Dad attacked another resident-what is likely to happen now?

[Rhubarblin]

My Dad has dementia and has been in a home since January. He attacked another resident-pushed him over and kicked him. My dad is much taller than the other man. Firstly this is absolutely awful for this other resident and I imagine his family are furious and want my dad out and I wouldn't blame them. I don't have any other details re the victim which presumably is due to data protection, so I can't answer anything in that regard but my dad can kick very hard. He's also been snatching things, shaking chairs and yelling in faces.
For context, my dad is only like this due to the disease, he's very advanced in the dementia now and doesn't know who I am. He's been on Risperidone for quite some time now, the dose has been increased every few months as it seemed to work less and less, it now doesn't appear to be working at all. He can be really aggressive and I'm certain this will happen again.
I was wondering if anyone else has been in the same situation and what was the outcome? Different meds or did they have to move elsewhere or sectioned even?

Have there been any developments OP? Just bumping this as my dad is becoming aggressive in his care home. Nothing physical but it can upset other residents.

Hi OP, I'm just wondering if there is an update on how they dealt with your father?

My dad went into a nursing home recently having been in hospital for a few weeks, he has advanced dementia and his behaviour seems to be getting worse, but we think the medication he's being given is making him worse.

You mention that your dad is on Risperidone which is an antipsychotic mediation - my dad was prescribed Seroquel (also an anti psychotic) months ago and we tried him on it when he was still at home, but it didn't agree with him at all - made him very agitated and aggressive when he usually isn't, so we took him off it and tried him on Mirtazipine instead (an anti depressant) which worked much better for him. He was calm and content, eating more and sleeping better.

Unfortunately it appears at some point during his hospital stay they put him back on Seroquel without telling us. Now that he's in the nursing home just a few weeks they have continued giving it to him and it makes him so agitated.

I read something recently on the Alzheimers society website that anti psychotics should only be used as a last resort for dementia patients so maybe you could ask them to wean him off it and try and anti depressant instead.

www.alzheimers.org.uk/about-dementia/treatments/drugs/antipsychotic-drugs

We are having to fight to get my dad put back on Mirtazipine and will be speaking to the doctor in the care home next week.

Hi @Rhubarblin how are you getting on? My mum attacked staff not long after she first went into a care home, and was given 30 days notice to leave. Not ideal but social care found her another place where she has been settled now for a couple of years.

Might he be entitled to funding for continuing care so that he is supervised more? There were some aggressive residents when my Dad was in nursing care but they were well supervised.
This isn't your Dad's fault as you know and the home needs to be suggesting solutions not just ejecting someone unwell who needs familiarity.

Has anyone assessed your Dad to look at other causes for him having aggressive behaviour, especially pain?

I get asked to see a fair few old folk with dementia with distressed or aggressive behaviour and often find they are in pain, osteoarthritis being so common.

Doing a PAINAD score - or just looking at their face when you move their joints, is really helpful

dementiapathways.ie/_filecache/04a/ddd/98-painad.pdf

It’s possible that he’ll be moved to a psychiatric hospital that caters for older adult mental health. Staff there are more equipped to handle violence and aggression, but yes he probably would be detained under section 3 of the mental health act. Care homes can handle aggression to an extent but if it becomes a regular occurrence then people are often referred to more specialist provisions.

What type of care home is he in? In Scotland we have different levels, residential, nursing and EMI (not great term of elderly mentally infirm) which depends on level if care needs/medication/supervision. I know this is so distressing for you, but please understand that this is something that happens often. Has his medication been reviewed recently. As @Farmageddon says it can be difficult getting medication right. Has the care home said they are having difficulty meeting his needs? There can also be input from the Elderly Mental Health Team, Care Home Liaison Nurse whose role is it is to offer support and advice in situation like this. Unfortunately with how awful something like dementia is, this is something care homes come across frequently and will have undertaken numerous risk assessments and care plans in place to manage. Sending unmumsnetty hugs.

Oh and definitely look at what @AnnaMagnani says re pain.

Thank you for all the replies. Initially the home gave me 28 days notice for him to leave. The Risperidone has worked quite well until recently so the prescriber upped the dose again and actually it's taken the edge off the aggression. He's already on anti depressants too. As he's calmed down a touch, they've said he might be able to stay but he needs a care worker with him all the time during the day so we're looking into trying to get this sorted, SS and various other agencies are now involved.
He does actually get pain from an old injury and the home seem more aware of this, you can tell when it's bothering him and are giving him pain relief when required now too.
I think things will probably escalate again soon though. The man he attacked is terrified and won't leave his room now.
He's in a care home in England (not nursing home).
I'll keep the thread updated as not a whole lot has happened yet, nothing seems to happen very quickly I'm finding, even when someone has been seriously injured.

My stepfather slapped another resident just before Christmas. He has dementia too. He’s being held under a DOLS order. The care home notified the LA safeguarding team who did a report and spoke to myself too. He had a meds review and follow up assessment from his mental health nurse.