I am making the 100 mile trip tomorrow to visit the head of nursing at the nursing home where I placed my brother J.R., who has dementia. Sunday after church I noticed the phone call and voicemail message from the nursing home. J.R. had become aggressive when an aide tried to redirect him. Before I tell you that story, let me tell you my story from my December 11, 2014 visit to that nursing home.
On December 11, 2014 my daughter and I went to the nursing home to visit J.R. We had a good visit this day because J.R. was alert and talking. We stayed at the nursing home about 1 1/2 hours and then walked to the front door to leave. There was a patient sitting in her wheel chair directly in front of the door. I knew they would not want her to go outside, so we hesitated, we did not try to open the door. One of the nurses Jane (named changed) saw what was happening, all she said before she rushed down the hall was, “Wait I will go get Barbara (name changed),” and away she went. A lady wanted to come in from outside, I saw she was not going to open the door and come in because of the woman in the wheel chair. So, I walked toward the wheel chair, took the handles and pulled the wheel chair backward away from the door. The lady outside came in the door. Oh my, what a mistake that was to move the wheel chair. I had no idea this patient could become so violent, the nurse that rushed down the hall to get Barbara did not tell me about that problem. The patient in the wheel chair, looked around at me, with a vicious look on her face and swung her arm at me. I jumped back, She threw out a string of profanity that would make a sailor blush, calling me some horrible names. She came at me in her wheel chair telling me she was going to kill me. I ran around a couch, she would try to come around the couch, I would do an about face, she would whirl and go the opposite direction. Finally she stopped chasing me and went back to her position in front of the door. Shortly after that Barbara arrived and tried to talk her out of going outside, saying it was cold. I could tell Barbara was afraid of this lady. Finally Barbara gave up and took the patient outside. We left the nursing home.
If I had known this lady had violent tendencies I would not have touched her wheel chair. I knew that was not the way to handle an aggressive patient. You do not startle them, touch them, crowd them, corner them, raise your voice, or try to control them. You speak quietly and try to redirect them.
What causes a dementia patient to become aggressive. According to the National Alzheimer’s Association – Medications, lack of sleep, infections, noise, getting in their space, and several other things. My brother has all of these problems, his feet and his legs from the knees down are swollen like rocks. They cannot get him to sleep and they change his medications constantly. So what happened in the following confrontation is similar with the problem I had with the patient in the wheel chair.
January 25, 2015 a nurse (Alice, name changed) called me from the nursing home. They told me my brother J.R. had become aggressive and injured an aide. The aide had confronted J.R. because he was pushing a lady in a wheel chair down the hall. The patient in the wheel chair was yelling and was quite upset because she did not want to be pushed. The aide tried to redirect J.R., but that did not work. The aide then placed herself between the handles on the wheel chair and J.R. J.R. grabbed the aide’s arm and twisted it behind her back. Needless to say, he injured her arm in some way. The aide confronted J.R. just as I had confronted the lady in the wheel chair in December. She stepped into J.R.’s space and tried to control him physically. The nursing home has made a report on this issue.
I will not know until tomorrow if they will ask me to place J.R. in another facility or whether they will add more medication. Nursing home staff members need to be trained in how to deal with aggressive patients. The stress never seems to totally disappear even when you place your loved one in a care facility.