Help with elderly psych patient with dementia. Can memory care keep an aggressive psychotic patient?

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My mom is approaching 80 and has had a history of mental illness. She refuses to take her medications and has had 4+ 302/303/304 episodes over the last 2 years, and more episodes over her lifetime. Each time she goes though the process of getting treated for a crazy psych episode, getting released, and then relapsing back into the care facility. Currently she lives alone but has also started having difficulty managing her personal affairs (like paying taxes, uncontrolled spending, disrupting the neighborhood). She insists she is fine and everyone else is out to get her (the schizophrenic diagnosis). So I am thinking it is time to get her moved to a facility. I have Durable Medical POA and I think the hospital this time will be willing to sign declaring her incompetence. Both her social worker at the hospital and her Department of Aging rep agree that memory care might be a solution for her. My question is whether a Memory Care facility has the authority and willingness to keep an aggressive psychotic patient. My other concern is that if and when she calms down and appears to be normal whether they can still keep her against her will. She is quite good at talking the talk while in the hospital but once released immediately goes off her meds and relapses within a few months.

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A person in my alz support group had this issue. It took a few tries from psych hospital to nursing home memory care. She had to return back to the psych dementia unit a couple more times before the proper meds were successfully found. The memory care part will deepnd on the type of meds involved
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Thanks again.

In the last incident my mom was supposed to be released on a court ordered injection cycle but either she didn't follow through or the meds didn't do enough to keep her stable. Unfortunately I wasn't privy to the order because at the time she wasn't deemed incompetent so I couldn't get information. Ugg.

Up until 5 years ago my mom had been on Haldol for 20 years. But the Haldol plus other drugs made her into a zombie to the point she looked like she had dementia. We got her off Haldol but now are dealing with the consequences.

I like your suggestion Sunnygirl about consulting with an attorney. I might follow up on that.
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We have a niece, much younger than your mom, with a schizophrenia diagnosis. We went through the... in the Psych Ward, meds leveled, released, quit taking meds cycle...a few times early on. Then we got a court order for weekly injections. She has now been level for 8 years. I don't know if injections are a possibility for your Mom or not, but thought I would share our experience.
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I'd explore if there are residential facilities for those with dementia and mental illness. I know of a place in my state like that. It's not a traditional Memory Care facility, but, more like a mental hospital, but, is for long term patients.

In my state, you need a doctor's order to place someone in a SECURE facility, meaning they can't just walk out the door when they want. To my knowledge, that's the only way to keep a person in a Secure Memory Care without their consent. But, I'm no expert. I'd gather all your paperwork and get a consult with an attorney who can advise you of the options. I'd also think that the case worker and Counsel on Aging Rep should be able to offer some information. They certainly see this kind of thing and may have some suggestions.
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I really appreciate your replies!

The hospital seems to be willing to declare her incompetent. So that shouldn't be an issue because my POA kicks in at that point. She just arrived at a temporary facility yesterday and is quite verbally and physically abusive. But she will most likely recover well enough to get out of her current treatment facility mostly because they can only hold her for a fixed amount of time and after a month or two the meds do work well enough to stabilize her. At that point with POA I am considering a transfer to memory care.

My question is whether you are sure that she can't get out of the memory care facility until I say it is ok OR they will continue an ongoing eval in which they could later determine she is well enough to leave. She is pretty sly and seems to be a master of getting out with no intention of taking her meds.

The other question is if she is declared incompetent with Dementia rather than psychosis (or both) then she would never reach a state where she could leave memory care. She certainly shows signs of Dementia but it is a somewhat cloudy diagnosis because of her psychosis. I know this sounds harsh but I am really afraid she is going to hurt herself or someone else.
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I think the key thing in your post is the part where she goes off her meds. In the MC she would be on the meds so would have a easier time.
And yes, they can keep her as she will have been declared incompetent. As the saying goes, this isn’t the hospitals first rodeo. Good luck and let us know how you handle this. It helps others in the same situation.
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You would need to have her declared incompetent before you could do a thing.
I would think that a stay in a psych hospital with a psychiatrist that specializes in the elderly would be your best idea. They can stabilize her there and then you could move her to Memory Care when she's calm.
As long as you have the letter(s) declaring her unable to care for herself and you are medical POA, she couldn't "talk" her way out of either facility.
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