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Help4her Asked September 2016

Psych evaluation needed for Mom. Nursing home or psych hospital?

Brand new to this site, also posted as discussion but will listen to any and all advice: My Mom has been in a nursing home for about a month now. She was diagnosed with dementia in 2010. She was needing 24/7 care when her name came up on a waiting list for a nursing home. We had to take it. She is NOT happy there, very confused and asks us when she is going home every day...but she was asking to go 'home' when she was in the home she's been in for 47 years, prior to going in the nursing home. She is raming doors, pounding on walls and sceaming to go home, that she doesn't belong there, that they are trying to kill her. She did escape the facility about 2 wks ago, took off out the parking lot and down the street with her walker. An Aide stayed with her and told me that my Mom thought they were kidnapping her and were now after her family. They increased her buspar (anxiety med) and changed her from adavan to seraquel (a sedative) and the delusions continue along with her anger. They called me (her POA Healthcare) to say they want to send her to a Psych Hospital then changed their mind, after my sister and I had a meeting with them, and said they would do it on site with a Psych Dr. Has anyone experienced this? Wondering if she should go to a Psych Hospital or let the nursing home try to do it. The nurses do not seem happy trying to handle her now that they've started the reduction of seroquel. They probably do not have time. I don't know how it would be in a Psych hospital but I'm asuming they have more time, can monitor her better, and possibly keep her calmer until they can figure out the best meds for her...except it will be confusing to be in another new place, she may not be able to come back to the nursing home she's in (they charge $250.00 to hold the bed and we can't afford that) so that would be another adjustment for her when she gets out. We want to help her with the best possible outcome...just not sure what that might be and it's very upsetting to me to hear the nursing home tell me how bad she is and that she could harm herself or others.

gladimhere Sep 2016
Help welcome to the site. I see you have posted this twice. That is not necessary as everything, question or discussion kind of gets thrown together. If you are not receiving replies, repost to that same question again to bring it to the top of the list for more responses.

Help4her Sep 2016
She's in a locked down unit in this nursing home but she can still read and understand that the door will open, in case of fire, after continual pushing for 15 seconds. Which she has tried.
Just spoke with her Dr. (ran into her while grocery shopping) and she advised me that the Hospital is better equipped to help and would be able to get her med's straightened out much quicker. Guess we'll probably have to let the bed go and hope there's something available after the Psych eval.
Thanks for the responses!

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cwillie Sep 2016
Since you have had a face to face meeting and they are willing to do the on site evaluation then I guess you have nothing to lose by giving it a try. If it doesn't work out you will be in no worse position than you are now, and the Psych hospital will always be there as a future alternative if needed.

pamstegma Sep 2016
My guess is she will not be going back to any nursing home unless it is a memory care (secure facility). Wandering and aggression require safer facilities. A standard psych eval is a 72 hour stay in hospital, but in her case, it could take longer. I would let the room go rather than pay for it.

Help4her Sep 2016
Thank you for responding. We were resistant because it took 6 months to get this bed and in our area waiting lists are 1 - 8 yrs long. She could come back from the Psych Hospital to find there are no beds in this area. We like having the nursing home in the town we work in. The next closest nursing homes are 20 to 90 minutes away, if not more. If the Psych stay was one day, we could come up with $250.00 but her Geriatric Dr is saying it could be 1 - 2 weeks. It is only my sister and I and we cannot scrape together $1750.00 - $3500.00.

cwillie Sep 2016
While the nursing home may be able to recruit doctors and nurses who have dealt with this kind of thing before the geriatric psych doctors at a specialized unit are the experts. If they have offered this why are you so resistant? As for holding the bed, I assume insurance/medicaid is covering the psych evaluation, and while you may feel it is unreasonable to pay for a room she is not using it is just like having an apartment, you pay the landlord whether you are there or not. Another thing to consider, if she can't be brought under control the nursing home has the ability to kick her out. Surely if you all pitch in you can scrape together $250.

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