My husband is in an ALF. They have been having a lot of problems with anger. They suggested I move him to another facility. The woman told me its a house and there are only about eight patients. The ALF thinks it would be better there because it would be a quieter place and there are few people. I don't know what to do any more. What other options are there when there is a big anger problem? Would a nursing facility be more able to deal with this type of issue or would they just medicate him? Thank you
In such a small environment, you would probably find (and I am only assuming this) that they would have ALOT of 1:1 time with your husband. Being such a small environment would reduce the tension for him and give him less things to get angry about.
Medication would not be ruled out, but more than likely used as a last resort so he doesn't hurt himself.
You will need to do some BIG research on this and ask LOTS of questions ...
* What kind of therapies are offered? Therapies include: Aromatherapy, massage, Reiki, Physical therapy, walking, outings (probably not in his case .. creates more behaviours) etc etc.
* Staff ratio? How many staff are rostered on at ALL times of the day and night?
* Are there any PRN orders (as needed) for medications? (This means he's not regularly medicated, only as required)
* What is supplied? What is required?
* Are there regular doctor visits? Regular medication reviews? Is there qualified nursing staff or personal carers?
My mother is in a very large facility ... capacity 700, present population over 600! BUT, they are dvided into small units of not more than 10. Mom eats and sits around and goes on outings and watches TV or plays bingo with the 10 people in her unit. She is in a single room.
When someone takes her outdoors into the couyrtyard there may be people from other units, but they all seem to know her by name, perhaps because few people are 'fresh air fiends' as she is ... and my brother has made an effort to get to know everyone he regularly sees.
Advantages of a large facility - doctor on duty all the time, ratio of staff to patient about 3/1, efficient medicine and food distribution, variety of activities, church services and concerts offered regularly, etc.
I would have thought a small facility had more intimacy and closer relationships, but as I see Mom withdrawing into her own world more and more, it now makes no difference at all whether she is at home, in a small facility, or a huge one - she has little idea where she is.
I am glad she is safe, warm, watched, under a doctor's care, given her meds, fed, kept clean and dry, and in a loving atmosphere. Many of the nurses and aides are from the West Indies, and such loving and caring people are amazing. I greatly respect and admire all nurses and helpers.
Maybe your father could stay where he is if the doctor prescribed a medication to reduce his angry outbursts.
If his anger is causing him to threaten other patients or strike others, there is no doubt he will be placed on some sort of medication. My FIL went through an aggressive stage in his lockdown unit with only eight other people so I don't know that a smaller place would be that much better in terms of keeping him calm. I will note he did tend to have there episodes after being taken out of the unit.
The doctor reduced his sleeping medication recently because he seemed so lethargic all the time. Presently, he is on three or four medications designed to keep him calm. The last two times we visited he was calm as well as alert and could respond to questions. He says he is fine and the aggression is gone for now. If he had continued to strike staff or other patients the only alternative was a psychiatric ward where he would have been placed on drugs as well.
My Mom has had no issues with physical anger or being physically violent. So this was not something I even considered when I was seeking 24 hour care for her. What I learned is that this is one of the first things they asked when I inquired about their ability to care for her. None of them were prepared to take her if there were prior anger or violence issues. I checked with probably 20 places in all, all different kinds of places. I pray this never happens. At least according to the checking I did, there's only one place that will take them if they have developed a history of sudden anger or physical violence. So I hate to offer even more possible problems, but you may be limited in your choices.