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 Scary episode at the SNF 
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Scary episode at the SNF
This afternoon at my husband's nursing home the fairly young and very mobile guy in the room next to my husband's went off on another resident--an old guy in a wheelchair--because he tried to get into his room. First, he pushed the poor old guy's wheelchair down the hall about 100mph then, after the staff finally restrained him, he went back and tried to ram the guy with a lift machine. He threatened at least three times that he was going to kill the guy if he ever tried to get into his room again, used all kinds of violent language and was totally out of control. Everyone was pretty shaken. Because I happened to be in the hall when it happened, I talked to the police about what I saw and commented that, either this guy goes or my husband does. Mental Health was called and they finally got there. I put Derek to bed for a nap and then went home to walk the dog, then went back. Apparently they took the perpetrator away. Hope they don't bring him back. I don't know why he is even in a nursing home, frankly. And privacy laws would probably preclude them from telling me.

Just when I thought I could spend more time away from the SNF this happens! :shock:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Mar 13, 2011 8:52 pm
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Scary episode at the SNF
That must have been extremely frightening, and it does make you wonder why the guy was there. I'm glad he was removed, and with any luck he will be re-evaluated and placed somewhere more appropriate that can deal with him.

Julianne


Sun Mar 13, 2011 8:59 pm
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Joined: Tue Aug 17, 2010 9:20 am
Posts: 184
Location: So Cal
Post Re: Scary episode at the SNF
Pat,
It makes me wonder if the guy had ever exhibited anything violent before. I'd really like to believe the administration and staff had no clue what the guy was capable of. Did the nurses on duty seem taken aback? Scary for all involved. Did Derek see any of it? Hope not. Glad he's gone. Whew. Sher

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Sher (53) married 29 years to Ken (66) who was diagnosed with LBD in 2008, but it most likely began many years before.


Sun Mar 13, 2011 9:50 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Scary episode at the SNF
Very, very sad. Maybe the young guy was off his meds. Maybe they tried a new med, or gave him a med that is contraindicated for his condition. Maybe this psychotic episode was a first for him and no one knew it was in the works.

Probably somewhere there is a wife or mother or daughter who is wringing her hands and wondering what in the world they can try next.

One woman in our local support group had found what seemed to be an ideal day program/respite care facility for her husband and was shocked when she was called to come pick him up one day because of violent behavior. (I think she had been using that center for a few months.) He had never been violent before, and he is not violent now, at home, but that episode greatly limits her options.

Obviously, care facilities have to protect their residents from such risks. I think we are woefully short on places that can handle this kind of behavior.

It is sad, sad, all the way around.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Sun Mar 13, 2011 9:58 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Scary episode at the SNF
Jeanne, I agree. A friend had to move her husband four times before she found a facility that would keep him. Finally he became too incapacitated by Lewy to do any harm, then he died about a year ago. Derek is often combative with the staff but is too immobile to do much harm. We do need more facilities that can handle these types of patients. I think this fellow has a psychosis rather than dementia and perhaps belongs in a different environment.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Mar 13, 2011 10:10 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Scary episode at the SNF
Quote:
Did Derek see any of it?

He heard what was going on and knew it wasn't good. I wasn't afraid of this guy
for myself and realized that I would have tried to take him down before I let
him hurt Derek or any of the other residents, for that matter. Not smart,
maybe, but it's the sort of idiotic thing I would do. ;-)

They need to have a better plan for these types of events. Having worked on an
acute psych floor I know that you have to have a signal that staff will respond
to for a 'show of force'. That will usually get the person to back down. If
not, you literally have to physically restrain him until the mental health or
police personnel show up [on the psych floor, we administered a strong
sedative]. You can't risk them hurting patients or staff. On a Sunday, right
at change of shift was probably the worst time for it to happen. And I don't
think there was one male staffer in the building.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Mar 13, 2011 10:14 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Scary episode at the SNF
I might've mentioned before that we had an LBD patient in our area who killed someone in a psychiatric facility. The situation is extremely dicey for many in care facilities.


Sun Mar 13, 2011 11:07 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Scary episode at the SNF
OMG, Robin! How awful! From what I observed, this guy could and would kill someone.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Mar 13, 2011 11:11 pm
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Scary episode at the SNF
Pat.... You reminded me that my sister told me that the 'home' where our mother had been placed took in a disturbed man as a resident ... and he was there only one night. His behavior was too violent for the staff to handle.

It is probably hard to judge how unstable people will react when put into a 'home' situation. I can't help but wonder how long the guy was living there before exploding.

My sister said the 'home' needed the money... but not that badly.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Sun Mar 13, 2011 11:24 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3402
Location: Vermont
Post Re: Scary episode at the SNF
How scary is this?! I think I would have been like you and wanted to jump the guy to get him away from the other resident, or keep him from my own LO. A 64 yr. old woman who moved in a few doors down the hall from my dad last summer - she was capable of doing something like that. She was constantly wandering in and out of other residents' room, including my dad's. She started screaming at my sister one day for no apparent reason (my sister thought she was visiting a resident there at the time, not a resident herself because she looked so young and healthy.) She tore out her own hair and trashed everything in her room, all in a matter of minutes before the staff found out. She was out of there pronto when that happened and put in a private psychiatric hospital till she died a few months later. The whole situation is really bad and really scary for everyone, and I do feel sorry for the family members of the person who gets out of control too. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sun Mar 13, 2011 11:31 pm
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Joined: Sat Jul 31, 2010 5:28 pm
Posts: 317
Post Re: Scary episode at the SNF
It is such a dicey situation. And the awful part is that it could be one of our LO's who became the perpetrator. We have all experience some kind of behavior that, if it escalated, could become violent. If you remember, last December Del was placed on a 72 hour hold because of aggressive behavior. He is too frail now to do much harm, but he could have in years past.

I am just thankful no one was hurt in the nursing home and this man probably shouldn't come back.Sounds as if he needs to be in a more secure group home where there are not so many frail people. I think this goes on more often than we realize.

Pat, I will be interested to hear about the relolution of this in the nursing home. You have an in with the help and even if the admin won't talk, I bet a few CNA's would.

Smiles, Nan


Sun Mar 13, 2011 11:35 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Scary episode at the SNF
Well, I did learn from an aide that this has happened a couple of times before [against the same other resident] and that he has a diagnosis of schizophrenia. She would probably get into big trouble for telling me so I'm not going to mention these facts to anyone else but they certainly concern me.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Mar 14, 2011 12:25 am
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3402
Location: Vermont
Post Re: Scary episode at the SNF
The situation sounds totally inappropriate for a SNF to handle. Good thing he's gone, but I'd talk with the director and find out what their policy is. They are really taking a risk having a resident who, it sounds like, needs serious psychiatric help. Keep us posted. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Mar 14, 2011 12:37 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Scary episode at the SNF
I talked with the SNF administrator this morning and found out a few things:
1. The out-of-control patient has been there for eight years and only recently had any 'issues'.
2. He does have a psychiatric diagnosis.
3. He is being kept in a temporary hold but they have to take him back until they find other placement for him, as required by law. But he will be separated from the 'trigger' resident and given 15 minute checks. Hmmm.
4. The administrator agrees that this is an inappropriate setting for someone with his 'issues'.

I offered my point of view, saying that having an able-bodied, volatile person like him housed with vulnerable, frail elderly people was like letting an unleashed dog run amok in a park where all the other dogs are leashed. He agreed but, of course, he was bending over backward to be agreeable. I also offered some suggestions about handling these situations [he admitted they were not accustomed to having these situations]. When I described the staff roundup 'show of force', he asked, 'Well, doesn't that cause them to escalate more?' I answered that, usually, they back down but even if it did, de-escalation must be secondary to containing the violent person to prevent injury to patients and staff.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Mar 14, 2011 7:27 pm
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Scary episode at the SNF
What a mess! It occurs to me that Lewy patients are sometimes out of control. There were a few times when I was glad Dale wasn't in some sort of facility. His unreasonable behavior could be 'controlled' more easily here at home.

However, his bipolar son was something else. I knew after living through a couple of major episodes that I could not live with it.

Eight years without a major episode may have given them an unjustified sense of calm even when they knew he had issues. It's a tragedy all the way around.

I'm so sorry for the worry that it must cause you, Pat.

_________________
Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Mar 14, 2011 7:36 pm
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