable.

It took some time to get the meds right and they needed to be tweaked occasionally. Mom was never over medicated or in a Zombie state.

I'm a caregiver and we have some resident that are like that, but when you have several others residents to take care of trying to redirect or calm one person is time consuming and it takes away the time for other residents. There may be places that you have a concern about the staff, so why keep your family member there so that they can hurt others or possibly get injured, if she is calm with just you and you don't want her to be medicated (not doped up), then she needs to go to a violent behavior or combative unit. Some people have worked in unit where everyone is mildly okay, that why they are opinionated.

I’m sorry your wife is experiencing a similar situation to my Mum when she first moved into full time care. Imagine how it must feel to be in a strange place, suddenly being told what to do by people you don’t know. For example being told to sit down when you don’t particularly want to sit down. Imagine being told that the bag you are trying to pick up is not yours and to put it back on another residents walking frame (when you are convinced it’s yours, because it looks just the same). Imagine being told you must leave a room because another resident doesn’t want you in there, but this person asked you to come in and say hello as you were passing and then changed their mind because they also have Alzheimer’s disease and forgot you are friends.
If I suddenly lost my right to liberty, to make decisions for myself and was being constantly told (not asked) what to do by everyone, I think I would become aggressive and strike out to defend myself.
I think this is what’s happening. Like my Mum was, your wife is just defending herself, defending her right to liberty.
We all need training (professional carers, family carers, friends too) in how to put ourselves into the shoes of a person with Alzheimer’s disease and imagine how we would react if we were being treated or spoken to, in the manner we (or other carers) are now speaking to and treating our loved ones in care. It helps one to understand how we can better approach a person with Alzheimer’s so that we mininmise stress and obtain a more positive response and outcome.
Most of the carers at my Mums care home are wonderful, very experienced and speak to the residents with care, love, empathy and consideration. They ask a resident if they would like to do.....rather than telling a person they must do........The most effective carers don’t order our loved ones around, they gently coax and encourage with great care and empathy.
There are a small number of carers in my Mums care home who lack this empathy and caring-they do not show respect to the residents in their care. These are the ones my mum has slapped-in response to the manner in which they approached her a number of times when she ended up in another residents room (by mistake or after being invited). Telling my Mum she must leave a room gets a negative response-she will become stubborn and refuse to move. Rather ask her if she could please come and help out in the kitchen or with another resident in the living room (this would get her moving immediately because she’s an ex nurse and just wants to help everyone).
I explained why I think my mother slapped the carer to her care manager the day after the first incident occurred. She was unwilling to hear me (understandably because a carer had been struck) and called a doctor in who prescribed a sedative (my Mum now takes 4 times a day). So my Mum is under sedation each day to keep her calm. It breaks my heart as I am unable to care for my Mum at home full time. I have to trust that the care home is doing what they need to do to care for my Mum in a way that is manageable for the whole team. She is not an agressive person, she just has Alzheimer’s Disease and needs to be treated with care & consideration of her condition. She is never aggressive with me, will do mostly anything when I ask. If she doesn’t want to do something (like brush her teeth or finish a cup of tea), I just change the subject, redirect her attention, and few minutes later I ask again and she usually cooperates. It’s an ongoing learning curve for both of us.
I think the aggression your wife is now showing is in response to the manner in which she is being approached. I hope this information about my Mums experience is of help to you and your LO.

if she does not calm down and gets aggressive, they could send her to the psychiatric unit for medications which will keep her doped up. She will just get weaker and eat less and decline. If the meds fail, they could kick her out.

My mother was diagnosed with dementia and alzheimers in 2006. She passed 2017.
I had the same happen to me.
What I found to help was I did not have a routine on what time of day I would visit. I always had to be on alert . If mom was trying to tell me she was uncomfortable in her surrounding? Payed attention which aides where working? Who also was her roommate? Just dropping in different times of the day keep everyone on their toes.
In the meantime , I made a friends with other familys in the facility. We keep each other informed. Called if we noticed anything. In the meantime, I talked to facililty Dr. on giving mom some anxiety medicine. They should supply music therapy to help calm her down . Also I talked to her on phone first before I went. She just wanted to hear my voice.

I hope you find this helpful.

I have to say I’m surprised that the facility would continually call you and expect you to calm her down. If you placed her there, that means she needed more help than you could render.

My mom was combative, she would wander and she was stubborn and uncooperative. She would even stick her foot out and try to trip the aides when they walked last. I never got a call to run to the facility to calm her down. They always handled it. I’d call a Care Conference and ask what they think should be done. I would not bring her home.

Hey Phogan, we are actually moving my Mom out of memory care tomorrow, after 5 weeks, because the progression since she's been in there has been through the roof. She was never aggressive before we moved her, so we're bringing her back home, and going to try and get her behaviors under control while we figure out how to proceed.

She has smacked a couple of care givers since she's been there, that was never our experience at home. I know it's the right move for Mom to come back home, but I'm pretty sure it's a axe blow to the head for me. Good luck, sir!

I'd discuss it with her doctor and consult with a geriatric psychiatrist. I'd explore if she would benefit from medication.

I'm not sure how I would react if the MC staff were not able to manage matters on their own. I might also ask for a team meeting to see how things are being addressed by them. They should be able to see trends, triggers, issues, etc. and create ways to deal with it. They should be trained to recognize the problem and make adjustments to help her.

I went through this with my dad while he was still at home. He would chase the caregiver on the shift out to their car and out of the driveway. They would go down the road and call me. I sought the expertise of a neurologist; in the meantime, his PCP put him on lorazepam. The neurologist was an advocate of melatonin; he used it to combat anxiety and sundowning.

How long has she been there? Maybe you should stay away for awhile. Sometimes memory care facilities request it. With my mom they requested a private 24/7 caregiver when the agitation was becoming an issue. That may come and yes, mom had to pay for the private caregiver too.

Facilities are understaffed and overburdened. The jobs usually pay around $10.00 an hour. What a stressful job and paid so poorly, turnover is very high.

Ultimately you have to do what is best for you.

Has she been tested for a urinary tract infection? These are fairly common in Seniors, especially in women. A UTI can cause aggressive and combative behavior, hallucinations and delusions. Facilities don’t automatically test for them. I had to ask that my mom be tested monthly.

Hopefully, the Geri Psych can suggest meds for her if it’s not a UTI.

Is she being seen by a geriatric psychiatrist?

In my experience, that is the specialist you want to get on "team dementia"