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bookish66 Asked April 2017

I'm not sure what facility is the most suitable place for Mom to live. Should I keep pursuing more appropriate places?

It's complicated! Mom moved from out of state to an ILF to be closer to me. She fell in January, did not break any bones, and went to the hospital for abrasions. Her incessant talk about dying prompted the doctor to call the hospital psychiatrist, who diagnosed her with severe depression, which was not a surprise to me. She went to a SNF, then into LTC in the same nursing home. She's oriented to person, place and time, has a great vocabulary, converses very well. No Alzheimer's, but definitely some dementia. Mom's short-term memory is sporadic, but sometimes great, recalling things from a couple of days ago. She's had delusions for a while, and went into a psychotic episode at the nursing home. She tested negative for a UTI, and after 3rd time, went to a psychiatric hospital for a week. Now she's in a locked memory care unit in a nursing home run by the same company. They tried a 3 day trial in the regular population side, but she got very grouchy and negative. So she's back with residents who are non-verbal, severely cognitively impaired, and not able to interact with her. The staff is great, and I feel she's getting good care. Of course, she's very unhappy there, but she's been unhappy everywhere! It's more for me that I want her someplace with peers. She's very verbal, and loves to talk about old movies and music. AL came to evaluate her, but she can't transfer and will always need assistance getting up from bed to wheelchair etc., which apparently is required for AL. I've been to all the local facilities at one time or another, and just don't know if I should keep pursuing a more appropriate place, or is she just caught in the middle of delusions and moderate dementia in memory care.

golden23 Apr 2017
Tough call. You say the staff is great and she is getting good care. I would be inclined to leave her there, unless the agitation of being in the other facility can be addressed successfully. Maybe the residents where she is,who are quieter, are actually better for her. You are saying this in more for you than for her. Try to focus on what is best for her. Let us know what happens.

AmyGrace Apr 2017
Its a really tough situation as she sounds like she is in between stages and care needs. Maybe if they can find the right combination of medication to control her agitation she could be re-evaluated. My mother was in AL and didn't want to be there. She started to get agitated and I would have to say "angry" and even pushed someone. They put her on Zoloft and it settled her down somewhat (not to say it made her any more cooperative, but at least she was more mellow)
If your mom is in memory care, do they interact with the other residents? Could an aide bring her to activities where the regular AL residents do crafts etc so she could have someone to talk to - or maybe seat her at a table with them for meals?

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jeannegibbs Apr 2017
If her moods are sufficiently stabilized, perhaps she will be OK in AL. Or maybe that environment is too stimulating. Sigh. Not easy to judge, is it? It would be interesting to hear what the social worker has to say.

bookish66 Apr 2017
During her 'episodes' she's very disruptive, hanging onto door handles, telling people to call the police, that she's being held against her will, at one point 5 staff members to deal with her. Very Jekyll and Hyde. The feeling by me and the social worker was she was overstimulated by the larger population. I guess agitation is a better description than 'grouchy'! Medications have stabilized her moods. I'm meeting with her social worker later to discuss all this. We have talked about it before, but with the idea of moving her to AL.

jeannegibbs Apr 2017
Being grouchy isn't usually cause for being in memory care. What else was the placement based on? If she's in a wheelchair she is not a risk for wandering. Is her behavior threatening to the staff? Disruptive to other residents? Does she require more one-on-one care than most residents in the NH?

Was the psychiatric hospital able to come up with a drug or combination of drugs that helped calm Mom? Has she had psychotic episodes since leaving the hospital? If she has, then maybe she is where she needs to be, for those times when she has episodes.

But if she is on a drug regime that reduces her psychotic behavior, then perhaps she would do better where there are other residents functioning at her social level.

It is complicated, isn't it?

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