An Altercation Involving Dad

Over a year ago, I wrote about an “incident” in which dad was challenged and ended up punching out at another resident in his facility. These incidents have to be tracked and reported to the state. In that case, dad was not considered at fault because the other man threatened him.

Yesterday, though, I was telephoned in the early evening by someone from the night staff to inform me that dad had been involved in an “altercation”. Dad had been in the activity room making his way in the line for his drink at “Happy Hour”. I have heard 2 versions of this story now, but it seems that dad had trouble getting past a table of card players.

Dad got frustrated and rammed his walker into a man who was seated at the table, I believe. He ended up in a shouting and cursing match with the other resident and then he began hitting him. Both men threw punches, but no one was hurt. The “altercation” was broken up by the male activities director.

I asked how to follow up on this event and was told to call the director in the morning, as it was currently after hours. I phoned the director this morning and she was on another line. She telephoned back on a conference phone with the nurse/case manager.

We discussed dad’s behavior and how he lashes out when he gets frustrated. Dad is otherwise a very quiet, peaceful man. However on those rare events when something happens that he can’t deal with, he lashes out with shouts, curses, and hitting.

The person who called last night said they had moved the Happy Hour from the main lobby to the activities room a few months ago, and they moved the starting time to about 30 minutes earlier. She said dad was late and was not going to get a drink so he got frustrated.

However, the director this morning said that was not the case. It was “6 months” since they changed the location and time, and dad was not late nor was he about to be denied a drink. Now neither the woman who called me last night, nor the director I spoke with this morning were actually present when this occurred, so I really don’t know exactly what happened.

The director also said that the Activities leader usually comes around to remind the residents that Happy Hour is about to begin. I think dad must have been in the bathroom or something though and missed that reminder.

The director said she had to report his altercation and she had to telephone his physician. The physician might want to make a change to his medications but she didn’t expect that would happen because dad was not in altercations before. Though she did indicate that he had instantly changed from the nice quiet man he usually is into a shouting cursing man on other occasions in the past.

I stated that I would like to find a way to prevent dad from running into frustrating situations where he loses control. He will not remember this event when I call him because of his lack of short-term memory. Still, I will try to bring it up when I telephone him tomorrow. I am not inclined to call him today as I need time to mull it around in my mind first.

The director mentioned the companions that visit dad and suggested that they come around 3 so they can walk him to the Happy Hour. I had considered the same idea last night after the initial phone call. The director said it in a way that made it sound like they were “just sitting around in the lounge” but maybe it was just my sensitivity to the situation.

In fact, the companions do sometimes just sit with dad in the lounge though sometimes they get him to play checkers or to walk around a bit to get him moving. Taking him to the activity room would be another way to do that. But I have told them they are free to go at any time of the day and shouldn’t feel the necessity to always go at the same time.

This morning after I spoke with the director, I sent an email to the companions telling them what had taken place. I suggested that if it worked out with their schedules, it might be good for them to come at a time that would allow them to walk dad to Happy Hour. I like for the companions to feel they have flexibility in their schedules and to also come at various times just so the ALF doesn’t know when they will be there. Still, if they are able to be there before Happy Hour, that might help prevent a future occurrence of this type of event.

Also, now that it is the end of January, the nurse companion who had visited dad last year should be home from her vacation. I had considered the new nurse companion might just visit dad in January, but now I think I would like to just add an additional companion visit or two. I asked one of dad’s other companions if she could come one additional day as well. Thus dad could go from 3 visits per week to 5, which would increase the expense, but reduce the chances of future incidents.

I haven’t heard back from any of the companions yet, so I don’t know how this will all play out. I sent my son a copy of the email I had sent the companions. He responded immediately as he couldn’t imagine his grandfather behaving like this. I explained that it was due to the dementia and that his grandfather’s social skills were diminishing and he was now behaving like a four-year old. Since my grandson is 4, it seemed like a good comparison as every mother has seen a child melt down when he was tired and frustrated.

I am afraid that these changes in dad’s behavior could lead to a request that he move to memory care. At this time I want him to stay where he is. I am far from home and dad has been happy in his current situation. So, if possible, I don’t want to make any changes.

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 Altercation, Alzheimer's Disease, Assisted Living Facility, Behavior Problems, Caregiving, Companion, Dementia, Elder Care, Eldercare, Incident and tagged , , , , , , , , . Bookmark the permalink.

20 Responses to An Altercation Involving Dad

  1. liramay42 says:

    I feel for you. Dementia really does turn our parents into toddlers. My mom is one of the most sweet, easygoing ladies you will ever meet – but I’ve had one “incident” reported to me by her ALF, where she got agitated in the dining room (because they had moved her to a different table and she didn’t remember that) and apparently rammed her walker into the side of the table and shouted. I haven’t heard my mother raise her voice since I was a bratty child myself. No one who knows her can imaging her behaving this way. It’s hard to know how to respond… and I feel anxious and frustrated, knowing that she is dealing with something that is so hard and so beyond her control, and I don’t know how to help her.

    • Yes, it is very difficult being a caregiver for a parent. They don’t have the capacity to follow the social rules any more and we are somehow expected to make them behave. I think the living facilities need to help by keeping the floor plan open enough for walkers to get through and reducing the un-necessary frustrations. Thanks for commenting on my blog.

  2. JodiMelsness says:

    Many thoughts here, but I’m thinking like a nurse first. Remember, time for him is so different. He might have felt he was late and not being able to be served. Frustration is a big thing with dementia and they do lash out, which sadly can be the norm. It must be frustrating for him to know, in a way, that he can be lost at times (thoughts and actions). I think it would be a good idea to have them come at that time, because socialization is an important piece too.
    I am not for just increasing medication for two incidents. Yes, he may be changing but I try and do other things first so that they behaviors may not happen, or try and make it not happen. It just sounds like he was angry and didn’t handle it the way it most likely would have, without dementia.
    As a daughter, you are doing a good job. You write just like I do and I would also increase the visits. He is there for a reason and things will come in. Stay involved and keep communicating with the nurses.

    • Thanks, Jodi. There is just one nurse and she is frequently too busy or not inclined to talk to me. But I also try to keep in touch with the aides who do most of the actual person to person communication, etc. I agree about the medication as I am afraid it would make dad sleep more. It could also add to his dizzy spells and fear of falling. I hope they are able to prevent his frustration so they don’t have to react to his acting out. I did just hear from the nurse companion he had last year and she will be visiting him in addition to the other companions. So that should help him too.

  3. boomer98053 says:

    Such a difficult situation – and apparently it’s not easy to discern “all the truth and nothing but the truth.” I’m not a nurse, but I am someone who has worked with the elderly (including my father and sister-in-law) who had dementia. I hope that prior to defaulting to a change in medication, the staff at the ALF, and perhaps your companions, can extract the cause of the behavior change and address the cause, rather than the symptoms. I know you’ve heard the following before but it bears hearing again: even something as mundane as a urinary tract infection (UTI) can change a mild-mannered Granny or Pappy into a monster with three heads.
    I wish the best for you and your dad. Since this is only the 2nd incident involving this type of aggression, I can confidently hope that this too shall pass.

    • Thanks, Irene. It really isn’t a sudden change as he has been apt to shout and curse at the aides when they try to make him take a shower and he just wants to nap. Most have learned to just come back another time and then he is cooperative. I think it was the frustration of being caught on the wrong side of the table and unable to easily get to the other side. He has never had much patience for waiting in doctor’s offices or things like that. In fact, he usually seems more patient in the ALF than he had in the past. But when there is food or a drink waiting, then I guess he isn’t willing to patiently wait. I hope he can avoid such situations in the future, and the companions may help him with that.

    • JodiMelsness says:

      Wonderful advice, even from someone not a nurse. 🙂

  4. Kathy says:

    I hope this situation works out for the best and your dad can stay where he is currently residing in the facility. My grandmother had Alzheimer’s and I found that any change in her environment that she wasn’t used to was very upsetting for her, and made things worse for her. Take care.

  5. jmgoyder says:

    I hope they put this down to a one-off situation and don’t move your dad. The facility must know what happened is out of character. Anthony is also becoming aggressive from time to time (particularly with new staff members who are unfamiliar). He, to is usually a peaceful, gentle person. I feel for you.

  6. Joy Johnston says:

    I hope your dad can stay where he is, because like you said, change is so traumatic. Those altercations can happen in memory care units as well. My dad was involved in a couple of incidents while he was there, including one time where he went to the bathroom on the floor of another patient’s room. That did not end well to say the least. I saw an incident involving someone with a walker and another resident sticking their foot out to trip them. I think it is really hard to eliminate such incidents completely in these environments, but hopefully the staff can minimize the harm they cause.

    • Thanks for your input, Joy. I didn’t realize how common this was. I did know that memory care residents tend to wonder into each other’s rooms, but I didn’t think about deliberate or spontaneous conflicts before dad had his events. It is hard to oversee care of a parent. At least with a preschooler you can keep they near you or expect complete supervision in nursery school. But for our parents, there are fewer “adults” per residents than in a preschool yet about the same mentality!

  7. M says:

    Prayers your way.

  8. I am sorry to hear about your recent struggle. I remember when my Dad went through the lashing out phase. It was hard at the time, but it passed for us eventually.

    Wishing you luck, strength and hope for easier days ahead. You are doing an incredible job with an incredibly difficult situation.

  9. Pingback: Companions Keep Dad Active | Let's Talk About Family

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