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That means she stands up unless someone is right next to her.
She is on hospice. They are trying to increase her antidepressant now (which I disagree with) and maybe adjust meds more if that doesn’t work?
Shes self pay on a memory care unit. Can the kick her out? I don’t think she’s as “aggressive” as they are claiming. But I’m not there 24/7.
Help please!
Thanks

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Yes, the SNF can definitely ask her to leave if her aggressive behavior cannot be managed and mom is too much for staff to handle. Why would you be opposed to an increase in anti depression meds??? That helped my mom quite a bit, along with Ativan when she went on hospice care in her Memory Care AL. Ask your hospice nurse for input and recommendations from their MD about what to do to best keep mom managed properly, otherwise you may be scrambling to figure out where to place her next. Your goal here should be to keep her calm, relaxed and safe at all times and not trying to stand up if she's a fall risk. Your other option may be to hire a sitter for her for that 1 to 1 care she's requiring. I'd try an increase in meds first myself without zoning her out....just enough to keep her calm.

Good luck
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LoopyLoo Dec 2022
Agreed. Don’t be afraid of meds!
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Is she in a nursing facility or memory care?

No matter, my mom was self pay in a large, national chain memory care. She was extremely agitated and didn't fail to let others know it or try to communicate it. She would hit, kick, bite, bang her head against a wall, attack caregivers, you name it, she did it. And yes they kicked her out, she was a danger to herself and others! The staff have more residents than just my mom to care for.

The facility gave us time to find a new residence but she had to have a private 1:1 caregiver until we could get her moved. She was on hospice at the time and hospice suggested a much smaller care home which worked out better for my mom and it was cheaper. The care ratio was better but she still had to have the private caregiver. And all of the residents there had been kicked out of their previous facilities.

You have to allow them to work with mom's meds to try to find what will work for her. If you don't they will be forced to send your mom to a geriatric psych unit to try to adjust her meds there. Then they will not let her return and you will then have an emergency situation with which to try to find placement for mom. DO NOT ALLOW THEM TO DISCHARGE TO YOU OR ANOTHER FAMILY MEMBER. Mom needs a facility, professional care.

I am sorry you are going through this, you are not the first and will not be the last. You have to allow the facility to do what they can to try to help mom. Remember mom doesn't like to be in the rages that she experiences. She is scared and trying to do what she can go express it, she just doesn't know how. That doesn't mean that her agitation is justified in any way. They are doing what they can for her.

Good luck, this is hard!
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In California, snf can’t just kick out a resident with nowhere to go. And just saying that she stands unless there’s someone there to retrain her won’t usually get her admitted to a hospital.

What they are talking about is chemical restraint, which is by far your most compassionate option. It’s that or wait for some fall to happen meaning the hospital and then them not taking her back on hospice.
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JoAnn29 Dec 2022
This is a private Memory Care and they can ask that she leave.
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My step-mother in memory care has also gotten very aggressive, especially at sundowners time.

We had to increase her meds again, it has helped her. We kept her off of meds as long as we could, we had no choice as the home was going to ask her to leave and we would have to place in a group home for patients with physiological issues.

We will increase the meds as needed, at this point it all makes no difference, she has lost ability to know what is going on, her mind is broken.
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My daughter says Medication is like quality over quantity thing. Mom is on Hospice. You want her pain and anxiety free. You want her as comfortable as she can be.

IMO those in charge of making decisions is the doctor associated with the Hospice team. The doctors and nurses at the MC should be working with Hospice and visa versa.
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AlvaDeer Dec 2022
Absolutely correct.
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Find out if her present residence has a recommended geriatric psychiatrist and make arrangements for that person to see her.

Brain functioning following diagnosis of dementia is common, and it’s kinder to employ carefully selected amounts of medication when specialized care is part of the planning.

The difference in my LO was AMAZING, and she enjoyed a very good full year before Covid.

Who’s the “they” who want to increase her antidepressant? Maybe better for you to work WITH “them” to get her a medication that works, rather than increasing something that doesn’t.

Hope you have a good outcome from whatever you decide.

Consider though- better to be an “only” than have a useless condescending sibling who does nothing to help and criticizes every move you make.
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lealonnie1 Dec 2022
"They" are doctors, as we all know, since staff at SNFs and ALs cannot hand out meds willy-nilly to zonk residents out, regardless of what some people may think (as we know). Even hospice requires a doctors order to administer meds.
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Because of hospice we easily found an appropriate placement for my mom. LL, it happens all sorts of ways.
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I would work with hospice on what meds could be tried to keep mom a little calmer. You don't want to have to move her. She's obviously not in great shape if she's in memory care and on hospice. She is not happy or living a good life at this point so I really don't see how a little more medication is going to be an issue from her, or even your, perspective. That's just the way I see it and the path I expect to take with my 79yo mom with dementia.
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Talk to the Hospice Social Worker and let the Social Worker that they might have to help find another place for mom.
If mom is on medication for anxiety there may be the possibility of trying another or adjusting the current dose.
While you may not agree with medicating someone sometimes it is necessary. This does not mean medicating until the person is in a stupor. Finding the right drug, combination of drugs, the right dose can sometimes be difficult and even more so if the person can not effectively communicate what is happening.
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