Support needed in nursing homes dealing with aggressive dementia residents

Above: Shirlee Engel reports on how dementia can cause aggression and how most care homes struggle to cope.

TORONTO – His brain clouded by his worsening dementia, 70-year-old Joe McLeod shoved another man at their Winnipeg nursing home.

Frank Alexander fell backwards, and hit his head on the floor. The 87-year-old had Alzheimer’s and died days later. McLeod was charged with manslaughter but the charge was thrown out in court because he was declared not fit to stand trial.

In an inquest into the death of Alexander, more details about McLeod’s violent behaviour emerged: he attacked care-home staff, in fits of punching and choking. He even allegedly told one worker she was doing to die.

READ MORE: Alzheimer’s patient violent before fatal attack, inquest told

Faye Jashyn has spent the past three years since the 2011 tragic incident wondering how she could have stopped her father from hurting others.

“We were told later there were many incidents. There were incidents of violence, incidents against employees, against patients, against staff,” she told Global National’s Shirlee Engel.

“Now everybody is looking at him as ‘he killed someone’… it’s going to stick with him forever.”

READ MORE: Blog by Global National’s Dawna Friesen: Dealing with dementia in your family

The footage tells the real story: a resident hits his peer, checks for witnesses then punches and kicks him in the head, for example.

Last year alone, there were five deaths deemed homicides at long-term care homes across Canada.

Those are the most extreme of cases, but resident-to-resident aggression is a growing and often overlooked problem.

Dementia and aggressive behaviour

Organizations are warning officials that residents at long-term care homes are at risk of harm at the hands of fellow residents.

Eleven per cent of Ontario’s long-term care residents are severely aggressive while another 35 per cent have moderate aggressive behaviours. Thirty-five per cent are dealing with psychiatric of mood disorders and 61 per cent have Alzheimer’s or other diseases.

These findings are all according to the Ontario Long Term Care Association and the Ontario Association of Non-Profit Homes and Services for Seniors. Between the two groups, they represent 630 homes. The statistics are based on analysis of information from the Canadian Institute for Health Information.

READ MORE: As dementia sets in, artists still recall drawing from memory

Living in close quarters with others who may behave in unusual ways may be what’s provoking the aggressive behaviour.

It could be singing, screaming, hitting or punching, according to Sara Kaur, who works at a special behaviour support unit operating out of Sheridan Villa Long-Term Care Centre in Mississauga, Ont. The SBSU is a 19-bed unit within the villa for clients who have a primary diagnosis of dementia with significant behaviours that can’t be managed in the client’s current environment.

Residents work with highly-trained staff until they’re fit for regular nursing homes.

Kaur suggests that conflict can be prevented by understanding dementia and a senior’s inability to communicate simple needs.

In one case, staff would complain of a patient who would undress himself in public. The resolution? Providing him with a regular bathroom schedule.

“He was disrobing but he was trying to say, ‘I need to go to the washroom. Help me.’”

The patient’s wife, MaryAnn Kalango, says that understanding a patient’s needs and what he or she is trying to convey is critical to creating a safe environment for all long-term care residents.

“Places like these are crucial. Because with Alzheimer’s disease, in a way, the guarantee you have is that there will be issues and behaviours and you need people to know how to deal with it,” she told Global National.

READ MORE: ‘Woefully unprepared’ for world dementia epidemic, report warns

A global study is predicting that by 2050, 135 million people worldwide will be living with dementia. It’s warning that right now, world governments are “woefully unprepared” for the epidemic ahead of us.

About 747,000 Canadians have Alzheimer’s disease and dementia and this number is expected to climb to 1.4 million in less than 20 years.

The Alzheimer Society of Canada, in its latest campaign, urged Canadians to consider early intervention if a family member or friend is showing signs of dementia.

READ MORE: Half of Canadians with dementia wait too long for diagnosis, Alzheimer Society warns

An early diagnosis could help with giving people with dementia the support they need and the skills, such as setting a routine as Kaur suggested, to help them with daily life.

carmen.chai@globalnews.ca
Follow @Carmen_Chai