It’s not all that common, but violence can be a part of dementia and when it is, you need to be alert

If your loved one is in a care facility, be sure you know how it handles violent residents, and understand you need to be a part of keeping your family member safe.

         YOU LEARN SOMETHING every day. Or maybe you just see something that confirms what you felt.

            This morning our local newspaper had an article penned by KFF Health New, a news agency that focuses on health issues. I’ll post a link at the bottom to the article I read this morning.

            It’s about violence in care facilities, and violence among patients with dementia specifically.

            I think I always have known that violent behavior can be an act-out with some dementia patients. Statistically it’s not a large number, but it is one that can have serious negative impacts on other patients, families and staff.

            It’s interesting the article appeared in our paper this morning because I’ve seen subtle signs of this in the care facility Connie is in. Let me hasten to say no one has been hurt, the violence has been more verbal, more self-directed and in some cases, unintended. But it’s something to think about.

            The KFF article zeroes in on one case, something that journalistically works to make a point but doesn’t always tell the whole story. I’ve seen nothing like what the article portrays, but if you look at the statistics that accompany the piece, there is enough there to cause concern.

            Violence can range from yelling, screaming, to upending furniture to groping in a sexually inappropriate way to outright attacks. At some point, almost any facility is going to experience it. Often it’s why a family decides it no longer can care for the person in the home. It’s probably more likely in facilities without a pure memory care unit where dementia patients are isolated, as opposed to where they mingle with other assisted living and nursing care patients.

            It’s at this point the facility does make a difference and anyone who is evaluating facilities needs to ask a pointed question: What do you do about violent patients?

            The KFF article quotes advocates who say many for-profit centers seem driven by a need to fill beds and so take patients that probably they should not; and even tolerate behavior that should not be tolerated.

            In our case the facility is faith-based and not-for-profit. It does not have to worry about filling beds. It has a waiting list for personal care, nursing and memory care. I know it takes serious violent or even improper behavior. There have been incidents, fortunately not serious, where I know staff has worked with families to learn about and control their loved one’s behavior. I also have no doubt that if improper and/or violent behaviors escalate beyond a certain point they would remove that resident.

            IT’S A TOUGH CALL, and one I’d hate to make because finding an affordable place for a loved one with dementia, or any other conditions that require residential care, is not easy. As I have pointed out before, a study not long ago found that 80 percent of Americans over 65 would need long-term care at some point and only 80 percent of that group could afford it without, at some point, going broke. Most care facilities, particularly the not-for-profits, know that and will do all they can to avoid eviction.

            But, as family of someone with dementia, if you put them into a care facility you need to be vigilant. To the extent your loved one is cogent, listen to them if they talk about behaviors that don’t seem right, particularly if directed against them. Talk to staff regularly. Be observant.

            I am in Connie’s facility every day, sometimes more than once a day. I watch. I listen. I know the residents who may have tendencies to act out. I know residents who may be verbally abusive. I accept they cannot help it, but I don’t ignore it. I don’t hesitate to talk to staff if I have a concern.

            We’ve always been told that we need to be observant about whether our loved ones in care are having sheets changed, hygiene kept up, are they eating, drinking enough water, getting exercise and so on. 

            But now, we need to add violence to the mix. Is our loved on safe? In most cases the answer will be yes, but to keep that answer “yes” means you have to be present and aware. You can’t leave everything up to staff, no matter how good or vigilant that staff is.

‘Scared to Death’: Nurses and Residents Confront Rampant Violence in Dementia Care Facilities

            Rich Heiland, has been a reporter, editor, publisher/general manager at daily papers in Texas, Pennsylvania, Illinois, Ohio and New Hampshire. He was part of a Pulitzer Prize-winning team at the Xenia Daily (OH) Daily Gazette, a National Newspaper Association Columnist of the Year. He has worked as a consultant doing public speaking and business training specializing in customer service, general management, leadership and staff development. He and his wife, Connie, live in West Chester, PA. He can be reached at [email protected].