Home for sometimes-angry 88-year-old with Alzheimer's?

Does anyone in the network have knowledge of small-group-home care situations in the East Bay for seniors with dementia? I'm hoping to find a private home where (four to eight or so?) residents live full-time with caregivers. I am particularly hoping something like this might exist in Oakland. 

Alternatively, recommendations for local geriatric-care advisors who know all the nuances of Oakland-area senior-care options would also be greatly appreciated. 

Context: My 88-year-old father is still managing many of his activities of daily living with a modicum of independence despite having fairly advanced dementia. (For example, he can dress himself, but needs to be instructed to change clothes or would otherwise spend days in the same outfit. He can feed himself, but needs to have meals prepared and presented to him, as he would otherwise forget to eat. He can brush his teeth, but needs to be handed a toothbrush with toothpaste already applied.) He has been living in a private room in a lovely, expensive, busy, and fairly large--75 residents--assisted living facility in Oakland for 2.5 years. 

Recently, Alzheimer's seems to be increasing his level of combativeness and the ease with which he gets triggered to anger: by the "noise" of other people's conversation, by other residents walking by, by someone telling him, "That's my seat, not yours!" Once he's triggered, he lashes out, shouts and swears at people, and has struck and attempted to trip other residents. We have ruled out typical underlying causes for mood changes (UTI and so on), and added a 2x daily dose of "calming" CBD to his med regimen two months ago. His doctor is considering adding an antidepressant to the regimen next. We are looking into hiring a private aide to sit around with my dad during the day to redirect him to prevent altercations, but this will be prohibitively expensive in the long run, and may just piss off my dad further anyway; he prefers to be "alone in company." If my dad's outbursts don't subside or can't be managed via meds, I have been informed by facility leadership that they'll kick my dad out to ensure the safety and peace of other residents. 

I'm hoping this wise network my have thoughts on alternative, smaller care situations, or care homes with a higher ratio of staff to residents, that might reduce triggers for my dad and keep him (and his fellow residents) safe and relatively comfortable in this painful late stage of his life.

Thanks for sharing your knowledge. 

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Hi, I went through the same thing with my no-88-year old father a couple years ago. He wasn’t aggressive but his dementia advanced past the point that his assisted living home would handle (point at Rockridge). I worked with Linda Wurth to find a small board and care home in Castro Valley where he is now safe and well cared for. Linda has contacts at many facilities throughout the East Bay. Her site is bettercarechoices.com. 

Very sorry you are going through this, and unfortunately it is familiar territory to my family as well.  It sounds like your father is in Assisted Living - but even Residential Memory Care programs (specifically for dementia) are not set up to be able to handle combativeness or extreme agitation or aggression and I think they are all likely to require the private aide you mentioned if they can't deal with his behavior.  Piedmont Garden's "The Grove" (41st street near Piedmont Ave) has a smaller-than-most Memory Care program, with 16 residents. 

Another GCM had told me about "Board and Care" places which sounds like what you are describing, where the ratio is something like 2 caregivers to 6 patients, but I don't know any more about that.

I recommend contacting GCM Linda Wurth, Better Care Choices: http://www.bettercarechoices.com/ to help navigate the process of finding a new place.  She came with us to Memory Care places and helped us cut through the marketing pitches.

It is great that you are trying to solve this by removing triggers and changing environments, but it might be that med management will also be needed. Your father's agitation may continue and may get worse - it is worth working closely with his doctor (ideally a Geriatric Psych), to find the medications that will make him less agitated.  This may take time, trial+error.  Might be anti-anxiety or anti-depressants, or may be stronger medication.  And in that category - the antipsychotic drug Seroquel proved very helpful in reducing extreme agitation in my mother's case (...I'm not a doctor, and of course YMMV)

My mother has Alzheimer’s as well and we moved her into a memory care facility ( this is in Sacramento.) My loving and happy mother is now angry and belligerent at times which still shocks me but this is the disease. I recommend you move him into a facility which specializes in Alzheimer’s as they are used to these behaviors and the staff are trained to manage. I have only visited one here in the Bay Area and that is the one in Albany called Belmont village. It was fabulous but also very expensive. I have two friends whose parents are there and they are very happy with the location, facility, and level of care. Good luck!