For the past 5+ years, I've been caring for my 84 year old mother who has dementia in my home. In the past month she has had a precipitous decline cognitively...knows my name but doesn't realize I'm her daughter, wandering, agitation that's starting to border on aggression, thinks her parents are alive & doesn't recognize my home as her home any longer. Fearing a UTI, I took her to the doctor. Urine was clean & we're awaiting a CT appt to compare to her previous one 2 yrs ago & to rule out strokes or tumors or whatever. He did a mini-mental...the first one that she's ever had to my knowledge...and she scored only 13/30. He stated that, in his opinion, she is incompetent to refuse nursing home placement but did add 3x/day Risperdal, & Trazodone at bedtime with the Seroquel she was already on to see if we could eek out a few more mon the at home. The first few days, she was markedly better...much more relaxed, less argumentative & less agitated. Last PM, she had about an hour to an hour and a half period where she was agitated that she needed to "go home" & there was no changing her mind. She is 100% completely self-ambulatory & I wasn't certain what I was going to do if she went outside & refused to come back in. Eventually she calmed & slept through the night. Tonight, starting around 5pm, she was extremely agitated, adamant that she was left in charge of my horses, that they were no longer in their fenced pasture & that she had to go get them back in. No amount of talking or showing her that they were safely contained appeased her. In desperation, I gave her the 1mg Xanax I can give in "emergencies". It didn't faze her one bit. It was as though I'd given her a Tic-tac! I'm pretty certain at one point that she was on the verge of striking me physically, but never did. Thought I had her convinced that all was ok because she could see them through the window next to her chair while she sat & watched TV & I prepped a very quick dinner of cold ham & cheese sandwiches (didn't want to be away from her long). I no more than got the first one made & looked out the kitchen window to see that she had slipped out the back door, down the lane to the barn, over the bridge & through the gate into the horse pasture. By the time I could bolt from the kitchen , she was attempting to get one of the horses to go towards the barn. The horse dutifully did as asked but then took a sharp turn to the left to avoid going into the barn & would have inadvertantly knocked mom down if it hadn't been for a nearby wall. As I'm running to intervene, she tried again with one of the other horses....one that's been known to kick first & ask questions later! Thankfully, he was in a good mood & simply walked away from her...but the whole incident *could* have been very ugly! (Tomorrow, I'm buying a padlock for the pasture gate...but, the mood she was in tonight, I wouldn't put it past her to try scaling the fence!) Despite all of the meds & the additional Xanax, it took her 3.5 very loooong hours to calm down again. This "near miss" has me deeply concerned that I can no longer keep her safe here at home. She has a long history of refusing placement...and even said she would refuse it the day I took her to the doc. I know her elder lawyer will be the one to petition for involuntary admission due to incompetence but what are the steps that I should be expecting & how long does it take?