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89yo parents. Mom has been on hospice care for a year. Dad is at his wit's end. Mom had a major personality change starting three weeks ago. Aggressive, violent, threatening. My first thought was UTI but it was dismissed.


Hospice was in the process of the paperwork at their home on Wednesday to put her in emergency respite care because dad needs a break, when mom picked up a can of pesticide and sprayed him in the face (this is an example of the behavior he has been dealing with for three weeks). This dq'd her from respite care so the hospice nurse sent her to the ER. They discharged her the next morning, said nothing was wrong with her.


Yesterday (Friday) was horrible. She left feces all over her room, while dad was cleaning that up, she went to other rooms and spread it all over walls, chairs, counters, you name it. She tried to push him down the steps, she hit him in the back enough to take his breath away. When the hospice nurse arrived, mom was outside half naked yelling and screaming (dad was inside cleaning up feces). They sent her back to the hospital, hospital called dad at 9:30 last night to come pick her up. He refused (doesn't drive in the dark and has trouble staying awake). He picked her up this morning, she is combative, refusing to take the meds for the UTI they now have diagnosed.


Nursing homes are closed, hospital won't keep, and she may very well kill dad if left in their house. Any suggestions? There is an appt Monday for a nursing agency to come in, but at $23.00 an hour, my dad isn't willing to pay for what is needed -- round-the-clock care.

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I was going to recommend a psych evaluation but I see that's already happening, thank God. No matter what anyone tells you, it's NEVER okay for an elder to be causing THIS much grief and terror for another human being. Your mother is not 'feisty' or cute, and your father is in a terrible position having such a thing to deal with!

If she's not having a reaction to a medication, which is doubtful, she can be having a psychotic break or something like that. A pscyh hospital is the best place for her right now, so a qualified doctor can try to figure out what's going on and get her back to thinking/behaving on an even keel.

A 'rest home' is the very best place for mom now, and it will give dad a well deserved and needed break from all the hysteria.

Wishing you the very best of luck moving forward, for you and your whole family. Sending you a hug & a prayer for peace.
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Lizaq2167 Jun 2020
Wow I am so sorry this is happening to your family. What a horrible disease. When mom was admitted to the hospital for what they thought was pneumonia on a Friday thankfully, palliative care called me to see how things were at home. I told her everything that had been happening which was nothing like your situation, but I did find that she had been drinking rubbing alcohol. They then determined that she was no longer safe at home. Have you tried calling adult protective services? Some of the dementia units are starting to reopen here in Wisconsin. Have you tried again with the nursing homes, memory care facilities, or hospice u it’s? I’m assuming you have. I think the psych evaluation is going to be your best bet. Palliative care at the hospital needs to be involved. Do you have an activated POA? We needed that to make sure it was our decision on where she went.
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She needs an emergency 72 hour psychiatric hold, often called a Baker act. Call hospice and ask how to get this done. You may need to dis enroll her from Hospice in order to get this.

Dad should NOT go and pick her up.
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graygrammie that is such good news that your mom is getting the care she needs and your dad is finally safe from the situation.

I want to encourage you to keep her in the facility. Dad can go visit and then get a break from the situation. Bringing her home is just not fair to dad and she obviously needs more care than he can provide, making it unfair to her as well. You said he is traumatized, that doesn't just go away and he will not be able to relax with her in the house, putting him at greater risk of having a serious medical event. Please encourage him to keep her in the facility. She can go back on hospice and stay in the facility getting her needs met, he can sleep knowing she won't be after him with a knife, win-win.
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graygrammie Jun 2020
Thank you for this perspective. I guess my hope had always been to not see either of my parents die in a nursing home. I really don't think dad will ever be willing to bring her home though. Even if he is able to forgive, you are right, the trauma doesn't go away.
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Baker-Acting someone is not pleasant, but it is a way to get someone the help they need.

I Baker Acted my daughter when she was 19 (even though she was no longer a minor) b/c she was abusing drugs and completely out of control--suicide threats nonstop, etc.

Hardest thing I've ever done. And the best.

I needed her gone---and she needed to be somewhere she was watched and treated. When I made it about HER needs, not mine, the hospital reacted differently--I wasn't just a burned out mom, SHE was a sick adult child.

From 14 days in there to detox and have meds adjusted--(the calmest 2 weeks of my life!) she had to appear before a judge to determine her next step. She could have gone to a psych ward setting for 3+ months---and she knew it. She was allowed to come home with the caveat that she get therapy and stay on her meds.

With your mom, it is more likely they will treat her UTI and evaluate her condition. If she improves much, they may simply transfer her to another 'facility'--during the time she's in the psych ward, these decisions can be made.

She's passed over the line from 'kooky' to 'dangerous'. Your poor dad.

I don't know why they wouldn't continue Hospice, but that is not really the most pressing point.

She could kill your father--or seriously wound him. Best to head her off at the pass, so to speak and get her in a psych ward setting soon.

Is she this hostile towards anyone besides your dad? A CG coming in may just make her worse. I worked EC and I would have walked out the door if my clients were at the 'fecal art' stage.

Good Luck. Be there for dad. Even tho mom is off the rails, he still loves her, I'm sure and this is breaking his heart.
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Isthisrealyreal Jun 2020
Because Medicare won't pay for hospice and hospital stays, so hospice has to be fired to get medical coverage. Hospice is used when it is decided that you will no longer be pursuing treatment. If hospice was doing their job they would have caught this infection, treated it and then there would be no need of medical treatment.
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Shad, do you REALLY THINK that a woman with long standing mental illness and who tries to attack her husband with a knife is "feisty" and not possibly psychotic?

Do you not see the need for psych meds for folks with demented and broken brains so that they can live in some kind of peace with their loved ones?
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graygrammie Jun 2020
Not sure who Shad is that you are addressing, but mom is now in a behavioral health facility for evaluation, will be going from there to a hospital to address medical issues, and then to a nursing home that is holding a bed for her for one week. Hopefully that is enough time.
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Grammie, there are fates worse than dying in a nursing home. What if your mom kills your father? She is then jailed for homicide (happened a few years back; elderly mom shot her 70 year old son/caregiver).

Because he was going to arrange for her to go to assisted living.

She died in jail.

Old age and death isnt what Hollywood depicts...saintly, calm elderly folks gazing upward at the light and being held by their adoring children.

The best depiction of an actual death that I've ever seen dramatized is that of the Mother Superiour in Poulenc's opera the Dialogues of the Carmelites. It depicts a woman of great faith, dying, in pain, agitated and violent, a doctor who will not increase her medication because it might tip over the line and kill her. She dies, gasping, losing her faith and thrashing. Hard to watch and terribly accurate.

I think that dying in a nursing home, with professional care and hospice at your side with morphine to ease pain is EXACTLY what I want.

I would not want to burden my husband or my children with caring for me if I became violent.
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greeneracres Jun 2020
After having witnessed terminal agitation, I wonder how often people are lying when they say that someone passed peacefully at home, peacefully in their sleep, etc.
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Where are you? Where is dad? He obviously needs some emotional support to do what is best for mom.

Yes, I would call the police, they will get her into a psych facility.
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graygrammie Jun 2020
I am five hours away with a husband with frontotemporal disorder and mild neurocognitive disorder AND possible COVID-19 (he refuses to go to the doctor and get checked). Mom is back in the hospital after coming to dad's bedside with a knife in her hand this morning.
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This is a dangerous situation for your father and your mother as well. They should not be left alone together at any time. When people are mentally ill, which Mom is, and they display violent tendencies, they can be crafty enough to use most anything as a weapon and they seem to choose one person, as Mom has chosen Dad, as a target. Dad (and you) need to become “hard-hearted”. Mom is no longer herself. She is violent and unpredictable. She needs to be out of the home and under 24 hour supervision. Dad is overwhelmed and unable to care for her. She can be Baker Acted and placed in a mental health facility where she will be evaluated and placed.

Some difficult discussions need to be had with Dad. I wish you luck. Please keep us posted.
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I would call the police. They should be able to take her to the hospital for the 72 hour psychiatric hold. Tell the police what is happening. Just call 911 on her. That’s what I would do.
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Grammie, if she is now a ward of the state, it is no longer going to be dad's decision what to do.

I think I'd be grateful for that, actually. The poor man need a rest.
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graygrammie Jun 2020
Yes, as of right now that is true. I was told that when she goes to a nursing home and he begins to pay the bills, then the state steps back out. His voice on the phone for the last few days has been so much more upbeat. He's even back to emailing all those forwards that seniors seem to like to send among themselves. Yesterday was a baby elephant vs goose. At least it gives us something lighthearted to talk about in the evening!
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