Dad getting aggressive in care home

It does sound as if he’s in the wrong care home, if he and one other resident are the only ones who don’t have dementia. Do the home not organise activities for residents, sing-songs, card games, film nights etc? They should.

I do really sympathise with you about the endless phone calls though. I went through the same thing with my father. It’s so depressing for you. But if he is mentally fit there is no reason why you can’t ask him not to phone you more than, say, twice a day. You might have to harden your heart and just not always answer, or switch your phone off, and if he complains tell him you are busy etc. I know you’d feel guilty but you are entitled to your life too.

Yep this.

My aunt was in essentially this same situation, she has dementia and had become aggressive with staff and other residents, their assessment was that they had to safeguard staff & residents so she had to remain in her room or that floor.

Her daughter went back to Social Services and they were able to find her a different home which had more staff, more space and staff specifically trained to handle these situations. My aunt has been in the new home for 2+ years now and is happy there however the home is further away which was the trade off.

Speak to your father's social worker. You won't have the amount of choice that you would if he was self funding, but Social Services still have to find a care home which meets his needs. So it would be worth making the argument that this care home does not.

If the SW agrees, they would need to find him an alternative placement. However it could be a fair distance away, and there would still be an aspect of confinement.

They still have to put him somewhere that will meet his care needs, though, and one of his care needs is going to be access to community and socialising, because that's one of everyone's care needs. I guess it is possible that he has been assessed as being a risk of harm to others but they shouldn't be barring him from socialising with other residents if he really has just been a bit rude to staff. I think you need to understand better what the actual problem is that they say can only be solved by him not being allowed to socialise.

I would consider looking for an advocate for him, OP - try speaking to Age UK or another charity that might be able to help you understand what he's entitled to. It's a home, not a prison, and barring him from the communal areas might mean that they aren't managing him properly one way or the other.

I agree - he sounds like he is in the wrong home. My mum became very aggressive in the later stages of Alzheimer's and it took a move from one home to another to find staff who were able to manage her and work with her despite her challenging behaviour.

This must be so difficult for you OP. I hope the neurology appointment gives some answers.

Bear in mind you only see a snapshot of your dad's behaviour, the staff know what he is like 24/7. Realistically, if he were allowed out of the care home, he would be unsafe. And he would very likely seek out alcohol.

If they are able to prevent him leaving he is likely to be under a DoLS (deprivation of liberty safeguarding). That is arranged by Social Services. It means he cannot leave the building alone for his own safety. But it doesn’t mean you can’t take him for an outing, if you want to and think it would be a good idea (it may not be a good idea).

As you say, he is disabled, alcoholic, doubly incontinent. He cannot manage on his own and a care home is really the only place for him. I doubt staff in a dementia care home are bothered about a resident just being ‘rude’. My mother is in a care home and the staff have no problem dealing with rudeness, unless it degenerates into abuse or aggression. The manager has to safeguard both the staff and other residents.

If they cannot cope with his behaviour other than by confining him to his room, there may be another care home which can.

As a side note, everyone is assuming you are in England but if you are in Scotland it wouldn’t be dols but welfare guardianship, but same thing applies in speaking to social work about it.

You need to ask them to refer him to the older peoples mental health service
He must have a social worker because someone has placed him in the care home and is paying the fees and if that la not him it's the LA
The key questions to ask for he manager are

• does he have a DoLs (deprivation of liberty safeguard) and if not would they please refer him
• can they refer him to mental health or get the GP to do so

The fact he's lost his mobility will be his age and the length of time he's spent in bed. This happened to my dad in his care home. It's their age; the inability to recover motility like a younger, stronger person would.
The being rude/aggressive stems from his frustration all round. It'll be the only way he can express himself. Again, my dad did the same. (When he first went in and was mobile, he used to go to the office, where the staff were busy working, open the door, smile at them all and turn the light out and close the door!!! Along with unscrewing light bulbs with a dinner knife! He knew what he was doing, it was definitely a f**k you!!!)
It's good that he's dry now, but if there's a pub next door, that's so much temptation, especially given that he's frustrated by his circumstances. Doesn't the home have any staff that could accompany him out for a "ride" round the block, just to get out and get some fresh air? My dads care home had staff provision for this every now and again.
But I would definitely address the fact that he's being kept confined to his room, with Social Services. His mental capacity will start to decline if he isn't able to mingle with anyone but staff! I've worked in a few nursing homes in my time and visited a few and I've never known this to happen.
I hope you can help to resolve this somehow 💐

I would revisit the idea of dementia. Changes in personality, increased aggression, mobility issues - it could be both alcohol issues and dementia iyswim. It could be worth investigating again.

As others have said, they cannot legally restrict your father's movements if he isn't under a DOLs. What are the homes reasons for restricting his liberty ?

If he does have mental capacity, and definitely had no dementia, then you need to find his social worker and discuss things. If you don't think he had one then you need to contact your local authorities adult social care. Maybe now his condition improved slightly, a different placement would suit his needs better?

Well one of the simple solutions is that he commits to stop being aggressive and rude to staff. I don't see why everyone is jumping in saying care home are out of order. Staff deserve to be in an environment where they are not being abused verbally. If your dad does not have dementia then he is perfectly capable of being cordial even if he doesn't agree with the staff.

He may also benefit from an advocate OP to help him get his own views across. See if there are any advocacy organisations in your area who support older people or people with cognitive issues but he would have to agree to this too.

You need to speak to the local authority about it again. It’s not legal for them to keep him there unless they have a legal order which would involve proving he isn’t able to make his own decisions. Whatever the case with that they need to look for creative solutions as pp said.

I apologise for assuming he wanted to go to the pub to drink. I guess they may have assumed the same.

They really can't just decide to imprison him, whatever the circumstances. I would talk to his social worker and the nursing home manager and I would tell them that unless this can be resolved immediately that you'll be making a complaint to the Care Quality Commission. We (well my sister) did this when there were issues with my mother's care and it was helpful.

I'm sorry you're having to cope with this. Can you turn your phone off for patches of the day, or at least just don't answer it?

Not their choice to make though Assuming no DOLS

So they’ve basically put him into solitary confinement. It’s inhumane and it sounds as if he needs an alternative solution.

Honestly letting an alcoholic leave a care home to go to the pub is reckless and they can't support that for obvious reasons..

He may not have been drunk in the care home yet but let's face it if he could get to that pub he'd be drinking. He's an alcoholic and he hasn't voluntarily given up he's 'abstinent in a protected environment' I can see why staff don't want him out and about to the pub in his wheelchair.

There needs to be a creative solution like him being facilitated to go out with a carer and have a soft drink but it will cost money for 1:1 that social care will be reluctant to spend. The DoLs process can be useful in forcing their hand on that.

Well they can't officially stop him from going out or restrict his movements if he has mental capacity to decide. If they feel he lacks capacity to make that decision they need to get a DoLs (deprivation of liberty safeguard) authorisation to certify that it's in his best interests and make it above board.

I'm afraid they can and very likely will give him notice to leave if he causes them lots of trouble by going out drinking and/ or being abusive to others. Care homes are private institutions these days and they can pick and choose who they admit. No care home is going to be happy to support an alcoholic who wants to go out drinking and come back drunk and abusive. Then it will be up to the social worker who placed him there to find him a different place. Either way it is not up to you to have to do this.

Does he have an official diagnosis of alcohol related dementia? Ask the GP to refer him to the mental health team to have this confirmed and to comment on his capacity and behaviour. The social worker or the care home might do this anyway.

Wow, that is horrendous, your poor dad. Surely that is not allowed?
Sorry I'm not in the UK but where I am we have plenty of aggressive residents and no one would ever dream of "banning" them from leaving their room, plus it'd be considered an illegal restraint. Isolation is elder abuse.
We would be focusing on managing the behaviour instead.
I hope you can work something out.

Do you think he's being rude and aggressive to the other residents? Is he upsetting them?