My mom has been getting worse and worse over the last few years with her undiagnosed dementia, but she refuses treatment. My dad is her caregiver, but over the last several months her paranoia and jealousy has gone into overdrive. He's 80 years old and spends every waking moment caring for her, but she swears he's flirting with every blonde woman that walks by (they don't even need to be attractive). I could go more into how bad her confabulation has taken over every memory and thought, but that's not my concern today.
I went out of town for a week and when I returned I find her spiralled out of control. She's been screaming at my dad for days, unending. She tries to kick him out of the bedroom at midnight, so he does to the spare room. But then she accuses him of trying to communicate and flirt with the woman across the street (which the bedroom faces), so she screams at him to get out of there and back in the bedroom.
On Christmas Day she remained out of control, accusing him of being a womanizer and she wants to divorce him... but he's not allowed to leave the house until they're divorced. Every time he tried to talk she screamed at him and threw chairs. Apparently over the last week she threw the Christmas tree around several times. She broke all the bulbs on it. The remote control was broken from her throwing it. She just keeps getting more and more violent, including hitting my dad and pulling his hair. My dad was crying.
So I finally called the cops because I didn't know what else to do. They ended up Baker Acting her. I've tried reaching out to the facility and it seems like they're not even admitting her in yet. It's been ALL DAY and they promise they'll feed her but from what I understand she's just hanging out by the front waiting area. I don't know what to do.
On top of that, I've been reading about the Florida Mental Health Act and now I'm not sure if they're even going to do an evaluation on her due to dementia symptoms. What should I do? What do I need to know? What's going to happen from here?
Things are a lot better now! I got her into a Memory Care Facility before I left for Spain (it was a miracle I found a room available in my time frame). I moved her in hours before my flight and it was a fairly smooth transition with no fighting or crying. I imagine that was due to her starting medication in the hospital.
It's been a month since she has been living there. Since getting on mood-altering medication, ALL of her agitation is completely gone! She still has very slight paranoia occasionally, but it is incredibly well-managed now. Even her short-term memory has slightly improved! The first week she was there, did not remember anyone despite being introduced several times and having conversations. Now she remembers the staff and even complains to me that some of the other patients are annoying to her during dinner because they mutter so much. She's involved with all the social activities and even does the daily exercise.
Things were so hard for SO LONG and it's amazing to finally have my mom managed. It's like I have my mom back, even though I know this won't be forever. It's so upsetting to me that we could have avoided this long mental strain and struggle if she only listened to us years ago and stopped refusing to be treated. She's gone from being a bitter hateful person to a very sweet woman who appreciates every time she sees me.
The struggle now is with my father. He sees that she is back to normal and thinks she can come back home now. That she is "cured". I will admit, now that she's treated properly with medication, she almost seems like she doesn't need to be there. She certainly seems better mentally than anyone else living there. But I know the downhill struggle that would create. It's very hard to keep them separated after 40+ years together, but he does not need assistance living just yet. He can still drive and cook, and live normally. Especially more now that he's no longer caring for my mom.
I wish there was a better middle ground for her to live in. Not one surrounded by dementia patients who are more advanced than her. I found a MC facility that has 3 separate "villages" but even the early dementia patients living there still seem more advanced than my mom. Then of course AL does not provide the care she would need, so I don't want that. Sometimes I consider moving her in with me and hiring health aids to assist with her medications, or even an adult daycare type facility (there is one down the street from me).
Anyway, I just wanted to provide this update to let people know there is hope. There is a light at the end of this dark time. It may not be a completely positive turn-around, but once you get past the hard part it DOES get easier. Calling the cops on my mom was the hardest thing for me to do, but we really didn't know what to do anymore. It was drastic, but it got her the help she so desperately needed.
1. Voluntary from the patient
2. Involuntary from next of kin AND a medical professional must agree
3. Next of Kin not involved or treated this way where the hospital revokes option 2 to rid themselves of the problem. I would keep refusing to have them discharge due to high risk. I would get online file a vulnerable adult protection order on behalf of your father. Social worker said you need a judge or guardian involved so start involving a judge. Get an emergency protection order signed by a judge. I have done it no fun but I did not have to pay an attorney just filed as a civil matter but involved a judge and hearing as it involved a vulnerable adult, your dad. You parents have become like kids to you, so do what needs to get done with the hand dealt to protect your own.
It would at least get the ball rolling in the right direction towards guardianship, and get things headed towards a guardianship. But listen to Alva Deer as she knows how binding this guardianship stuff may get and decide carefully the who and what of this difficult situation. Acting as guardian for 2 parents a huge commitment, so weigh the pros and cons, will it put you in charge of their best interests or will it embroil you in more enabling and destruction at your life?
Happy New Year. I hope the wheels stop grinding at the hospital at least for a few days.
Not good news. Last night she got Sun Downers as usual and gave the staff a lot of grief. They revoked her competent status and asked for my permission to put her on 5mg of Abilify. I said yes. They have revised her diagnoses to Dementia with Agitation.
The Social Worker contacted me this morning to say my mom is now there involuntarily and she cannot stay there without a court date. I told her I'm leaving for a work trip Friday, could she stay there until the 11th? She said absolutely not. The Social Worker said my mom would benefit from a neuro psych evaluation. I said I agree, can I please request that? She says no, that is an outpatient service. My mom has received a psychiatric evaluation per the baker act law and now they are done.
After the phone call this morning she does not answer my calls but she does respond to text messages. I asked if I will ever be able to speak with the Doctor and she stopped responding to me.
How can I get them to pump the breaks?? I'm about to cry this is so overwhelming!!!
Thanks for update number 3!
You are going now to have to EMERGENTLY connect with the social workers in this institution. TODAY.
1. Tell them of all your discussions with nursing as regards your mom's apparent incompetence. Tell them you do not have a diagnosis. Warn them you will not accept a discharge without full diagnosis and paperwork as to your mother's competence in her own decisions. That is to say a neuro-psyc consult with a good doctor and testing.
2. Tell the Social Services what you told us about the current doctor. You cannot function with a doctor who cannot speak to you.
3. Tell Social Services that currently you believe your mother needs
A) dianosis
B) prognosis
C) possible placement
4. Tell social services that you will consider contacting JCAHO (Joint Commission on Hospital Accreditation) if there is any attempt at an UNSAFE DISCHARGE of your mother without a diagnosis and full discharge planning.
It is crucial now to find out if you are dealing with mental illness or dementia.
If the latter you can accomplish things (placement) more easily FROM THE HOSPITAL; and if the former you are up the creek with no paddle permanently and I would caution you not to attempt guardianship of any kind. It is impossible to act for someone mentally ill because you won't be allowed to, and worst of all, won't be allowed to resign guardianship as you require a judge's permission to do so and they won't let you off even if you are ill.
Until you know whether you are dealing with dementia or not (sounds like you are) you cannot know if mom needs placement or not (sounds like she does) and if dad won't agree to that, then you are helpless and cannot help in this at all and you need to back away from them and leave them the number to APS. At that point my advice to you would be to move 1,000 miles away. Because you won't be able to help and will be desperate every second of your life if you stay.
She is now not Baker Acted. They will begin to discharge her to your care. You need to STOP THEM and you need to start to talk with your father about her placement with diagnosis.
Good luck.
She was transferred to the hospital psychiatric ward. When we came to visit over the weekend, the nurse told me the Doctor seemed her competent and prescribed no medication for her. While we were there, they had her sign papers saying she was no longer Baker Acted and is now there voluntarily as an inpatient. I spoke to the social worker and the techs that work with her and they all told us she definitely displays signs of dementia. Saturday night she had a bad sun downers episode and kept calling me, because she forgot that she already spoke to me on the phone or that I already saw her earlier that day. There is an available phone in the hallway that patients can use if they know the number to call. It got to the point that I had to ask the techs there to please get rid of our phone numbers because she will continue to call us every 5 minutes for the rest of the night. The next day that same tech told me that my mom gave her grief the entire rest of the evening and got angry we weren't answering our phones. She struggled with her until her shift ended and she had to go home.
I'm getting very worried about this doctor. Originally I was told by the hospital that the psychology ward doctor would call me once she was transferred there. No call occurred. Up until this point I've had very productive conversations with the doctors asking me questions and understanding the situation, but this one hasn't spoken to me at all. When I went to visit I asked why I hadn't heard from the doctor yet and the nurse told me I very likely would never hear from him because he's hard of hearing and almost never makes any phone calls. My mother masks very well and even the nurses said that at first she seems totally fine. It's only after you talk with her for a while that you notice she's repeating questions or hasn't remembered anything you said to her. A woman I spoke to who runs a MC facility (where I'm considering taking my mother) said that unless you know dementia, people are still very smart (dementia doesn’t change their brightness) and they can cover really well... and my mom is very good at covering! So I'm incredibly worried now that she will not get a diagnosis OR medication and he will just try to send her home like nothing is wrong.
We have visited her two days in a row and she didn't remember that me or my father were ever there. In fact, she still thought I was away on vacation and doesn't remember that I was there the day the cops were called. She is still stuck on my dad's "infidelity" though, and throughout the entire visit kept telling him he needs to "stop looking at blondes". This is the thing that got her violent and landed here there in the first place. I told the nurses to please please please inform the doctor of their experiences with her. They told me to speak with the social worker on Monday, which I definitely plan to do. I'm so very worried how this will go.
However, normally next of kin if one steps up to decide on healthcare, it needs to have the tone of a unanimous vote.
I deal with this in hospice. We had a case where the dad had durable POA over the mom who had late stage dementia. Dad had earlier stage dementia which many medical pros found disturbing as he directed mom's care. I confirmed with legal that if necessary we would take consent signatures from the daughter to put a note that the Dad disoriented times 1 and the Mom disoriented times 3 out of 3 (person, place or time).
Look up the state laws on Next of Kin for Healthcare (it usually follows the same guidelines for division of assets with no will). Follow your instincts. These people together gave you life, your mom and dad. I don't think it sounds like your parent will fight your decisions after discovered sobbing over this. Even with senile degeneration of the brain, few would forget that someone dealt with it for now.
Also while he still makes decisions or has sound mind perhaps sit him down with the social worker or a legal advocate to discuss his wishes. His status will get brought to light from that discussion. For me dignity would involve stating my wishes in advanced directives or POA while I still could. If my loved one took the time to do that with me I would never devalue that. But if I have any degeneration of the brain which causes lack of insight than it became too late.
Please continue letting us know what happens.
You’re doing US a favor by letting us know how things proceed. MANY have or will have to deal with a similar situation.
She is being transferred to the psych ward tonight and I've been told I'll be contacted by the doctors and social workers there soon.
What's concerning me now is my dad. Will he be the only one with final say on whether she comes home or not? So far all primary communication has been through me and I'm hoping I can explain that my father can't make the best decision in this case.
I was with him all day today. Sometimes he'd talk about her going to AL after this, and even talked about the possibility of living there with her. But sometimes he takes about her coming home. Then a loved one called to get an update on the situation and he was saying stuff to them like "When she comes home I'm going to start giving her Guta Kola" (an herb for memory) even though we already had a conversation about how her brain is beyond herbal help at this point. He discussed finding a smaller and more affordable apartment if she goes to AL. I've been telling him that if she goes to assisted living, he can absolutely come live with me! But he replied "Oh no, your mother wouldn't like that!". So he's not entirely with the reality of the situation yet.
I think it's very clear he is no longer capable of being her primary caregiver at 80 years old. He just doesn't understand certain concepts and he obviously wouldn't be able to control her if she decided to stop taking her medication.
If you go this route, Dad should see an Elder Lawyer about splitting their assets. Moms split will go to her care and when almost gone, Dad applies for Medicaid. Once she is on Medicaid, he remains in the home, has a car and enough of their monthly income to live on.
Your Moms Dementia is extreme. Don't let them tell you there is help out there, its hard to come by. Once you take her out of the facility, she is your responsibility. To get help thru Medicaid you have to have nothing in way of assets. Help from the County is all based on income. So if Dad has assets, he will have to pay out of pocket.
As this doctor and you know, there’s no cure for dementia. Most likely, he will be prescribing antipsychotics and mood stabilizers or elevators that will eventually calm her behavior as long as she’s taking them. The issue is that many people then think they’re fine so they stop taking them.
The first mental health place did not accept Medicare but they transferred her to a hospital that does. I spoke with the doctor and this was the first actually helpful conversation with medical personnel I've had in the last few years. He agrees t all of this is textbook case dementia symptoms and he told me they are going to run a series of tests to prove that fact and get her on the right medication. I'm not sure where things may go after that, because it sounded like he would discharge her home after that, but she's stopped taking medication in the past so that does worry me. I will try to talk with the hospital social worker about where we can go from here. I know my dad doesn't want to live apart from her, but I think he's getting much too old to take care of her himself. I also travel for work quite often, so I couldn't have her move in with me either. It was hard to have this happen but I'm just thankful she's finally getting the medical diagnosis we have needed for years that she refused to get.
You are absolutely correct. The next step is the social worker to get her placed if your father will agree to this. She cannot be sent home because there IS no medication that will make her better.
Sounds like you are handling this perfectly. Wishing you the best of luck and care.
You will be prescribed meds and expected to followup with a local physician.
Most healthcare workers are off this week. Your Mom is dealing with an extremely skeleton crew of workers. Expect nothing to move fast.
She's still better off on the hospital with the limited healthcare staff than she'd be at home. She's violent and paranoid with dementia and that makes her dangerous to herself and others. She as Baker Acted. The father can refuse to let her back home because she's an unsafe discharge. He needs to tell them at the hospital that he staying somewhere else and will not take care of her.
Staffing is very light this week.
In Florida usually you are released in 72 hours.
IF they send her home by ambulance and dad lets her in the door then call for next incident and have her transported by ambulance to the hospital and repeat the process until you get evaluation, diagnosis and paperwork that indicates she is no longer competent in making her own life decisions.
I am so sorry. I think you knew somehow this is all coming, but her killing off your Dad first with this stuff isn't going to work to improve her own life or anyone else's. What a sad way to spend your holidays. Again, I am so sorry.
This might mean they have to discharge someone. That gets hard on the holidays as they have to make sure the person placed able to safely leave with the Holiday skeleton crew in place. Nobody moves on Christmas without crisis. Not easy to admit or discharge at all. More like getting into or out of Harvard University.
It has to get pretty severe to Baker Act so at least it heads in the right direction. It sounds like it progressed past the annoying no accountability showboating sweet talking phase to full blown late stage agitation that must get under control. They will not discharge until this gets treated. Now the fun of deciding what their next forever homes will look like the next big hurtle.
No one wants to see a husband and wife split up but we had a case recently on the local news where the husband stabbed his wife to death in Memory Care.
I on the other hand feel stuck indefinitely in the no fun AND no consequences phase of agitated sun downing, showboating, then getting away with everything. So far my Dad has not caused the level of violence described. YET.
He does not know his pissing contests now involve driving into things, losing his car, pullups, incontinence that could lead to sepsis. He also does not know that it has to get really bad like sepsis or destroying christmas trees like this to get admitted as they scramble to make room.
Sorry to dump my problems but I look forward to the day when symptoms severe enough to get results such as this.
I would request a meeting with the social worker asap, meaning you and dad have to have a blunt mutual understanding of what yall want to do beforehand.
And let’s face it, he probably will want her home, especially if she’s stabilized on psych meds. And it will likely then be a matter of time before she thinks she’s fine without the meds and gets violent again.
Still, that’s probably what he wants. In that case, get him a life alert or an Apple Watch so he can call 911 from his person.
Also, apparently she hasn't been admitted yet because they don't take her insurance. So I'm not sure where they will take her from here. If she hasn't even been admitted, when does the 72 hours start?