My mom is in a nursing home with dementia and paranoia. Last night she punched one of the workers.

I might punch someone out if I'd just had my hair styled and someone wanted to wash out the set!

Does mom have a regular bath night? Is there some was you can make sure that she doesnt have someone attempting to wash her hair after she's been to the hairdresser?

...first of all "Cetude" you need to not call care residents "inmates"... now about the question; Id be very serious about finding out why her hair was washed. If she's not being listened-to and staff are doing what "they want" over listening to or not picking up on signs of her distress or unhappiness that your mother (or anyone) are expressing, then a punch or strike may have been the only way your mom determined she could stop them. Staff are notorious for abuse, and yes that includes ignoring, belittling, condensending, acting as if the residents are valueless regarding their own self decisions,demands, cares and thoughts... and as many have mentioned here, I personally would not be so quick to medicate. I'd look a bit closer to the event and the entire setting, and I do mean entire, In which your mother is forced to live day after day in before any medication is requested (remember, it's allot easier to get meds prescribed, then to get them unprecribed, so be smart and think of her, not you, not the staff.)

Ask the director of nursing to get a prescription for anti-anxiety medication one hour before bathing. Sometimes all they need is a small dose of Ativan and they are not so upset.

.... I want to explain something if I may, and yes in regards to this post. Lets look at the existence of care facilities and then what our parents must experience in them. ....When we have no other place that "fits our parents needs (or ours) be it full or part time, then care facilities are (most times) our only options. Care facilities (be them any name you wish to call them) must actually "care for the persons residing. They are paid to do that very act because either we, or each state, are willing to "pay the facilities staff members" to be nothing more than courteous, patient, intelligent, reliable, alert, helpful and kind. Is that not our hope? Those are our requests that we have for our parents, yes? Indeed it is. Now the reality is this; we are not there 24/7 to watch over them. Much can and does take place each and every hour of every passing day within these "facilities. Some good, some bad. We have learned that the industry within its workforce seems to attract either the very kind or the very unkind, and then you have the ones in-between, the "its my job for 8 hours a day until I clock out." its an industry of incredibly high turnover rates in quits, fires and rehires of employees, for a reason. ...Yet, our parents live every single day in this industry. The poster mentioned her mother has paranoia, well without knowing all details, I imagine we all would have "paranoia to some degree when in these places. I imagine paranoia is only one thing they feel. I mean look at the reality; They go from independence, to dependence, and it most likely wasn't their choice. They are forced to live with having many different people come to their "space" every day. They have strangers approaching them, directing them to do this or that. They are forced to trust actual medication being handed to them and being told to "take this" They are now forced to having complete strangers bathing them (let that one sink in.)... They are now forced to be "social. They are forced to "put up with and learn staffs personalities & temperaments. They are told what they will be eating, even if its written with a smiley face on a chalk board in the "dining room" as if a "special of the day" is to be glorified. They are actually unprotected, unless they feel safe because someone has taken them under their wing or someone, a staff member, has taken a 'liking to them. They are now expected to live by rules and schedules. So the "paranoia, that many are "diagnosed with" in these facilities, may be factual, or just may be a true and (should be) a reaction to the actual environment they are now expected to "enjoy." and not complain. Facilities that are "pretty, or a smiling face that greats us as we visit, all of that may make us "feel like we made a good choice" for our parent/s .. and perhaps we have, but we dont live there, do we... they do. So if a parent is at risk, or vulnerable to being subjected to less than expected care (even an unexpected hair washing, I mean think of what actually had to take place to wash her hair when she didnt want to have it washed) and if they cannot or will not (for fear of raising problems) protect themselves when things occur (I'm talking anywhere from abuse to even a snooty or attitudinal Aid, or a grumpy nurse, etc) then someone being their voice, their advocate, their "eyes and ears and their power to do something when things go wrong, or if/when things look fishy, or strange, is very important. So take a little time and check things out for her. Thanks.

My mom gets really agitated when we try to do anything she doesn't want us to do, but she is now on meds and it helps. So if you think this was a one-time, one instance occurrence, then I'd just wait and see. But if this becomes an ongoing thing, then I'd ask the doctor for a little something.

It's possible that your mom's hair was not "freshly done" -- to her, it was just done, but it could have been a week earlier. My mom hates bathing and refuses to let staff bathe her. I am able to gently get her cooperation so I am the one who bathes her once a week. We have a little routine now that seems comfortable for her, but would be too time-consuming for staff. Yet every time, mom tells me she "just showered this morning" so she doesn't "need another shower." I am fortunate that I can be there for her, because she is quick to be verbally combative with staff over anything she perceives as "telling her what to do." And I have full confidence in the caregivers at her AL - they are wonderful.

One of the hardest parts of beginning the journey of dementia with my mom is that she's feared this disease her whole life and hoped she'd die before she ever faced it- and I thought for the first year in she kept forgetting about the diagnosis but she didn't, she wasn't ready to talk about it yet. Now that her motor skill loss has made her need nursing home care (second worst fear of her life), she was recently ready to talk about it. She knows she has good days and bad days and forgets people and remembers little details. But one of the sweetest moments we have is when we are alone in her room, she will lower her voice and say "has it started yet". The first time I thought she meant bingo! But she said, "I know what comes with this disease. I know my personality may change and I may act mean and do aggressive things someday. Have I changed yet?" And I always tell her "you seem like my mom to me!" She knows the possibilities yet she's so alert she's just aware more than most.

Sweet story, John's girl. My mom handled the diagnosis well, but her greatest fear was getting mean as well. She has gotten more "sassy" now that she is in the late stages. It started about mid stage 6. Now she is in stage 7. We look for triggers and do all we can to create a calm environment but she still has bad days...we just tell her we her and work through them. She also has good days...and some superior days. Sometimes she is fairly clear and says "I am so sorry...I was so mean" We know it isn't her so we just say "there is nothing to be sorry about, you are wonderful"and she is. One day she said, "I'm in here and I can't get out" That one made me cry

Ouch, That Hurt, Tired1of4!

Tired1of4 said, "Physical restraints is inhumane, and only the most severe mental health sufferers should ever be required, and senior care facilities are not where those individuals would be."

My Answer: Again, this happened in the 80's
1. The NH was Private Pay Only, with 18 beds.
2. Cost was $80,000 a year (1982-1984)
3. Actual item used "Posey criss-cross restraint vests" (look them up)
4. Lady I was talking about, the son was a police officer (he knew rights, right?)
5. Jersey State Inspections a few times a year. Legal and/or appropriate AT THAT TIME

Tired1of4 said, ". . .you should not be anywhere near the care of an elderly person without proper training and potentially to change your "thought process, and to remove how you were "trained" years ago."

My Answer:
a1. WHAT??? I am not the one that is exhausted!
1. I stated it was in the 80s, not 2016! Now, instead of poseys they medicate.
2. "Proper Training?" Yes, I went back to school in 1997, things had changed for the better. (BTW, I had the highest score in both Clinical and State Exam in the school's history, Clinicals-100%, State Exam 98%). I, also, have a Bachelors in Paralegalism and am a Licensed Real Estate Agent. And have a doctorate in hard knocks. ; P Currently taking creative writing classes on-line. You are never too old to learn!
3. I take offense to you jumping to conclusions and especially saying I need "therapy."
4. I NEVER restrained Grandma (stroke at 101 years old), NEVER restrained my MIL, although there were times I wanted to, NEVER restrained my Mom and don't plan on it. You are right, without a Dr. order, you cannot restrain them in a private home, I got 98% on state exam, I didn't miss that one! BTW, what was your score tired1of4?
5. I had it all to do in the NH, transferring residents who weighed 200+ pounds from bed to chair and vice-versa by myself. One good thing is I developed "guns" and hard-rock thighs at that time, I weighed a mere 120 pounds soaking wet.
6. I remember one lady who had a feeding tube up her nose, she had the wrist restraints on because she kept pulling it out, blood everywhere, YIKES! That was before we were required to wear rubber gloves and protective clothing. Yes, rules have been changed for the better. One morning I came in and one of her wrists was swollen, it was pulled too tight, I went right down and reported it!

Tired1of4 quoted me, "you then mention "I think the nursing home made a mistake giving them sugar and music etc" .

My Answer:
Obviously, you haven't done your homework on dementia. Sugar, Caffeine, Loud Music, Crowds, Loud talking, etc. can set a dementia person off. May I suggest you read, "Learning to Speak Alzheimer's" by Joanne Koenig Coste, "Surviving Alzheimer's" by Paula Spencer Scott and my favorite, "Creating Moments of Joy" by Jolene Brackey. Those are just 3 that I have laying at my desk.

My Thoughts on You

Well, to tell you the truth, after reading your profile, I decided not to bad mouth you the way you did me. I did leave #6, you can guess what the other 5 are. ; )

6. I see you are exhausted, exhaustion is the main reason to give it up, check out the section on "burned out." Also, go to youtube and watch the Teepa Snow videos and listen to her say that we caregivers stand a 60% chance of getting Alzheimer's just because we took care of them, why, because of stress. Then watch more of them to see what our stress does to the Alzheimer's person. The atmosphere around dementia is suppose to happy and tranquil, no stress. Start relaxation by breathing slowing in through the nose, then slowly breathe out of the mouth, do this 3 times. Get oxygen to that brain because when we are stressed we don't breathe right thus no oxygen, beginning of dementia!

You don't like the people working in NH. Let me tell you it is a hard, thankless job. Think about it, those people working there are doing the job a lot of people don't want to do. We know your mother, father, grandma or grandpa better than you do after a time.

Another good thing that has opened up is that if a resident does hit NH staff, a report is filed with the state. That was a rule in Jersey when I worked there but a report was never filed. That may differ region to region, here that's the law. It's helps the staff member and I can't help but wonder if that is some kind of black ball against the resident. A NH may request that a family member come and sit with the resident during the day, if things mean a lot to you or they are combative, especially in the beginning or a problem arises.

I have a little more to say to you , Tired1of4, and advice for the rest of you. Stay tuned to Part 2

To: momdoesntknowme… i loss my mom about month ago in nursing home from natural causes. Everyone in the nursing home thought she was sweet compared to other patients. She had moderate dementia. The only time she was mean when she felt like she wasn’t treated respectfully or she was scared. Most of all, she felt sad because she was missing hugs and comfort!! The way you wrote, sounded like all patients are mean and abusive to the staff. The staff needs to be more patience with people with dementia. Just walk away when you see it coming and when they calm down, go back to them. When they have sun downers, then that is when they get agitated and lash out. Right now, I’m dealing with my dad who is 89 and he has dementia (he knows it in somewhat). I back off when he gets nervous, anxious and talks mean. I have to do that because I have cerebral palsy and I can’t run. LOL

So, it takes a lot of patience! I know that the staff don’t make good money. However, I really think some staff in nursing homes blame on the patients for hitting them and won’t admit what they did. Some of the people with dementia get very frustrated because they don’t know how to express their feelings.