My Father lives in a Nursing Home in South Alabama, has been there a year. He has Dementia, is blind, confined to a wheelchair. He is a Medicaid recipent. Today he became aggressive with a male Nurse. It is my understanding that he was “fighting” with him. They have had a nice relationship before. An ambulance was called to take my Dad to the hospital for his behavior, no injury.
I saw him earlier in the day, his behavior was different.
He has been admitted, maybe a stoke caused behavior. I will know more tomorrow.
Can the Nursing Home not let him return?
I hope they sort his issue out soon. It doesn’t matter to them that he is on Medicaid.
I know this must be very upsetting for both of you.
If he has an infection then he’ll need a little time for the antibiotic to help. Let us know how he is doing.
A nursing home can have very good reasons for refusing to continue services for somebody who needs more care than they are able to provide, or different care from what their staff are trained in. So if something has changed in your father's condition which means that they cannot keep both him and their employees safe, wouldn't you agree that they would be right to say so?
But I also wouldn't get ahead of yourself. What can't happen is that your father is kicked out of the hospital with nowhere safe to go. If the hospital can find out what caused this isolated incident and get on top of it, well and good and the NH should be content to welcome him back; but if he needs a step up to a specialist memory care or dementia care unit they'll work with you to find one.
As your father's advocate, it is only reasonable that you should be given a detailed report of what exactly happened. Sudden aggression could have a clinical cause (uti, stroke) but it could also be that something freaked him out or that he's in pain. You know that the nurse wasn't a stranger to him and that they had a good relationship, so that wasn't the issue; but it would be really helpful if the nurse could describe what was going on - all clues welcome!
My dad got upset when the one cna was assigned to him. He got very agitated when she walked in the room. This happened sev times. At first I thought thats odd, he is fine with everyone else. One time she walked straight into the room and shoved a hamburger in his face and told him to eat. No hand washing. Nothing. That shocked me! She threw bedding on the floor. Nursing homes get fined for that. Other times his face was bleeding quite a lot from being shaved. These were big long scrapes down the side of his face. Like someone pushed down on the razor very hard. This went on for a while. Long story short she was fired I believe. So there could be a valid reason he is aggitated. Not every cna is a good one. My dad got along with everyone else. So there was a real problem.
I would see what is going on with your dad's work up in the hospital first. You can always go to the hospital/that floor's social worker and talk to them. They will help you. You can set up an appt with them too. They can discuss options when he is ready for d/c. Discharge. They are very nice.
A nursing home can say he needs a different facility. There are medical ways to deal with his agitation if it is caused by dementia. He wont get thrown out into the street. The hospital Social worker can help with your concerns and where to put him if he needs another facility. Good luck.
Once he has been evaluated and the reason for the incident resolved I would think there would be no problem letting him return.
It could be anything from a UTI, the Nurse could have surprised him and grabbed him and he was not expecting it. It could have been a stroke...
The balancing act is they have to keep residents safe as well as the staff.
By now you have the evaluation.
I am sure if it was anxiety an adjustment on medication could resolve the problem. If this was the first incident I doubt that they would evict someone based on that. There must be written policies about behavior problems and what they do to correct the problem before a resident is evicted.
Please let us know how this was resolved.
The social worker at the Geriatric Psych Unit told me that the NH cannot refuse to take my dad back. After 2 weeks my dad went back to the NH; sadly, my dad passed away about 3 months later in September from dementia. We are in CT - not sure if laws differ per state
I hate this disease. Best of luck to you and your dad.
I’m sorry about your Dad.
It is a terrible disease.
When a behavior interrupts the daily operations, causes concern for the well being and safety of employees and other occupants of the place of business a company may take action. AGAIN please read your terms and agreements. Too often we speed through the contract and don't really get to read the small print.
It seems as if there’s medications to calm people down. Have they tried anything? Unfortunately, if he’s a danger to the staff, they might try to transfer him, but they would need to prove that they tried different strategies to alleviate the problem first. In this case, information is power. Read the contract carefully, so you are armed with information if and when the time comes.
Best of luck!
He will be able to return to his AL.
Thank you so much!
He may just have a UTI. Or perhaps he requires a mood stabilizer if dementia is getting worse.
I do hope that his caregivers communicate very well with him before touching him or anything! The elderly can become so sensitive with age.
It sounds like an isolated incident. He could have just been having a bad day or something....
All the best!!
If there is any question in your mind, have a nanny cam placed in your Father's room.
My step-father has always been non-aggressive his entire life. His Alzheimer's/dementia effects him most often when his Sundowner's starts. Both my husband and I have experienced this prior to placing he/Mom in their new residence. He has had to be "talked" down and the easiest for him is to tell him Jesus does not like him acting like whatever he is doing at the time. His children refuse to accept this behavior, they say he has been like this since they can remember.
It is stated in the contract that he can be removed as well as Mom should she become too difficult to handle.
This is when the person is placed behind the "double locked doors" with specially trained personnel to handle.
But, they cannot endanger their staff nor their other residents. If he has had more subtle incidents and this was an escalation, they may not let him return. He would have to be admitted to a specialized unit. The hospital or his SNF can refer.
I am sorry you are going though this! I know it can be stressful! Hang in there. Here are a few quick ideas/thoughts.
Yes, the NH can refuse to take him back. However, since he is in the hospital they cannot discharge him without another place to go. The discharge planning department can help.
First, ask to speak with his case manager, social worker or discharge planner. She/he can call the NH to determine what their thoughts are moving forward regarding placement. They can also explain what is going on medically so the NH can better understand where his behavior is coming from.
If it was not an outright medical issue, he may need an evaluation from a geriatric psych doctor to see if his medications need adjusting. Either way, if this information is explained to the NH they should consider taking him back if it is an isolated incident. If they don't want to take him back you can work with the discharge planner to determine what other facilities are options for him. This can all happen quickly so the sooner you speak with someone the better!!!
Good Luck!