First time visit to a secure dementia unit ! Does it get easier ?

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Captainchrissie
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Date Joined Aug 2013
Total Posts : 10
   Posted 8/16/2013 12:26 AM (GMT -6)   
Dad has had dementia for 5 years , recently had a bowel operation and he is declining fast so we now have to put him in a dementia unit.
I saw a lady in the late stages which terrified me and it was so clinical .it is the only place available . Am I just in shock or is this what the norm is ?
The staff were nice .

Red_34
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Date Joined Apr 2004
Total Posts : 23547
   Posted 8/16/2013 7:00 AM (GMT -6)   
When my gma had her bladder removed, her kidneys started to shut down and she ended up with a nephrostomy tube coming out of her back. Every 6 months she would have to go in and have it replaced. Each replacement was harder on her mentally as the years went by. People with dementia have a hard time with anesthesia and pain medication. It highly disorientating to them.

Your dad may bounce back a little when he recovers but unfortunately there is no guarantee. And yes, there are other options available. Once he recovers from his surgery, he can go home with you or another family member, you can hire a full time care giver that can go to his house, if he lives alone, he can go into an assisted living center that caters to dementia patients. But whatever you do, please do not put him in a nursing home. Nursing homes are very institutional and can be an unfriendly place.
SHERRY
Moderator-Allergies/Asthma, Alzheimer's, IBS, Co-moderator-UC
Diagnosed Left sided UC '92 - meds: Apriso, Remicade (6mp discontinued due to neuropathy)*Unable to tolerate ALL mesalamines*, IBS, Diverticuliar Disease, Fibro, Sacroiilitis, Raynauds, OA, PA, Rosacea, Psoriasis, Dry Eye and allergies controlled by Zyrtec and Singular

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/16/2013 7:14 AM (GMT -6)   
Thank you , the problem is he is suffering sundowning and gets violent . So we have tried him at home and it was too hard on mum.i am not sure of round the clock care as very expensive

Red_34
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Date Joined Apr 2004
Total Posts : 23547
   Posted 8/16/2013 7:16 AM (GMT -6)   
Is he on medication to help stabilize his sundowners? Such as Namenda?
SHERRY
Moderator-Allergies/Asthma, Alzheimer's, IBS, Co-moderator-UC
Diagnosed Left sided UC '92 - meds: Apriso, Remicade (6mp discontinued due to neuropathy)*Unable to tolerate ALL mesalamines*, IBS, Diverticuliar Disease, Fibro, Sacroiilitis, Raynauds, OA, PA, Rosacea, Psoriasis, Dry Eye and allergies controlled by Zyrtec and Singular

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/16/2013 7:31 AM (GMT -6)   
He was on something with a t a yellow wafer

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/16/2013 7:33 AM (GMT -6)   
I hated the place , it was horrible I have just woken from a nightmare about it .i have written to my brother about any alternative

Red_34
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Date Joined Apr 2004
Total Posts : 23547
   Posted 8/16/2013 7:51 AM (GMT -6)   
Hopefully you can find a suitable solution. I wish you all the best!
SHERRY
Moderator-Allergies/Asthma, Alzheimer's, IBS, Co-moderator-UC
Diagnosed Left sided UC '92 - meds: Apriso, Remicade (6mp discontinued due to neuropathy)*Unable to tolerate ALL mesalamines*, IBS, Diverticuliar Disease, Fibro, Sacroiilitis, Raynauds, OA, PA, Rosacea, Psoriasis, Dry Eye and allergies controlled by Zyrtec and Singular

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/16/2013 7:52 AM (GMT -6)   
Thank you , it is such a worrying time

Together With Alzheimer's
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Date Joined Jul 2013
Total Posts : 5
   Posted 8/16/2013 1:02 PM (GMT -6)   
Placing your loved one in a nursing facility is a heartbreaking task. Sorry you and your family are enduring this difficult transition. There are a few things you need to do asap: if you have the Power of Attorney, request that the facility give you a copy of the Physician's Orders. This is a listing of all medications, and standing orders for every treatment that has been ordered along with the frequency and duration of each treatment. If you're not the POA, ask that person to request the Physician's Orders. With that in hand, you'll know which medications are being used. Look each one up online, download information and keep it in binder so you can refer to it. If you're not sure why each medication is being given, call the charge nurse and ask. The thing about meds is that they are often misused. Alzheimer's patients are like you and me--medications leave them feeling sickly. Many times, getting 1:1 companionship and assistance for your loved one will deter the behaviors. Don't forget, persons with Alz. suffer from diminished ability to communicate with words. But they CAN and DO communicate, with their behavior. Behavior isn't merely good or bad; through behavior, the person with Alz. is telling us something. Our job is to figure out what that person is trying to tell us. It's not easy, but if you observe carefully, this can be done. Once you know what's wrong, you'll be in a better position to correct the issue. Also, there ARE long term care facilities that use psychotropic meds sparingly. They're not easy to find, but they ARE around. With high staff to resident ratios and a ton of engaging activities, persons with Alz. are able to function at their fullest, without medications! Believe me, if I had it to do over, I'd find this kind of facility for my mother and place her there. So, do me a favor--do this for your loved one. My thoughts and prayers are with you.

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/16/2013 3:11 PM (GMT -6)   
He is still in the general hospital at the moment and is having really bad days .
Mainly wanting to escape
Up all night
Trouble with swallowing
Violent episodes
I will find out today the meds he is one and yes look them up
He is meant to go to the dementia hospital on Tuesday and every fibre of my being hate it ...thank you everyone for advice

Together With Alzheimer's
New Member


Date Joined Jul 2013
Total Posts : 5
   Posted 8/17/2013 6:52 AM (GMT -6)   
I don't recall if your dad was having difficulty swallowing before he went to the hospital, but, regardless, check to see if swallowing issues are a side effect of any of the meds he's on. Check the same for aggressiveness. Also, what is his oxygen intake like? Low oxygen can also cause violent episodes, panic, etc. Running away almost makes sense, given his situation--we are hard-wired for flight vs. fight. Don't forget, hospitals aren't equipped to deal with this type of behavior, except with meds. Transferring him to a dementia unit may provide him the respite he needs, given the staff there knows how to help him. Be sure to make an appt. to speak with the charge nurse before he gets to the unit. This will be a step toward establishing a solid working relationship; it also demonstrates your commitment to his care. If you're not happy with what this unit has to offer, find another situation for him, preferably before he's discharged from the hospital.
Catherine Gentile, Editor
Together With Alzheimer's
http://www.catherinegentile.com/Together_With_Alz.html.

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/17/2013 7:21 AM (GMT -6)   
OMG , it sounds so technical ! Of course it does we are dealing with a persons life !!!

I phoned my brother with all these questions in a previous post and he diddnt want to know

He is going to New York tomorrow for work from Australia and will be away for the transgression from the hospital to the secure dementia unit. I had big honest talk today and he just said the home would be better as he will have his own doc , etc

Thank u for helping me ,

Yes ,my hank you so much .i went against to the unit again today and one of the nurses I knew indirectly , I tried to form some sort of personal bond that dad is my loved one . Thank u

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/17/2013 7:23 AM (GMT -6)   
How do I. Know about the oxygen intake

Together With Alzheimer's
New Member


Date Joined Jul 2013
Total Posts : 5
   Posted 8/17/2013 8:22 AM (GMT -6)   
Re: Oxygen intake: ask your dad's nurse what his oxygen level is. They should check this when they check his blood pressure; they usually put a clothespin like object on one of his fingers to get a reading. Good oxygen intake gives a reading in the 90's, but google this to be sure (this is part of being an advocate; doing the research and becoming informed lends authority to your questions, which, in turn, causes the staff to take notice and respond accordingly). BTW, if the nurse doesn't know what his oxygen level is, ask her/him to check it.
Catherine Gentile, Editor
Together With Alzheimer's
http://www.catherinegentile.com/Together_With_Alz.html.

Together With Alzheimer's
New Member


Date Joined Jul 2013
Total Posts : 5
   Posted 8/17/2013 9:08 AM (GMT -6)   
Here are a couple more possibilities: 1) is your dad dehydrated? Ask the staff how much liquid he's had since his surgery. They should be able to give you a day by day report. Dehydration is a huge problem, particularly among the elderly. Having said that, not drinking 5-8 glasses of water/day will affect anyone, not just those who are elderly. 2) Might your dad have a urinary track infection? UTIs can cause very difficult behaviors. If your dad hasn't been tested for a UTI, ask the staff to do so.

Given all the possibilities we've been discussing, don't forget what Sherri said: that undergoing surgery and coming out of anesthesia can be very confusing, esp. for someone with dementia. Also, in the elderly, it takes longer for the anesthesia to wear off, so your dad may be suffering from side effects of that. The effects of the anesthesia together with the side effects of whichever other meds he's taking may be contributing to his behavior.
Catherine Gentile, Editor
Together With Alzheimer's
http://www.catherinegentile.com/Together_With_Alz.html.

Gizzy'n me
Veteran Member


Date Joined Jun 2013
Total Posts : 1870
   Posted 8/17/2013 10:00 AM (GMT -6)   
To Captainchrissie:
 
   I don't recall seeing your Dad's age ... or the health of your Mother. But, irregardless of both, care for your Dad will be demanding. It may be too much for your Mother to handle even after his surgery recovery period. And whether it's in his own home with 24/7 trained care or in an assisted living enveronment for dementia, it will be expensive too.
   One thing for certain, as someone else here said, a "nursing home" is likely the last place you would want to see him go. As painful as it may be, you want to visit a number of facilities for care and try your best to evaluate them. Since your Dad is still in the hospital, you have a little time but probably not much - unless he could go into a rehab facility for a few weeks before needing to go into a more permanent place. However, few rehab facilities are equipped to handle dementia patients.
   There is, I'm afraid a good deal of research ahead ... but it's needed to make the best decisions for your Dad - and your Mom. From what I read here, the POA (power of attorney) would be good for you to have - at least the medical POA, if your Mother has a hard timemaking decisions. The blood oxygen level may be more necessary for an Alzheimers patient than a Dementia patient. Ask your doctor. 
 
   A brief background of my experience and medical conditions:
I have had COPD for over 5-years, so I'm very familiar with the blood oxygen level. In fact, I have my own meter I use occasionslly at home. It's a very simple quick procedure, and in my case - when I have my blood pressure checked, they check my blood/oxygen level at the same time - because I have COPD. That's essentiallyObstructive Pulmonary Disease caused by Emphysema.
   Last Saturday, when I was at my Psychologist, I asked him specifically what the difference was between Alzheimers and Dementia. There is a substantial difference in cause, in treatment and sometimes even in age of diagnosis. I asked because my Mother has been suffering with Dementia for over three years now ...how much more ... we'll never know, because she hid it so well.
   Her trip started officially on Easter of 2011. She had been living alone for over 15-years (since my Father died) and was still driving in a limited way as late as 2011 when she was 93-years old. She fell in her own kitchen on Easter Sunday. I found out, and met her neighbor at the hospital that morning. After three weeks in the hospital for observation mostly, her doctor said she can go home - but not alone. she has to have a licensed and insured 24/7 caregiver ... which we did.
   My house is a 40-mile round trip, and it's a two-story - so movingin with me was not an option even with a caregiver hired. Then, she is a very independant person ... refused to leave herhome ... so for the 15-months, she lived with a caregiver and I was over once or twice a week plus on the phone daily.
   Last August, the Dementia got worse .... episodes in the middle of the night and slightly violent. She was admitted into the hospital because she insisted someone in her house, late at night, was trying to kill her. She was under observation for over 4-weeks, and then I was told she could not go back home - even with a caregiver. They did not have the medical expertise to handle her at this point.
   And so, my search for a place for her started. I went to 6 different places, two of them were equipped (I thought) for her. then one of them called me back and said, after looking at her hospital records, they would not be equipped for her - but they did give me a recommendation
  And that is where she is now ... and has been since September of 2012.
 
   It is an Assisted Living Home for Dementia and Parkinsons patients. It is infinitely better than the one "nursing home" I went to see and not much more expensive. It is the closest, in its physical presence, to a large home ... actually 4 large homes - each with a capacity of 20 patients max. They have terrific programs there to stimulate the mind. They do not allow the residents to just wither away in their rooms in front of a TV alone.
   I did a financial study recently, and I found that it actually was costing a little more money for Mom to have a live-in caregiver at her ownhome than living in this Assisted Living Home. But - she was alone, except for the caregiver - and only one SS check and partial pension check was coming in.
   There's no question about it ... either is an expensive proposition. In my Mom's case, her lifetime savings have been going for over two years now - and will not last much longer. Since her home had been sitting there for nearly a year unoccupied ... I decided to sell it months ago. The closing was two weeks ago ... and now her new bank account has enough in it to keep her at the Assisted Living Home for close to three more years.
 
Difficult decisions ...... maybe too hard for your Mother to make. In both of their best interests ..... you probably should have Power of Attorney for both medical and property. And that's a tough thing to face too. I know, I had to do it!
 
Good luck on your decison-making ... and to your family.
 
Rob
 
 
 

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/17/2013 3:59 PM (GMT -6)   
Thanks everyone
Yes I saw them put a clip on his finger ,but he refused it .
Mum is in her late 70's very healthy but also very tiring for her so we help with cooking her meals and staying with dad .i looked up 7 stages of Alzheimer's and dad is at 6 .

I went back o the dementia unit and felt a bit better about it they staff have been there for a very long time which I thought was a good sign .

I spoke to my brother of my concerns and he just says the home will be good as dad will have his own doctor and they will sort out the meds there .

Dad goes on Tuesday my brother wants him to go in an ambulance I thought that might frighten him

Dad is 80

Captainchrissie
New Member


Date Joined Aug 2013
Total Posts : 10
   Posted 8/17/2013 4:01 PM (GMT -6)   
They are always saying his urine is too concentrated . He refuses to drink much , I read about thickening the liquid a bit and that helps

Together With Alzheimer's
New Member


Date Joined Jul 2013
Total Posts : 5
   Posted 8/18/2013 3:50 PM (GMT -6)   
Interesting that your dad does better taking liquids when they are thickened--this is a great strategy! It's important that he takes in sufficient liquids; if this is the way in which he get liquids into him, keep it up. I'd also ask for a swallow evaluation; that way, if and when he's transferred to another facility, the information concerning his swallow function will be included with his reports. Between his behavior and the dark concentration of his urine, it sounds as though he is dehydrated. Dehydration and also cause medication reactions...which might explain some of the behavior you've described. Keep up the good work; you're making good inroads.
Catherine Gentile, Editor
Together With Alzheimer's
http://www.catherinegentile.com/Together_With_Alz.html.
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