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My 61 year old husband has dementia due to a head injury he sustained about 10 years ago. Our youngest daughter and I have been caring for him in our home (I work full time and she’s a full time student), but his behavior has gotten very difficult to manage. In October he got an infection, declined drastically, and after 10 days in the hospital, went to the nursing facility for rehab. He’s since been discharged from rehab and I plan to keep him there for long term care. He’s gotten better physically and can now feed himself and walk, but his mind did not recover. He thinks he’s at our home there, and is only oriented to person, not place or time. His behavior is often combative and aggressive, and he’s difficult to manage. The nursing facility has been trying to discharge him since he got there. I agreed for them to make referrals to other facilities in our town, but no one will accept him. I requested a psychiatric evaluation, and they just started adjusting his meds this week (after 4 weeks of this). They want us to come and sit with him and watch him. He goes into other resident’s rooms, and gets agitated when redirected. I’m afraid they will evict him. I am no longer able to care for him at home, but I am worried about what they plan to do. Does anyone have any experience with this? If no other local facilities will take him, how can they kick him out? This is incredibly stressful, as anyone who has cared for a loved one with dementia knows. I’m only 55, and can’t believe this is my life! Thanks for any ideas you might have.

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Thanks to all. The facility SW is doing everything she can to find a new place that would be a “more appropriate” setting for him, but hasn’t been able to find one. She wants him out really bad, so I’m sure she’s working hard to make it happen. Last week she was trying to get him into a geriatric psyche hospital, which I agreed to, but so far, I don’t know if they will take him. I went to see him today and he was so snowed I couldn’t wake him up. I do think with proper medication management his behavior could be improved.

I just can’t get any peace. It’s hard enough to have to place my 61 year old husband, but still having to deal with all of this is just gut wrenching. Thanks for listening.
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My mom was kicked out of memory care because of her behaviors. She was a danger to herself and others. She was on hospice at the time, they recommended a much smaller, homey care home where all residents there had been kicked out of the previous facility. And it worked well for mom. The caregivers there all had specialised training in how to effectively deal with aggressive behaviors. So make calls, ask around, there is something more appropriate for him. Starting with inpatient geriatric psych assessment is a great place to start.
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According to a geriatric psych nurse that I know, this is the most broken part of the system for Alzheimer's patients. There are no LTC facilities for aggressive dementia patients. Instead, they end up in and out of psychiatric hospitals. And where they go in between is problematic.
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Here in NJ there is a place combative Dementia patients are sent to so meds can be adjusted safely. Then they r returned to a NH. My daughter is an RN in a rehab/NH facility. She says it can take a month to see if a med is working. Then to find out it's not and have to try another one for another month. You husband sounds like he has anxiety. There r meds for this. If the NH won't get a phyc eval then u take him to a doctor if possible.
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My relative with dementia was asked to leave a facility because she was wandering into male patients' rooms and trying to get into bed with them. She just thought that she was still at home with her husband and that was where she belonged. However, I totally understand that the other patients and families had every right to complain. We were fortunate to find her a bed at another facility but we had to wait a couple of weeks for it to open up.
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I hope that as the adjusted meds kick in your husband's behavior will become more manageable. Surely the facility should wait to see how that works out! And perhaps by then there will be an opening in Memory Care. Can you arrange for someone to be with him during the day, for a few weeks?

Your poor husband! He can't help his behavior. His brain is broken. The poor facility! They must protect their staff and other residents from potential violence. And poor you! It is terrible enough to have to have your loved one in a facility, but this situation is a nightmare. Hugs to you.

My mother had a tough time adjusting to nh at first, especially at night. She wasn't combative but her hollering was disturbing other residents. I slept in her room for a couple of weeks and was able to reassure her each time she woke up wondering where she was and panicking. After I stopped visiting on the night shift, when she woke up she would ask where were her daughters and she would be told, "They are all sleeping. That is what they want you to do." After this rough transition Mom settled in well and was content there. But at the beginning the nh was talking about moving her to the memory care floor.

I know your situation is different. I'm just wondering if having family with him for a while, and waiting for the meds to take effect might help him through the beginning period.

(I know that sometimes the advice is for family not to visit until the new resident has a chance to adjust to his new environment. But one size does not fit all, and for some just the opposite can be true.)
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Sorry to hear about your father. Some nursing home memory care units don't have the ability to care for people with combative and aggressive behaviors. One of our nursing homes has 3 different memory care units and each unit has different behaviors that they deal with. Are you willing to place your father in a facility in a different town? Maybe the State Ombudsman or another agency that specializes in the elderly can give you a list of facilities that might be better able to care for people with behaviors similar to those your father has. Here's a hug from another "person in the middle".
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They do have a memory care unit, but every time I mentor, they just say they have no beds.
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Thank you all for your responses. I am not sure what the admission papers say, but the law in my state make it hard for them to discharge people with dementia, but if other patients are at risk, they can. It is incredibly difficult. I can’t control him, and I can’t control the facility either, but I feel so stuck in the middle! Thanks for the hug, I need it.
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I don't know the answer but want to reach out with a hug. You are in an incredibly stressful situation.

Does the NH have a Memory Care unit?
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IS there a psychiatric facility he can be admitted to so that his meds can be adjusted in a more controlled and supportive environment?

I don't think they can unsafely discharge him, i.e. send him home.
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I'm sorry to read this. To answer your questions, what does the admission papers say? A NH can and will evict someone if they feel the person is a threat to the safety of themselves and/or other residents of the facility.
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