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My husband has Alzheimer's and was combative & aggressive.  There has been a noticeable decline in the last few months & then on New Year's Day, we had to have him admitted to the hospital as he was having severe anxiety and trouble breathing. He ended up getting pneumonia & c-diff and was put in isolation and eventually moved to a skilled nursing facility. He has a below the knee amputation, and is confined to a wheelchair. He is being kicked out of the skilled nursing facility & must either go to a care home or home with me. I work full time, and am 18 years younger than him. He is 79 years old. They nursing facility said that the insurance will not pay anything else for him to stay there, as they cannot justify improvement in his behavior or physical therapy - mainly because of his cognitive skills. He has hit the nurses on occasion and has threatened others so they don't feel it is really safe for him to come home, and suggest he go into a facility that is locked & capable of dealing with his behaviors. The problem is, these places are $3,000 and up per month. I have applied for funding through our state but am told that will take several months, and that many people will not qualify. I had a full time caregiver that stayed with him at our house while I was at work. He is willing to come back & help me out, which is awesome, but I am kind of afraid to bring him home. I want to keep my husband & myself safe and am worried that something will happen once he comes home, however, I don't see any other alternative unless the funding comes through, but short term I don't see I have any choice. Also, before he went into the hospital he was not sleeping much at night, and neither was I. He would either get up and wander around, or he would start yelling & carrying on, and then I couldn't sleep & yet I still had to get up and go to work. Ideally, I would have someone to stay with him as a sitter at night, but I am already at my maximum amount for paying for caregiver expenses, so unfortunately that is a luxury I can't afford. He has two grown children, but they are not really willing to help out much at all. Any ideas? I know sometimes we get so entrenched in our own situation that we can't see straight!



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When you say funding, so you mean Medicaid? You want to get him admitted to an appropriate facility "Medicais pending" Go to the discharge planning office at the facility he's in and ask for a list of facilities that have the appropriate level of care for him. Then start making phone calls and get him on every waiting list.
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I would ask the grown children if they are willing to commit to a monthly amount to contribute to his care. Not sure how much you are paying the caregiver but some of the home care agencies have great 24hr deals. For example if you sign up for 24hr care its a flat $150 per day instead of $14 an hour. Maybe that can help with sleeping for work. But the discharge case manager should be able to give you a list like stated above.
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Is he a veteran?
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I am caring for my 85 year old husband who is in the late stage of dementia. I am 11 years younger and worn out. Nursing home is over $5,000 per month and even though he has long term care insurance, it only covers $113 per day...so I can't afford to put him in one. He has had violent episodes and I live on pins and needles most of the time. The doctor put him on Lorazapam 1mg, 3 times a day and Risperidone .25mg at night. It has helped a lot and he stays in bed at night now. The only problem with the meds is that he is at a bigger fall risk and I have to help him get up and help him with walking. He goes to day care 2 times a week, but don't know how long they will accept him there as they have had problems with him getting agitated. It's all become a living nightmare!
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you may want to hire an agency or a private caregiver to at least offer you some kind of help and relief at night. If you do not get adequate rest, you will not be able to help your husband either. You should talk to the social worker at your current nursing facility and see if they can suggest other facilities that they may be partnered or affiliated with. I do think private home care would end up being cheaper in the long run, even if you hire someone 24/7 or overnight. This would be much more affordable than a facility.
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When my friend started to resist anyone helping her with her incontinence at the AL facility/memory care floor, the nurse there suggested I get into a geri-psych ward in a hospital to find a medication that would calm her down without making her dopey. It was a great suggestion. It took 3 1/2 weeks for them to do this, all covered by her medical insurance and it worked and allowed her to stay in her AL facility-memory care apartment until she passed on. I had been to his hospital many times before and never knew they had this special floor for dealing with patients like this. Wishing you the best! I know there's an answer out there for you somewhere. As the dementia worsens, sometimes this aggressiveness passes away, too, as they enter a different stage.
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We tried the private home care, but 24-7 would cost us $13,000 a month for one person. The AL facility/memory care apartment I found was $11,000 a month for 2 people so the husband and wife could still be together. Now that the wife has passed, it's down to $7,000 a month. A combination of retirement income, social security, savings, long term care insurance, IRAs and the eventual sale of their condo will let me cover this for years. When their assets are depleted, VA can help out. The AL facility will accept the reduced public financing after 18 months of residence at their regular rate, so I feel I found a safe haven for them first as a couple and now as a widower. The memory care level of care has been great.
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You should immediately seek the assistance of an elder law attorney in your area as you raise more than one legal issue. From this website, at the top right, Click on "Money and Legal" and then click on "Elder Law". You can then type in your city or zip code to find an attorney to help you. If there is not one in your area listed here, you can also check at naela which is the National Academy of Elder Law attorneys.
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If you have not done so please talk to his doctor about the violence. My mother started behaving like that. Hitting me, throwing things, she even threatened to hit me in the head with things. This was after we upped her Aricept to the maximum recommended dosage. I did some research and brought my findings to her doctor we adjusted her Aricept back down and added Namenda and another drug (sort of a mild sedative that he suggested which she has since been taken off of). After about a week of the news dosages, she is just back to her happy, sweet self.
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The best advice you have here is to seek the help of an elder law attorney. You can also go to the Area Agency on Aging and they will help you with an attorney and other help that you need. I'm checking with them today for my husband who has Alzheimer's. They are a great resource.

Good luck to you and keep us posted. When people find answers many of us can profit from them.
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