What to do if an assisted living facility is going to evict a “difficult” resident?

Try to stay on good terms with the AL as what they can do is find a plausible reason for them to call EMS to have EMS take your stepdad to the ER / ED of a hospital. Then once he is there, the AL will refuse to take him back. Ideally he will be hospitalized (MediCARE pays) for 3 days so that he can be discharged from a hospitalization with orders for post hospitalization rehabilitation to be done (MediCARE pays @ 100% first 20/21 days and then At 50% up to 100 days if progressing). There will be a facility who will take him as a rehab patient as reimbursement rate paid by Medicare is pretty solid. And once his Medicare paid rehab ends he transitions to a custodial care resident. How that gets paid depends on his financials. If he’s married, imo doing a LTC Medicaid filing is not ever a DIY as it’s complicated to segregate assets and best done by an elder law attorney experienced with LTC Medicaid. While he’s in rehab, is when you start to work on all this.

If he’s not technically hospitalized, then the discharge planner at the hospital will contact family to come and get him. You need to be prepared for this call and be able to firmly and repeatedly say that neither you or anyone in the family can provide a safe and secure environment for him. The discharge planner will end up having to find a facility that will eventually take him.

the ER / ED dump happens all the time. That they appear to have had a TIA transient ischemic attack is often used as the reason to call EMS as it’s real subjective as to how it looks. You want to stay on good terms with the AL and have his bill paid as you want to be able to go,and get his things from his apt, etc.

fwiw my mom had Lewy Body Dementia. Her issues were more about hallucinations and visual distortion's that were 100% real for her. She had the Lewy shuffle for walking. She was by & large amiable even when she insisted folks were stealing from her and had meetings in her IL apt as it “had the good sunlight”. Once she moved into a SNF on a set medication management schedule, things got better, like did activities at her NH, was social. The dementias can all be different from 1 individual to another. Eventually your SD will find the right care environment and mix of medications and therapies to have things smooth out.

It will be up to social workers to do placement, and this will likely begin with SNF where evaluation of different medications and medication cocktails can be tried and assessed. I am so sorry. But your Dad cannot be in ALF at this point for the sake of other residents. He will require memory care or nursing home and he will likely be kept medicated enough that he is comfortable and without agitation. Unfortunately this can lead to falls and loss of appetite, and you may now be facing end of life issues.

You cannot find placement that does not exist and the best thing to do is allow those who are dealing with dad to do as they must. The ALF may eventually need to transport him to Emergency services, there will be admission to a locked unit and assessment and medication. From there the social workers will have to work their magic. The thing to know is that there is little you should do or COULD do now. And certainly you cannot take him into your own care. That is definitely OUT. I am terribly sorry for this. My brother was diagnosed with Lewy's 5 years ago and hoped with all his heart he could die before this stage he saw coming. He got sepsis and did just that after one and one half years. I was very grateful to the fates for not allowing him to suffer this extreme indignity and loss. My heart so goes out to you as you stand helpless witness to this torment of one you love. Get hospice on board as soon as you are able.

Please take him to a neurologist for proper medication, my mom was like that til she got the right meds. It is not an all cure but cuts the paranoia and hallucinations way way down. Memory care is the way to go.

lostmymind2
Try your state rep. The facility is his home. There may be laws that protect him.
Ask the state rep if he can be evicted if he does not have any place to go.
This may buy you some time. Also follow through with the VA. If his medication is prescribed by his neurologist, you need to talk to the neurologist and ask his/her advice. Give examples of the angry behavior. Ask if the medication needs to be changed or tweaked. Also check to make sure he is taking his meds. If he has not seen a neurologist recently you may need to schedule an appointment. You may have a lot of advocacy work ahead but do not give up. I hope you have Medical POA.

Follow Igloo's advice step by step, don't waver, and don't take him home.

In my experience, ALs do not have Social Workers. Maybe the larger ones or are part of a community but the two where I live do not. Your Dad should be in Memory Care with the propper Medication prescribed by a Neurologist, at least.

VA will assist your stepfather. #1:first verify if he has a VA account. Using his DD214 information, register him with VA at va.gov. Create an account, if he has an existing account: contact nearest VA hospital. He must get a blood draw @ VA & see PCP. (One will be assigned) #2: PCP will provide a you to get your stepfather seen in the Neurology Clinic & any other issues that he may have. #3: see neurologist & other providers. Doctors will prescribe medications for him, these meds can be picked up @ the facility or mailed to him directly. #4: most important: begin the claim process to file claim for SERVICE CONNECTED issues. The VA MAY DETERMINE your stepfather needs in house 24 hour care. Go to va.gov to get the forms needed to get him evaluated at the nearest VA hospital. It is not an easy process but the VA WILL PROVIDE CARE AT NO COST. be persistent!

It sounds like he is too far gone for assisted living.

He likely needs memory care, as the anger and verbal abuse are likely made much worse by the lewey bodies.

No other assisted living facility will accept him. He has likely gone past the level of care that an assisted living facility provides. It's time for a memory care facility.

lostmymind2: Speak to a social worker.