My mom is in a nursing home with dementia and paranoia. Last night she punched one of the workers.

It is not uncommon for persons with Alzheimer's to become combative during some caring tasks. We need to think about their needs and dignity as we do so. I care for my mom in my home...she does occasionally hit, kick and spit. We look for the trigger and work to find ways to do these things more appropriately. Showering and hair washing is tough for her too. She does not like the water running on her. We give her a sponge bath about twice a week on the bedside commode and a full shower about once a week. We use a shower chair and a hand held sprayer. That way she can be soaped, then rinsed and water doesn't continually flow over her. Find out if the nursing home uses Teepa Snow or Naomi Feil techniques. Perhaps you could suggest they look into those. I am not opposed to ever using medication for agitation, but feel it is often way over used and would try other methods first. It is good that you are advocating for your mom.

Cetude, I was shocked that you used the term "inmates"; I think clients, residents, or patients would be more appropriate. The term "inmates" has a negative connotation. I hope you haven't heard staff members refer to their residents in this manner. If that is the case, it should be reported and staff members need "retraining".

Yes, it's very common. The goal is to do everything with elders in their care, to keep them calm. But, hitting [sometimes with their assistive devices], biting, scratching, deliberately tripping-up others, yelling, crying, screaming, etc., can make it sound like Bedlam, and cause injuries for staff, the elder themselves, and sometimes to other elders.
Elders may APPEAR weak because of age and infirmity, but Adrenaline can still fuel even the weakest-appearing elder, to be able to rip skin off, even break bones, of someone they get ahold of; they spit [spreading germs], knock syringes askew or grabbing them and stabbing the nurse with them, etc.
Injuries happen, despite everything staff can try, to keep things as calm and orderly as possible. Thankfully, bad injuries don't happen too often; lower-levels of harm can be more common.
When someone cannot communicate in any other way, fear is still in the mind, and drives them to resort to whatever means they can, to express themselves.
Many really desperately hate being in a facility; it represents the ultimate loss of freedom, and loss of their faculties; somewhere inside every demented mind, they know things aren't the way they should be.
Basic survival instincts in most, are very strong, so they fight, when they cannot communicate in better ways.
It's worse if staff workloads are too heavy [even with basically adequate staff, loads can easily, suddenly, get too heavy], or if certain staff are unexperienced with the individual's care needs, or if there are other factors happening that upset the elder. And there can be some not-so-good staff; usually, those do not last long, working in facilities.
It's a moving target, trying to keep everything calm and running properly, in elder-care facilities, which usually run on far to slim a budget, or, are badly managed. Staff on the "front lines" of any company, be it health care, banking, hardware, or whatever, are usually the 1st to get laid-off, leaving those remaining, short-staffed.
Nursing staff has ALWAYS been chronically 'kept to-the-bone'...which guarantees that if anything staff-intensive happens, all work loads must be triaged into what absolutely must be done, and what can be put off for later....everything can easily go off the rails, if those on duty, are not at the top of their game.
It's a cognitive dissonance of sorts, between staff pushed hard to get things done on-time during their shifts, where so much can derail best efforts, and elders who seriously need more time to get their stuff done.
Slim numbers of staff per patient population in facility, is sometimes bad insurance and administrative cost-cutting, betting nothing goes haywire that can hinder staff getting their necessary tasks done...which can result in half-baked job of things, or, doing things out-of-order to what is normally done.

... I am reading over and over again from what must be people in the care industry itself defending the "job, and stating to this poster that violence is common practice in dementia, that aids or others are subjected to violence as a usual part of the job. I say (and do excuse) bs, because Dementia is not full of violence, some violence can and does occur depending on what direction the disease has taken per individual and also depending on what surroundings the individual is subjected to, but it is not "typical, no it is not. If an individual is expressing violently, that individual needs genuine immediate attention (and should have had long before the outburst.) Meaning their communication skills need assessed (is their communication compromised? Can they express themselves, their needs, their wants, their fears, etc freely and well?)..Then, their medication (usually over medicated) situation needs assessed and then actually addressed and I do mean actually addressed (such as my mother was prescribed 13 medications before I reentered the family to take on her care, she is now down to one medication. That feat in itself had taken me over one year and 3 physicians fired to get that accomplished.) To Aids, CNA's Nurses and all staff, curators included; As another has said on here, are often "understaffed, so what, you handle it, you deal with it well, carefully and maturely. You (meaning all within the industry) are paid an hourly (or salary) wage by either private persons like myself, or the state (thru all of our taxes).. So learn the job, be good at what you do, be of actual help and of actual service, or leave the job before you harm (meaning before you loose your patience and harm someone because the industry of elderly care may not be for you) or, before you become harmed (by a non communicating, or non listened to or over medicated (both body and verbal language) resident out of your own inabilities or your own inexperience .. because if an individual is being genuinely "listened to and genuinely cared for you can almost predict an outburst through "watching and listening to their agitation, their dissatisfied expressions, movements, sounds, etc. If you are good at what you do, you can at I do mean most times completely change the environment to a safe and more reasonable one for the resident. (remember, they are the ones you are caring for not other aids or teh facility, but the individuals themselves). Here's a little hint and suggestion if elderly care-giving is even a road to take or one to leave; If you are a genuine deeply good (very subjective here, but very meaningful) person who genuinely "cares for other humans" (and only you can answer that yourself) decides to be an elderly care employee, you will learn intuitiveness, how to watch, how to decompress situations before they escalate, how to relax and cause a healthy more calm environment, you will notice issues of lacking, issues of need, and you will be "in-tune" to what real care means, and what it takes to accomplish making a person, "happy, "relaxed "safe and "self assured. If that is you, then you usually remain and become an excellent care giver within the industry. (Alertness, intuitive deep genuine cognitive care and kindness is missing in elderly care across the board, across the nation) ..An impatient, control hungry, power seeking, belittling person, selfish person, one of possibly a narcissist attitude, will be a harmful care giver employee (and I've seen many of the later in the industry, to be quite frank, I've seen more the later than the more preferred) ... So to you industry workers commenting, ask yourselves which type are you, and should you be in the industry at all. You are not in a war here, you should not be just out to get through your day, you are being paid to care" to care for" and to care "about our parents and grandparents in our absence, do you understand.

...cont....( and trust me there is a difference between taking care of a senior 24/7 at home privately then placing them in a "paid for care center/facility." Such as I myself, I am experiencing my mothers Dementia, her Dementia (each individual suffering from Dementia can have different Dementia symptoms, some are typical and recognizable of the disease, some are not) is making it difficult for my own family dynamics, but by no means and in zero ways does that mean when I place her again for the betterment of everyone involved, including her, will my expectations of quality of care be less than what I expect of myself simply because of our private scenario at the moment. Also, I do know from which I speak. She has been in 4 extended care facilities and one senior care assisted living in her senior past.)

It happens. My mother is in a dementia care facility and just today when I was there a patient threw a glass of water all over the CNA. Another CNA was also showing me a mark on her arm where a patient had hit and scratched her. This particular lady is a little bitty thing, but she is strong as an ox and it took 4 CNA's to get her under control. The CNA's who work in those facilities have a tough job and they don't get paid well. The hair washing and bathing is usually on a schedule of every other day or a couple of days per week. If a hairdresser is coming in and she is getting her hair done, you would know about that probably for sure because they bill the patient directly, usually. I'd get a handle on the schedule and see if she was confused about the day. If I were you I would get with your mothers doctor and see if her meds need to be adjusted to calm her down a bit. Her dementia may be progressing to another level. Have a talk with the administrator, but keep in mind those CNA's are doing the best they can 99.9% of the time and if you feel your mother was mistreated in some way, you need to have all the facts straight because it could cost somebody their job.

I worked at an 18 bed nursing home in the early 80's. We had 2 CNA's on day shift and 1 CNA on evening and 1 CNA on night shift.

I can tell you I got pummeled quite a bit when working by myself (evening or night shift). One lady would bite, kick, grab your hair, everything to keep you away from her and you know what, I loved that lady. I got my share of her bruises but she was special.

One man slammed me into the wall one time, knocking me to the floor. I think I was out for a few seconds. I told the RN I wouldn't take care of him any more, she needed to do it.

The worst whooping I got was from a lady who had dementia, had a bad hip operation and was in constant pain. The lady who owned the nursing home had a party every month for those who had birthdays that month. Most of the time, this lady stayed in bed but this month was her birthday.

Me being on evening shift, it was my job to get her ready for bed and to get her there by myself. Back then almost every resident had restraints. In order for me to get her nightgown on I needed to untie the restraint. When I went to take her clothes off, she went at me with all she had sitting in that chair. Me, knowing if she got up out of the chair she would probably re-break that bad hip so I leaned into her to keep her in one place and try to tie that restraint back again and protect my face after the first lick was in my eye. She hit me all over my head, shoulders, arms, face, etc. I finally got that thing tied and stood up I looked into the hallway trying to catch my breath and the owner of the nursing home was standing there watching the entire incident. She looked at me and said," go ahead and take a 5 minute break."

For the next week or so I walked around with bruises all over my upper body, including a black eye.

I think the nursing home made a mistake in giving these people sugar and getting them all excited with music, too many of people, loud people, etc. The place wound her up, I think that is what set this lady off.

Now, my Mom has hit me, came at me with a hammer and also trying to stab me with pencils and other things. For the most part, this was in the beginning of moving to this house, she was confused. Her husband wasn't here and she didn't know where he was, she was thrown into a situation that she didn't understand.

As time has gone by, I haven't been threatened by her for 6 months or more. I have been with her for over 18 months.

So, the people are going to get hit who work in these fields, it's a given. The people with dementia are going to strike when they feel threatened or confused.

..to "momdoesntknowme".. I read you, I hear you, but did you read what you wrote... you wrote; "back when most had restraints" ... what type of human nature do you think would come out of you or anyone who was "restrained either for minutes or hours each day. You ad the intense fear that Dementia can cause an individual, including loss of memory, loss of logistical recall (meaning they can take a nap knowing where they are, and wake up not knowing)..ad intense senses of "being kept" back to the short term memory laps of the disease, they may not know who you are from one moment to the next ..then ad "physical restraints?? ... Think hard about that. Physical restraints is inhumane, and only the most severe mental health sufferers should ever be required, and senior care facilities are not where those individuals would be.

As I read these responses..I am just more firm in my conviction to never allow my mom to be put in a facility.

... " to momdoesntknowme" ... continued from my last... you then mention "I think the nursing home made a mistake giving them sugar and music etc" ..then you stated "I finally got that thing tied" ..In all due respect, you should not be anywhere near the care of an elderly person without proper training and potentially a therapy type counseling to change your "thought process, and to remove how you were "trained" years ago.

.. To "Grammyteacher" ... the horror stories are real, but (as I say with lite breath) there are a few facilities that "understand the human condition, and are respectful to the changes and needs of our elders and tehy demand that same respect from their employees and settle for nothing less.(Ive yet to find one) .. But if you ever find the need, through your own research, will either find one that you trust, or you will find there are none .. Its up to you, just as its up to all of us. Know this, if you find she may need what you cannot provide, just stay active, alert and be there often so she, no matter what, would be safe because of that.

Okay, this CANNOT happen again! Get mom different or additional medication. Note to Babalou-really? no, I don't think a sane person would do that. It was the staff's error.

"Cetude", I don't know where you live, but we don't call nursing home residents "inmates," nor do we "impound" them like cars. Not all nursing home are "horrible," either. I have volunteered in many that were lovely places where the residents receive excellent care. My own mother was in one in Phoenix and she loved the Care Center and the staff. My siblings and I made sure it was one with an excellent record, and besides, she was very outspoken and would have let everyone whom she knew that she was not getting the care she needed.

If you have not, I do wish you would research care centers before passing such judgment that could keep some people from seeking the help they really need with a loved one. Sometimes a family has no choice but to move a parent or other loved one into a care center for the sake of everyone involved. Caregiving at home is extremely difficult, especially if the person needs 24/7 care.

"goodgravy123, I agree with those who say don't just jump to medicating your mom without doing some research. Is this a one-time event? Has she been exhibiting anxiety in other situations? What meds is she already on, and could one be causing anxiety in her? Is she eating well? Or sleeping well? Does she have a roommate upsetting her for any reason?

Check on these issues, and more. If you are her guardian or POA, ask to see her medical records and read the Nurses/CNA notes. It the care center has a chaplain, meet with them, tell them your concerns and see if they can read her notes. Most chaplains have to make notes in the patient's charts about their visits, so she/he may be willing to fill you in on what's going on with your mom.

If you find out your mom is anxious about many things and she isn't cooperating, eating, or sleeping, then an anti-anxiety medication may be warranted. Good luck and hope all of our advice helps.

Welcome to your new normal. The two behavioral issues from dementia patients are verbal abuse and physical abuse. Hopefully, the facility knows how to handle it.

Kaylani- it was good to see a positive response. I quit reading all the posts after yours-too many. There are bad places and there are great places. Our mom has been at a small place (I will not call it a facility) going on 3 years. We like some staff more than others, but overall, the care is genuine and caring. The turnover of staff is low and mom has been with many of the same residents. We cannot all care for our loved ones by giving up our jobs. This is something without an easy solution.

Tired1of4 has written great truth! And why, I, as a retired RN, with two parents who had dementias, recommend that if dementia or Alzheimer's etc is involved, that a placement be in a facility or wing where there is specialized training in caring for dementias. My Dad was in a wonderful facility. They even had a Geri-Psych office that came in to see residents as needed. All their staff had training. They really overall, followed the Teepa Snow trainings well. Staffing was pretty good...matching state guidelines...with 3 staff on duty around the clock for 15 residents...so 1 caregiver for 5 residents on average...plus an LPN on each shift, rotating among all the 5 cottages, but supervising caregivers, and med techs for issues and back up help. And, when well trained staff were on, there was some thought as to what channels the TV should be set to, and quiet music that appealed to the elderly, was played during meals and quiet times, and staff got done to eye level and talked to residents slowly and with care and smiles and love and patience. They understood diversion and redirection techniques, and all was generally wonderful. BUT, there could be other shifts, where staffers put the TV on 'their' programs, and/or played their type of music on the radio, and when it was a quiet moment, they sat in the corner on their own private cell phones, instead of communicating with a resident, or watching to see who looked as though they wanted or needed some help. They did not pay attention to the general guidelines about taking every resident to the bathroom at certain times, or to prep them for meal times.....and therefore, there was not much observed diversion or redirection, because when they were not focused on their jobs, they were 'wasting time', and then when some action or issue had to be dealt with, those staffers just wanted to 'get it done and over with', so it didn't happen with love, patience and good communication. THOSE were the staffers my Dad called 'the bosses'. He didn't like having one of them assigned to him. The ones he liked he called , 'My friend '. Easy to see which one would gain cooperation from the resident. Too bad that we cannot expect a certain clear standard of care from everyone, but we cannot. Some are caregivers because they love the elderly, because they are studying to be nurses, because they've cared for their own relatives and enjoyed it....others are caregivers because they want to make $8/hr to pay their rent or put gas in their care, and they really do not care what they are doing to earn the money.....they are there for the shift and the paycheck..... And others are in the middle between those two extremes. It's sad....and obviously, its better if we can keep our loved one at home and do it ourselves or have enough money to hire our own caregivers to come in, but the time, energy, stress and expenses are outrageous for most to deal with for years and years and years..... It is SAD, beyond comprehension that there is not more help to keep these needy and loving elderly in their homes. I am 72. I literally fear, that the way we are going, that sometime in the future the elderly will walk in for an MD app't and the doc will say, " Well today, the gov't says you will get your shot...." just like taking the sick dog to the vet. I really fear it could come to that in another 10 or 20 years......and if I am still around, I hope our girls will fight to keep us from having to be put out of our misery because we cost the world too much and contribute too little.....

Mine did the same last week. She is one of the sweetest, kindess people you'd ever meet, but with the dementia and paranoia she's another person, one I don't recognize. And it's killing me to see her go thru this. I keep hoping she'll soon die in her sleep. She hasn't called me by my name in weeks, but at least she still knows I'm her daughter. But there's less of my mother every week and more of this angry,, paranoid person. I just seem to upset her so my visits are short.

...Joannes, those very thoughts in the last of your comment, have run through my mind lately... exactly.

Joannes, you show a real love for life. That's swell, keep fightin' till the end!

I will have no one to look after me when I get old. I have no idea what will happen to me, or who will put me into a nursing home. No idea. I don't have a big, jolly, loving family left, and being placed in some awful nursing home to molder away - alone- for who knows how long is not as appealing to me as it is to you. I hope I croak of natural causes before that. I would WELCOME 'my shot' someday, frankly, long as I didn't know it was coming.

..Lassie, aside, yet in a way related .. I myself, through this experience with my mother, speaking of my every day care for/of her and also her Senior Care facility experiences, I now ponder of my own elderly years ahead. I have two young sons, and I must say in the deepest of honesty, I will not want them doing what I am for my own mother. Things are running through my mind often as to how to plan, be that in a different country, or what have you, or what ever I decide, it for certain will be less obtrusive, less traumatic to my own children then what Ive experienced with her, because I will take measures to make it so, for them...as already said, I will not want my children stopping their lives, possibly harming them financially, or destroying their own private lives because of me (the word destroying can mean many things.) These are things I've never had to think of, until, I started caring for my mother, and now my plans of my own senior years will be carefully drawn up, legally written clearly and set, before and if I need them to be activated. To figure things out now when all my cognitive function is here, is an opportunity my mother did not take advantage of, so her life, is in my hands, and that responsibility weighs heavy on ones soul.

... there are cultures who are used to aging parents and grandparents remaining in the homes of the younger generations and is some cultures they understand it to be their duty. Most in America were not raised that way. Because our economy is built around taxes, pharmaceuticals and governmental programs... So we are pushed from the nest and expected to earn tax dollars by age 18, married by 25 and re-producing more tax makers.. and the American culture has frowned upon ever returning home again. Senior Care facilities are built into this economy, and being sold as part of the American culture, so they had better darn well get it together and be extremely good at it very soon .. or this culture/these next two generations may reverse on them and start taking things in their own hands, and if that happens, look out economy (said with sarcastic humor, but of much truth.)

Sometimes dementia residents strike out because they don't understand what is happening or why. Imagine how scary it must be to have a "stranger" put their hands on you in a most personal way! That being said, I must remind some of the writers posting here that residents in care facilities have rights. It is our job as advocates for our loved ones to monitor situations carefully and impartially. I think that some investigation is order to try to determine the facts of the incident. Did your mother try to tell the caregivers about her getting her hair done and her desire not to have it shampooed again? Did something occur that required her to have her hair washed? Was it a miss communication between staff and resident? Or is it a striking out behavior that is turning into a pattern? After you have a good idea of what occurred, then you will know how to proceed. I believe that being fully engaged in your loved one's care not only benefits them but also the facility that they live in.

I've observed a variety of reasons why residents in my mom's memory care center strike out - my mom included -

Some folks just don't like each other and I've noticed that my mom and others will often refer to certain staff as mean and think they're going to hurt them ;
Some caregivers have a smiling happy face and they usually get a better response ;
A lot of times certain residents fall asleep and staff will come and just try to pull them up to go to bed - think of how you feel when you fall asleep watching tv - do you want someone tugging on you to get up ?

Of course my mom doesn't even want me doing certain things and snaps at me - she's very sensitive about having her bottom wiped or her hair washed in the shower or her fingernails cut - all of these things she didn't like b4 dementia and so now her reaction is magnified even more so.

Anger and hitting out are non-verbal expressions of helpless people, or people who feel that they are helpless. The totally insensitive women who washed your mother's hair should be disciplined - there are ways of giving a bath and showering an old person without dousing their heads with water.
What is more - the hairdresser would have treated your mother gently and used a pleasant smelling shampoo. But not the workers who would have used body detergent to clean her hair - leaving it very itchy, dry and unkempt.

So your mom's reaction was perfectly normal. It is up to you to go and make a HUGE FUSS to the managers at the care home and to point out just how aggressive that action was. And you should keep on arguing until they "get it". This is not a time for tactful negotiation, this is a time for you to go in and stick up for your mother's rights to be treated as a person, even if her mental processes are impaired.

What happened to her was a travesty of care, and should not be allowed to happen again. It would certainly not be tolerated in the care home where my own Alzheimer's friend has been for two years. Visits to the hairdresser, baths etc are all arranged automatically and are written down.

I was reading last night about as the dementia advances and they lose the ability to communicate verbally, this is a way of making their feelings known. I guess she didn't want her hair washed. Sometimes the antianxiety drugs can be excessive to keep them docile, but the workers have to be protected, so I'd just keep an eye on the medication. It's a difficult time. My dad is the sweetest, best mannered person every and I didn't want to believe he was hitting either, but then he got mad at me a couple of times. The frustration in his face was heartbreaking.

Personal experience: Years and years ago, my husband got laid off and I needed a job fast. The first nursing home where I applied took me immediately. I was a warm body that moved. Minimum wage. I was 19 years old. It was an eye opening experience and a moving one that I never forgot. I'm 56 now. I went through care training. I was also taught to eat as if I was blind. The food was so bad, I threw up immediately. I remember it like it was yesterday. There was a woman named Ruby, no teeth, could no longer talk, who used to wander in her house dress and slippers throughout the facility all day long and, pardon me, poop on the floor. It was not deliberate. That's "just how it was". Every day. One time someone cleaned it up with a paper towel. A nurse gave a resident ("resident", not patient) some medicine. A pill dropped on the floor and rolled onto the spot where Ruby had pooped. The nurse picked it up and put it in the resident's mouth. I almost fainted. There is a lot of fainting and nausea with new employees the first few weeks. Especially when they get a resident who has diarrhea. With medications in the system, the stench is indescribable. I was taught to keep a bottle of perfume in my purse and spray my arms down before doing the clean up. During the clean up, I was instructed to breathe deeply into my arms every once in awhile to avoid throwing up. This preserves the dignity of the patient and keeps you on your feet. The strike at the plant continued and so did I. One man I took care of was particular and fastidious. He preferred to have his "appendage" wrapped every day in a clean washcloth. No, he was not a pervert. He wanted things a certain way. I did it, without complaint. The other employees didn't want to "fool" with his ways. He was a kind and encouraging man. After awhile, he demanded that I take care of him, not others. I treated him with great dignity. Lovely man. Then there was Goldie. She was blind. Her son, professional, mid-thirties had her personal (gorgeous) bedroom furniture installed in her private room. He took her clothes home to be washed. He visited her EVERY DAY and fed her her lunch. No, he was not a mama's boy. He was an incredible human being. Then there was the man who I put on the elevator and took down to the shower room and cleaned. Later, A staff member asked me if I had any problems with him. No. The staff member was surprised. He already had tried to rape three nurses. Good to know. There was a lady from Kentucky who was not properly cared for at a different nursing home. I helped with her impaction (look it up) and cleaned out her bed sore that was a big hole three inches wide and three inches deep inside her body. I felt anguish deep into my soul. I took care of an Alzheimer's patient. She was nice and very lost. She was in a wheelchair. As I was bending over to put on her slippers, she snatched a handful of my long blonde hair. I simply, gently unfolded her birdlike fingers off my hair and we moved on. I talked to a staff member about it and she told me that's so and so, she likes to pull hair. Good to know. As I later cared for her, I stayed out of range. Many times nursing home residents have three great days and then they die. I assisted a woman who had a dog. I picked it up and played with it. She and I and her dog had such fun. There was no dog. She died three days later. Usually, death happens on the night shift and a staff member cleans up the body before transport. Minimum wage. I was never asked to do it. When "my" residents passed away, I went to pieces. There was no way I was able. The strike ended. The nursing home insisted that I work BOTH Thanksgiving and Christmas. I felt that it wasn't fair and I was done. I was 19. A kid pulled off the street. With the lives of the elderly in my hands. My mom has Alzheimer's. I built a suite for her in my home. The contractor and I customized it for an Alzheimer's patient. He and I went to five stores and he tried out 80, yes, 80 recliners until we found the perfect one. Plush, heat and massage, small for an 85 lb. woman. Flat screen tv. Fireplace mantle. N.A. Noel artwork (beautiful). Ocean blue walls. Faux silk blackout drapes, sheers. White french doors. The OT and PT people were in shock when they visited. It is so beautiful. They helped me customize her bathroom. Its all beautiful and the cost is incredibly less than a nursing home. She has the finest food and medical care. Who takes care of my mother? I do.

Ouch, That Hurt, Tired1of4!

Tired1of4 said, "Physical restraints is inhumane, and only the most severe mental health sufferers should ever be required, and senior care facilities are not where those individuals would be."

My Answer: Again, this happened in the 80's
1. The NH was Private Pay Only, with 18 beds.
2. Cost was $80,000 a year (1982-1984)
3. Actual item used "Posey criss-cross restraint vests" (look them up)
4. Lady I was talking about, the son was a police officer (he knew rights, right?)
5. Jersey State Inspections a few times a year. Legal and/or appropriate AT THAT TIME

Tired1of4 said, ". . .you should not be anywhere near the care of an elderly person without proper training and potentially to change your "thought process, and to remove how you were "trained" years ago."

My Answer:
a1. WHAT??? I am not the one that is exhausted!
1. I stated it was in the 80s, not 2016! Now, instead of poseys they medicate.
2. "Proper Training?" Yes, I went back to school in 1997, things had changed for the better. (BTW, I had the highest score in both Clinical and State Exam in the school's history, Clinicals-100%, State Exam 98%). I, also, have a Bachelors in Paralegalism and am a Licensed Real Estate Agent. And have a doctorate in hard knocks. ; P Currently taking creative writing classes on-line. You are never too old to learn!
3. I take offense to you jumping to conclusions and especially saying I need "therapy."
4. I NEVER restrained Grandma (stroke at 101 years old), NEVER restrained my MIL, although there were times I wanted to, NEVER restrained my Mom and don't plan on it. You are right, without a Dr. order, you cannot restrain them in a private home, I got 98% on state exam, I didn't miss that one! BTW, what was your score tired1of4?
5. I had it all to do in the NH, transferring residents who weighed 200+ pounds from bed to chair and vice-versa by myself. One good thing is I developed "guns" and hard-rock thighs at that time, I weighed a mere 120 pounds soaking wet.
6. I remember one lady who had a feeding tube up her nose, she had the wrist restraints on because she kept pulling it out, blood everywhere, YIKES! That was before we were required to wear rubber gloves and protective clothing. Yes, rules have been changed for the better. One morning I came in and one of her wrists was swollen, it was pulled too tight, I went right down and reported it!

Tired1of4 quoted me, "you then mention "I think the nursing home made a mistake giving them sugar and music etc" .

My Answer:
Obviously, you haven't done your homework on dementia. Sugar, Caffeine, Loud Music, Crowds, Loud talking, etc. can set a dementia person off. May I suggest you read, "Learning to Speak Alzheimer's" by Joanne Koenig Coste, "Surviving Alzheimer's" by Paula Spencer Scott and my favorite, "Creating Moments of Joy" by Jolene Brackey. Those are just 3 that I have laying at my desk.

My Thoughts on You

Well, to tell you the truth, after reading your profile, I decided not to bad mouth you the way you did me. I did leave #6, you can guess what the other 5 are. ; )

6. I see you are exhausted, exhaustion is the main reason to give it up, check out the section on "burned out." Also, go to youtube and watch the Teepa Snow videos and listen to her say that we caregivers stand a 60% chance of getting Alzheimer's just because we took care of them, why, because of stress. Then watch more of them to see what our stress does to the Alzheimer's person. The atmosphere around dementia is suppose to happy and tranquil, no stress. Start relaxation by breathing slowing in through the nose, then slowly breathe out of the mouth, do this 3 times. Get oxygen to that brain because when we are stressed we don't breathe right thus no oxygen, beginning of dementia!

You don't like the people working in NH. Let me tell you it is a hard, thankless job. Think about it, those people working there are doing the job a lot of people don't want to do. We know your mother, father, grandma or grandpa better than you do after a time.

Another good thing that has opened up is that if a resident does hit NH staff, a report is filed with the state. That was a rule in Jersey when I worked there but a report was never filed. That may differ region to region, here that's the law. It's helps the staff member and I can't help but wonder if that is some kind of black ball against the resident. A NH may request that a family member come and sit with the resident during the day, if things mean a lot to you or they are combative, especially in the beginning or a problem arises.

I have a little more to say to you , Tired1of4, and advice for the rest of you. Stay tuned to Part 2

You have no idea of what you speak about the NH ins and outs a few posts above mine, no, not a clue! The male resident who slammed me against the wall was in the room with his visiting wife, he didn't have dementia, he had a stroke and was paralyzed on one side. All I did was go in to say hello, it was close the end of my shift so I was going to ask him if he needed anything. Before I could get that out I was rudely interrupted by my head hitting the wall. The excuse the wife gave was that I looked too much like his daughter, ok. Is that how he treated his daughter? The odd thing was the wife did nothing for me, not even yell for assistance, just left me on the floor. There is no way of knowing what we are going to encounter at any time.

For most residents, it takes time to get to know what ticks them off or what gives them joy, it may be nothing we do or say, it may change day to day, hour to hour, moment by moment. My Mom memory retention is under 10 seconds. It is an adjustment for both the resident and the facility. The RN makes the med changes with the Dr, we take care of the resident and report.

The lady that I talked about who kicked, punched, bit, kicked, grabbed hair was always like that no matter what you did or said. Oh, and she could cuss like a sailor too. Every morning I would enter her ward, she would see me and say "You GD, SOB of a whore."(she didn't use the alphabet, she would say the real deal). And I would reply, "It takes one to know one, huh Lena?" Then out came this big laugh from her and her reply was, "That's right!" Every morning started with a big hearty laugh from everyone who heard. I can hardly believe I can remember that being from 1985. I loved that lady! The staff knew where to find me at all times because they could hear me laugh! I always had a good time with the residents.

The people who work in NHs need to love those residents as I did when I worked in Jersey, the people who don't like the residents, it's not a job for them. Each and every one of those residents holds a special place in my heart.

I always, always spoke up for the residents, I knew I was their voice because they had none, mostly because no one ever visited them. It landed me in trouble a few times but I did what I had to do. Remember the golden rule: Do unto others. . . I could not keep still when something wasn't right.

I stayed overtime just so I could get some residents to play bingo, we never had the time otherwise.

I apologize to anyone whom I have offended, that wasn't my intention.

Anyone thinking about placing their loved ones in a NH, my advice would be to go often to check on them. If staff knows you are coming they may pay more attention. Find out the ratio of resident per CNA/RN/LPN, all shifts, if it's 18/1, like me on evenings when lots of feeding needs to be done, then keep looking. I can always tell if it is a good place by the smell when you first enter, that's a good indication of what's going on. If possible take your loved ones clothes home to wash, believe me they are thrown together with all kinds of stuff you don't want to know about!

Oh, I just read a few weeks ago that the nursing homes can boot a resident out when the resident stays too long in the hospital. The article stated that they may only hold that room for so long. Be sure to check out their policies about that. Private Pay is not booted as much as Medicaid. The hospital will set up another NH but think how hard it would be for a resident to get used to a whole new place and people.

PEACE

Yes, its common in dementia. Mom was the sweetest, most gentle and kindest person until dementia got bad. Part of it was her frustration at being in AL when she didn't want to be. She would argue with us, complain and refuse to cooperate. One day she pushed a friend and struck out at my sister. The doctor put her on an anti-depressant which helped a lot, at least it made her less physically aggressive.

Wow...heated discussions! I've had a grandfather with dementia that became so abusive to my grandmother that he had to be put in a nursing home...and was restrained to prevent injury to others and to keep him from trying to leave. Yes, he had to have a locked gate on the fence at home to keep him from leaving.
I've worked on the geriatric ward with patients that were violent...we were required to have two people in the room to care for these patients I specifically remember one old gentleman that put one of the nurses in the hospital he beat her so badly...yes, he had restraints. I don't remember ever seeing any of the staff treat him badly.

My grandfather died over 30 years ago and the hospital I worked in was over 30 years ago. Now I am facing some of the same problems with my husband. Fortunately, his "senior care" team has been able to find medications that have controlled his outbursts and he laughs most of the time now. He did attack my daughter-in-law once when she came to my defense. And I had two altercations with him before the medications and I did suffer a back injury from one.

My son and daughter-in-law insisted that he needed to be put in a nursing home, but I persisted in working with his medical team to find a solution. I still have people encouraging me to put him in a nursing home, but I just can't do that. He is no longer violent and he is still able to do a lot of things for himself. If he can't remember something can't understand how to do things he used to do, he does get frustrated and irritated, but now he just goes in his room and watches TV. I am with him all the time as he can't be left by himself.

I know some people don't have the options or the patience to care for people with dementia and assisted care and nursing homes are necessary. I feel sad for people that don't have someone to care for them at home, but I also feel for the staff people that do care for people with these problems.

I hated when the "family" members of our violent patients would complain about their care because we truly did give them excellent care. I always wondered why they weren't caring for them if they thought their family member was so mistreated. I grew up in an error when most elders remained at home and other family members took care of them. My grandfather was the only one that was put into a nursing home because no one could care for him. He died three months after he went there. He had heart disease and vascular dementia.

My heart goes out to those afflicted with this terrible disorder, their families that suffer terribly from seeing the decline of a loved one, and those that dedicate their lives to caring for those that can't care for themselves.