Dad getting aggressive in care home

[Remmy123]

My dad is 77 he was an alcoholic and lost mobility so kept falling over .. spent months in and out of hospital, had carers that came but it wasn't enough he had terrible bed sores, feaces on carpet etc drinking all day

Hospital sent him to a council funded care home. He was in bed for months recovering (still none the wiser as to why he now can't walk) i thought he had dementia but he has put weight on and memory has improved so much so I don't think he has.

we got him an electric wheelchair and he thinks he can now do what he wants and go out alone.

he gets v rude and aggressive to the staff they have now banned him from leaving his room so he is now stuck in his room. He can't go to the lounge or restaurant downstairs.

he kd like this because he feels like he is being treated like a baby and has lost his freedom. It's not all the time as staff say he is really funny and lovely and so he volunteers.

i took him to the lounge yesterday and everyone had dementia and not with it at all and only my dad and one women had mental capacity.

my dad can't live alone and he can't live with me but he is calling me 6 times a day saying he is suicidal that he can't stay there. That they won't let him downstairs. Why can't he go out etc

I feel drained from this I am having a call with the manager as they can't leave him in his room

I'm worried this is it now fior tears and years until he dies stuck there with no freedom but he can't live alone!

not sure what I can do to make life more bearable and can only visit on de a week

thanks

None of this sounds at all good. Is your dad under a Deprivation of Liberty? Where do you think he wants to go - is it to buy alcohol, go to the pub, go home or just to get out and about?

I would speak to his social worker about the fact they are denying him his liberty. You cannot just confine someone to their bedroom without processes in place. I would also question how they are doing that if he has an electric wheelchair, if they are refusing his request to be hoisted into his wheelchair they need to evidence why they have removed that choice.
If he has capacity there is nothing stopping him from choosing to live elsewhere but if the LA are funding his care he will struggle to get agreement to move.

Thanks both for responding. I have never heard of depravation of liberty .. I will google it now.

he wants to go to the pub as it's right next door however I've told him he can't alone so he gets that now. He calls me saying he wants to go into his new wheelchair and they have refused this as he gets demanding asking to go down to the lounge etc so I asked them
to put him in his bedroom chair instead for now.

yesterday he was in his wheelchair but they knew I was coming so I took him downstairs a and it was fine

today he has called so many times and they said he isn't allowed downstairs only up and down the corridor until I speak to the manager because the other week he was rude to the staff! So he is basically banned!

I said you can't confine him to his room and a corridor!

the LA are funding his care it's unlikely he will be able to get a flat - I gave back his warden assisted flat as it was on the third floor and now I'm thinking I've made a huge mistake. However he is double incontinent / an alcoholic / disabled with no money!

Right so he wants to go and drink. And smoke maybe?

This might be one of those impossible situations. I can see why staff don't want to care for him when he is drunk, and have perhaps decided to stop his ability to go looking for alcohol, along with refusing to put him in the wheelchair so he's not mobile. But there would have to be some kind of process covering this, they can't just imprison him.

I think you need to talk to the manager and to the social worker he presumably has? It sounds as if he desperately needs an addiction support worker. Do you think he would agree to that if his GP would refer him? And when did the GP last see him?

Thanks - he is dry but when I say he wants to go to the pub he just wants some freedom. He isn't asking for alcohol as such but can't understand why he can't go out on his own.

but now he is r being refused to go into his wheel chair and go downstairs to
the restaurant etc so stuck in his room

he has never been drunk in the care home

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

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.

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.

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.

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

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

Not their choice to make though Assuming no DOLS

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?

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.

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.

Thanks all - I am hoping the manager will call me today

can I reiterate he has NEVER been drunk in the care home and he is nice to the residents but he does get aggressive with staff when they refuse to lift him into his chair or treat him like a baby.

he called me dozens of times last night as now he thinks someone has got it in for him downstairs in the home now he is paranoid!

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.

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?

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 💐

Thanks very much all

he hasn't even been tested for dementia .. he hasn't even been told why he can't walk his legs kept giving way , he then became double incontinent.

he is on a long wait list for a neurologist it's been months!

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

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.

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.

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.

Thanks all

they responded to tell me he isn't confined to his room only but he is confined to that floor (first floor no restaurant / activity room / outside space)

they say when he comes downstairs he is rude and aggressive to staff and residents

i was downstairs with him Sunday and staff and family members told me my dad is a good laugh and is lovely!

not sure we can choose an alternative care home because he hasn't got any finances at all .. didn't have own property etc