An Incident Report – Assisted Living


I believe an Assisted Living Facility has to contact the resident’s family each time there is an official “incident”.  I am not sure of the definition of an incident, but two have been reported to me in the past month!

When the ALF lost electricity after the hurricane in late October, the ALF manager called to inform me that they had lost power.  They were using generators at the facility and this provided sufficient electricity to operate the kitchens, common rooms and kitchen and bathrooms in the residents’ rooms.

The second incident occurred this past week.  I received a telephone call from one of the evening aides.  She said she had to inform me about an incident that had occurred the day before.  She was a fairly new employee and had just learned that she should have reported the incident to me the day it occurred.

It seemed that dad had been involved in a dispute about his “lady friend”.   I have written before about “Mary” who sometimes sat by dad on the sofa in the lounge area.  See “Dad and A Lady Friend” and “Another Sunday Family Visit at the Assisted Living Facility“.  Dad enjoyed Mary’s company, but Mary was a bit forgetful or fickle or something.

Frequently Mary was with another man (I will call him “OM” for “other man”) I had seen Mary with OM many times in the past, and was surprised when she began spending time with dad.  Dad introduced Mary to me one day and told me she was his friend.  But after that, I often saw Mary sitting again with OM, and dad sitting alone.

I heard rumors that OM considered Mary to be “his” and he didn’t like it when she sat by dad.  Apparently this relationship issue came to a head the other day.  Dad was sitting in the lounge where he usually does, on the sofa in the television area.  Mary and OM came into that lounge and decided to sit on the same sofa next to dad.

Dad requested that they sit with Mary in the middle as he knew her and he didn’t know OM.  Mr. OM took great exception to that request and began to shout.  He said he would sit wherever he wanted to.  And while he spoke, he waved his arms in the air near dad’s face in a typical Italian American fashion.  (Not to appear prejudiced, as we are all Italian and I also talk with my hands ;))

Anyway, dad saw these hands coming towards his face and he reacted by punching OM in the face.  By that point, the aide who was right behind them handing out medications stepped in to handle the situation.  She reminded them that they could all sit on the sofa, and that dad should not have hit the other man in the face.

“He started it”, said Dad, in a typical 7-year-old fashion.  The aide said yes, she saw the whole incident and knew that the other man had begun to shout first.  Dad is a very quiet person and has never been involved in a fight so far as I know.  The aide said that it was true that OM had confronted dad, but it was wrong of dad to hit him.  Dad explained that he thought OM was about to hit him in the face, so he punched him first.

Here I will note that OM is heavier and appears younger and stronger than dad.  He is louder and quite possessive of Mary.  Dad agreed that he would not hit OM or anyone else any more.

I asked the aide who phoned me if this would have repercussions for dad.  Would they want to throw him out or anything because of it?  She didn’t think so, but the manager and the nurse (who must be officially second in command) are out for the weekend, so I won’t find out any more until Monday.

Today, when I went to visit dad, I saw he was sitting alone on the sofa and I was thankful for that.  Mary was in the nearby lounge with some other women.  OM was not in sight.  I talked to dad first about some family issues.  Then I told him I heard he had been in a fight a few days ago.  He said it wasn’t a fight, it was an argument.  I said I heard he hit the other man in the face.  He insisted that he didn’t hit the other man.  I reminded him that he can’t hit people.  He said it wasn’t much of an argument and he couldn’t even remember what it was about.  I think that is probably true.  After all, dad has Alzheimer’s disease and I think probably Mary does also.  I am not sure about OM, but he clearly believes he has a proprietary relationship with Mary!

I hope this was a one-time conflict and that Mary and OM will go back to sitting in the other lounge where they have always sat in the past.  I had thought it was great progress for dad to be spending more time in the common areas and less time in his room.  Now I’m not so sure!

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About letstalkaboutfamily

I am a retired and was the primary caregiver for both my parents before they passed. I have children and grandchildren. This blog is an attempt to connect with other caregivers and share ideas and experiences. I hope you will let me know what worked for you if you had an experience similar to mine. The main issues I am going to talk about are elder care, death and dying, assisted living, family relationships and hoarders and hoarding. Other topics will come up as I address the issues and my relationship with other family members.
This entry was posted in Alzheimer's Disease, Assisted Living Facility, Companionship, Elder Care, Eldercare, Lady Friend, relationships and tagged , , , , , , , , . Bookmark the permalink.

16 Responses to An Incident Report – Assisted Living

  1. terry1954 says:

    reminds me of teens battling out their love affairs………sorry this has happened, but in my opinion, that OM had it coming, when those hands began flying. your dad probably did think he was going to get hit. I have never had the impression that your dad is anything other than a fine man and a gentleman

    • Thanks, Terry. Dad is a quiet person. He doesn’t remember the details of the “argument” and I find myself wondering if “OM” does. I don’t want to see any long term quarrels developing out of this. I think ALFs are a lot like small towns, and all the same issues develop that one sees with people who live in proximity every day.

  2. jmgoyder says:

    How awful. Anthony has become a little aggressive lately with some staff (verbally) which is out of character. This dementia does my head in. Hope your dad is okay.

  3. boomer98053 says:

    If you feel that the administration of the building is considering discharging/having your father moved to a different AL facility because of that one incident, please know that your local LTC Ombudsman program should be contacted immediately so they can get involved and assure that your father remains where he currently lives. Certainly causing physical harm to staff or other residents is a serious matter, but the facility knows this was an unusual circumstance, and they even know the cause of it. Your father felt threatened. The facility must make reasonable accommodation to keep your father at their facility, not move him out. There are steps that can be taken to dissuade another confrontation. Your local ombudsman program can help you out. To find the LTC Ombudsman program in your area, go to: http://www.ltcombudsman.org. Click on the state in which you live and local programs will be listed in your area. Much luck to you!
    P.S. I am a LTC Ombudsman in my state of Washington so I know for a fact that your father can’t be forced to move because of that incident.

  4. Thanks, Irene. I really don’t expect anything to happen from this. I asked the aide and she didn’t think it was a problem but was told that she had to call and notify me. Because it happened over the weekend, i don’t think there were any administrative people around. I will be there tomorrow so I can ask a out it at that time. It is always good to be reminded of our options however. Thanks for the reminder.

  5. kimjoy24 says:

    I can relate. My dad had a buddy at the nursing home at first. They were roommates and would plot escaping the nursing home together. They would wear each other’s caps. But then at some point, they had a falling out. Dad would shake his finger when the other man would pass in the hallway and say he could not be trusted. After that, Dad did not have any other “friends” that I know of at the nursing home.

    The worst incident report I remember was where Dad went into someone else’s room and defecated. The other patient hit Dad and he had to go to the ER.

    • Wow! That is actually what i had thought an “incident” would be — something serious enough to warrant follow up care. I am glad dad and the other man were fine, but it made me nervous to hear it called an incident. I guess with Alzheimer’s, we never know what part they remember and what they forget. Dad remembered there had been an “argument”. He just didn’t remember hitting the guy.

      Some of the men seem to be loners, but others have tried to draw dad into conversations. Dad mostly doesn’t respond to them so far as I can tell, though maybe he will be more outgoing now as he is more used to his situation.

  6. Jenny says:

    I am both an RN with elder care (intermediate care and inpatient hospice) experience and a person whose close relative spent the last years of his life in assisted living with dementia. As a nurse, I can tell you these situations are fairly common. Whenever you have residents with dementia or psychiatric problems sharing space, “arguments” abound, and as people live together longer some developed long-standing grudges. Physical altercations are inevitable, especially when you understand that dementia alerts not only understanding of the situation and social skills but also impulse control. You are correct that the facility should notify you of every incident requiring a written report. IAbout ramifications for your dad-in some states it is a requirement that police be called for any physical aggression among LTCF residents-this may not be the case in your state since you didn’t hear about it and it must be done as soon as the incident is discovered…or maybe the aid just didn’t know. In any case, I have seen police called to the facilities I worked at many times. They do a report but I have never seen charges it arrests, even if someone was injured, when the aggressor has any significant degree of injury or serious psychiatric illness. So, if you do find out police were called, it is highly unlikely they did anything more than a report which very likely no one will ever see. Likely nothing will come of this except they may keep a closer eye on those there when they are together. However, keep in kind that they also are probably required to notify OMs family as well, and even if the staff don’t reveal your dads name to the family OM may along with telling them anything about your father, so at times incidents like these can cause tension between families-hopefully in your case they to have been caring for a loved one with dementia and will understand. But other than their potential reaction, there usually isn’t ant action from the facility for a mild isolated incident.

    If this happens again or becomes a pattern for your father, there are some things that can happen. The facility could send him to the WE for a psych evaluation which could result in admission to a psych ward, though typically the ER simply clears him and sends him back. The facility may want to obtain an outpatient psych eval. If this becomes an ongoing, daily, severe issue or if OM were ever injured by your dad they would probably move him to a different building or wing to minimize contact between them. Usually they will do anything they can to avoid throwing someone out. That said, occasionally assisted living facilities have rules on admission that if a resident developed behavior problems they would need to go either to a different area of the facility, or to a facility with a higher level of care. Again though this sounds like it is your fathers first incident-hopefully it will be isolated!

    • Thanks for your comment, Jenny. I don’t forsee any further problems as my dad tends to sit by himself in the less used of the 2 adjacent lounges. However, there was a meeting held between the ALF and the families of both the other man and the lady friend. I think they have been involved in other incidents and that is why the ALF is working with them and their families. Dad just happened to be sitting there when they approached him. It is interesting to know what can happen.

      Dad’s ALF is extremely small. There are no other wings or other areas as there are not that many rooms and the only lounge area (2 adjacent lounges) is near the nurse’s station by the front door. The whole “incident” was seen by the aide who was giving out medications and she said the other man was the aggressor. The director told me the same thing — they view the other man as the problem and dad was just defending himself as the other man was waving his hands in front of dad’s face. Hopefully it won’t ever happen again, but if it does, I expect it is the other man who would be moved. I will just wait and see as dad is happy where he is now. I can’t imagine dad could ever injure anyone as he is not strong enough and the other man is heavier and more aggressive. Still, it is something to think about.

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