Expert: Paula Damgaard - 10/7/2008

Question
QUESTION: My father has been in a facility for almost a year with alzheimer's.  Just recently he was sent to a hospital to be evaluated for being overly violant to people in the nursing home.  We got him to a state where he is calm .  We found that within a week he is doing it all over again. This is the second place we had to find. I am really scared for my mom and my dad.  My dad because i wonder where will they put him now?  My mom because i don't know how long she can endure this.  I quess my question is How long will he be in this violant stage. He has had this for over 5 years now.

Cathy

ANSWER: Hi Cathy, I am sorry you are going through this.  I wish I could tell you how long it will be but I am not a gypsy!  

My bigger concern is the care your dad is getting.  I can't understand why if he was calm in the hospital he wasn't calm at the home.  When we have a patient that is that way we have them seen by psychiatrist with admission to the psych ward.  There they get them to a place where they are "happy" and can then be returned to the place they left.  Do you know if the home where he returned had him on the medications that the hospital had him on?  I know that seems like a "duh" kind of question, but you would be surprised at the number of times patients are discharged from the hospital and then their medication orders get "lost" and the patients end up back at the hospital and the hospital MDs can't understand why the drugs aren't working and then they find out it is because the patients never received them once they left the hospital!!  

That is why I am concerned for your dad!  He should not be violent again just because he went back to the home.  The drugs the hospital put him on should be keeping him "stable".  I would go to the home and request a list of the medications he is on and then compare them to what the hospital says he should be on.  If he is indeed on the ones they ordered then I would find a geriatric psychiatrist who deals with dementia and have him seen by them.  If he isn't on the medications, I would bring the results you find to the director of nursing at the home and ask why is he not on these medications when they were ordered for him on discharge??  

I hope this helps.  This is an ugly disease and sometimes very difficult to handle.  I hope what I said helps.  Please let me know how it goes.  If you have trouble finding doctors call the Alzheimer's Association in your area they may be able to refer you to someone.  Take care Paula

---------- FOLLOW-UP ----------

QUESTION: Paula,

Thank you, your answer really helped.  Now my dad is back in the hospital and he has only been their a little under a week and now they say he seems fine start looking for a place for him (3rd time). We also found out that everytime he is admitted to the hospital for aggression this goes in his "record" and that now when the places see this they tend to not want to deal with him.  I have never seen anything like this.  I am perplexed and now getting angry.  When none wants him what do we do then? Is their none to help my family.  The social worker really does not seem to help us at all.  She says nothing she can do.  What kind of facility will take him?

Thank
exhausted
Cathy

Answer
Cathy, I would ask if there was another social worker to look at your case.  While they can't change his records, they can certainly make it known that he is now on the proper medications and is not acting out.  

Are there any units there that are Alzheimer's units?  They should be better prepared to care for your dad.  I know he is not the first demented patient to act out so someone there must have the ability and the compassion to care for him!  

I hope you can find one soon.  I worry about your health!!  Paula