Can you recommend a website for answers in dealing with nursing homes?

1whocares asked...

father has Alzheimer's with psychosis and agitated features. His disease has progressed beyond where I am able to take care of him at home. Caretaking for my father presented many issues that I found answers for at this website. Where do I go to find out how best to handle issues that arise with the nursing home. For example, angry outbursts that threaten to cause injury to staff and residents, overmedication, falls, and a disconnect with nursing home doctors. The smaller issues are resistance to care, bathing, and taking medication. I have found so much helpful information here that got me through tough times with my father at home, but I find the nursing homes resistant to outside information or suggestions. I realize that their load is heavy, but I feel like I'm talking to a block wall. This is the second nursing home as Dad was kicked out of the first one when they found him too difficult and unsafe for the staff to manage.

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

I'm sorry you're facing such a daunting situation. I wish I could provide a specific answer for you, but there are some factors that were not included in your query that would provide more input and allow me to give you a more complete answer. Therefore, I'll make some assumptions, which may or may not be correct, but as I stated, without knowing more, it's very difficult to provide a "perfect" response.

I'd be interested to know if your father has been evaluated by a geriatric psychiatrist and a geriatric neurologist to fully determine the basis of his psychosis, agitation and angry outbursts.

Are the nursing homes you've used in the past and are currently using specifically designed and staffed for Alzheimer's patients, particularly those who have certain behavior patterns such as your father is demonstrating? Not all nursing homes are equipped, nor their staff trained for difficult, abusive or combative patients. If his current residence is not an Alzheimer's specific type of facility, that could be part of the problem.

Are your father's doctors, particularly his psychiatrist and neurologist aware of his increased combativeness and outbursts? Who is monitoring the levels of anti-psychotic drugs that he may or may not be receiving. There's no doubt that violent types of behavior can be controlled by proper levels of certain medications, but some drugs have unwanted side-effects and must be even more carefully monitored.

Talk to the Executive Director and the Director of Nursing at the facility and calmly share your concerns. Try not to "tell" them how to care for your father, rather ask what can be done to keep him calm, safe, happy and well-cared for.

What you must also be aware of is that certain facility clients, perhaps such as your father when combative, create a situation for facility staff that may jeopardize their personal safety. In all cases, while the patient must be of primary concern, so too is the safety and concern for the staff. They are not expendable and are often in situations that require steps be taken to protect them from harm by physically stronger, larger or out of control patients.

There is almost always a solution, but it requires a complete team effort, and there's no reasoning with your father in his current state. By partnering with his doctors, both inside and out of the facility, and seeking cooperation and teamwork from the facility staff, you have a good chance of finding the perfect mix of prescription medicines and approach to his care to insure that he will be in and remain in good hands. Best of luck.