How do you deal with a doctor who is not the least bit interested in helping mom get into a memory care facility which she definitely needs?

Well it might be time to consider changing doctors. See if you can get an appointment with a good geriatric psychiatrist (you can always tell her it's just a geriatric specialist if she balks at seeing a new doctor, then you can get a new regular PCP who will need her old records but will get their own test and make their own evaluations. When you are searching for facilities, specifically look for ones that have security alarms - the patient wears a bracelet that is almost impossible for them to remove that sends an audible alarm to any outside door they approach. Another type of facility that you can check out is one that has a secured MC. There are quite of few of them that have units or neighborhoods that are secured with locked doors; these unit often have their own outdoor gardens and patios that are also secured. Best type of place for those who may tend to wander off and hurt themselves.

At the hospital it is the social worker who will help you with placement. There must be diagnosis first that Mom isn't competent or safe alone. Social Worker can help you get guardianship or conservatorship if you are not already POA. Do not allow her to come home, because from there they will place it all on YOU to find a facility. I assume there has been no neuro psych consult and no diagnosis yet, and that has to come first. Good luck!

Every Memory Care facility I have ever seen has LOCKED units so that the residents do not wander.
I can not believe that wandering is the only reason that she was rejected at a facility.
And there has to be more than 1 Memory Care Facility in your area.
Talk to the Social Worker and they can help you get her placed in a facility that is appropriate for her needs.
Stress to the Social Worker that mom can not be discharged to her home as it would be unsafe for her to be alone. Also make sure that they are fully aware that mom can NOT move in with you.

My mother didn't need a doctor's recommendation to get into her MC. The MC sent out their own nurse who evaluated her. She did the "count backward from 100 by sevens" test (passed), "Who is the president?" test ("The man with the pig eyes" Close enough-- passed), and just when I was expecting her to be rejected, my dear mama said to the nurse, "Have you met my [imaginary] husband? He's on the roof helping NASA with a satellite that crashed."

They welcomed her with open arms. :-)

Has she had a needs assessment done by the facility?

I am confused by your post, because where I live, MC is the very place you would place a wanderer.

If your mom can live alone I would question her need as her doctor as well. Typically the person needs to be cared for 24/7 before a doctor will say that they need a facility.

Sometimes we just have to stop propping them up so that they fail on their own before we can get the help needed. It's a terrible system but, that's how it works.

Get another doctor

Agree with Panda - find another doctor.   This one doesn't seem to have your mother's care in mind.

I would locate another doctor that listens carefully to a patient’s needs and is interested in working with you, her caregiver in fulfilling necessary medical needs.

Did you ask him what he isn't helping or suporting you in this endeavor?
The short quick answer is get another MD.
I would imagine you've tried this before contacting us here ?
Are there other extenuating circumstances you are / or need to consider?
I believe you mom could be a wanderer AND need to be in memory care facility - can't these both be true?
Find another facility and have MD change diagnosis.
Be aware of Covid and facilities.
Has you mom been vaccinated?

Why in the world would a memory care facility reject someone who wanders? That is a big part of memory loss, thus the need for memory care. Call the doctor and ask him to help you get her placement. I mean, if he documented 'wandering' there has to be a diagnosis for him to put with that word. The only thing I can think of is some memory care units may not have secure exits to keep her from wandering outside. Ask the facility who rejected her - why is she rejected and do they know a facility that could handle her care.

I'm also wondering, do you even need a doctor to help you get into memory care? Call some and let them know she has begun to think people in her house so you feel she'd be safer in memory care. If it's a requirement to have this diagnosis, demand it from the dr who documented a related problem.

Seems your mother needs an evaluation to determine the type of dementia she has as well as the "stage." Ask your doctor for a referral to a neurologist, preferably one that specializes in geriatrics. This specialist would be a better ally than your mother's primary care provider... and will understand the wording needed in her charts for memory care placement.

I needed a specific letter from mom's doctor to become my mother's rep for her pension (it is federal, no feds accept ANY kind of POA.) He promised the letter (all documents incl POA sent to the BEFORE the appt.) but NINE months and multiple calls plus portal pings/month later, nothing. Meanwhile, we were moving forward anyway. She was already in MC before I got the letter needed from a new doctor.

We had NOTHING from a doc in hand but went looking at MC facilities in my area. We had POAs etc, but per the EC atty, those are not helpful for making a move. What he said may apply here as well - no one can force them to move. I had the same issue with docs and her driving - none want to get in the middle of it. So, the doc may not feel it's his job. Atty suggested guardianship, but it's expensive, it takes time and I don't think she would have passed the testing courts would have done. Also, the facility chosen wouldn't accept a committal.

It does seem odd that a MC unit would deny based on being a wanderer. They are generally locked down for that very reason. If that place isn't locked down, find another!! It wouldn't be safe for her there.

The facility usually does the assessment. Doctor notes are typically pretty skimpy, lacking in detail often. Once we settled on the place, paid the fee, they had me fill out paperwork and answer questions regarding mom. Even before that, taking her there to see the place once it was finished, YB was adamant she'd prefer AL, but I said no and so did those taking us on the tour.

I would have a chat with the facility you tried, to get more detail about why they said no. IF it is a NH with MC unit, and she doesn't require specialized nursing care, she likely will be turned away, esp if Medicaid might be involved. Check out others in the area. Some states will fund regular MC, but many states don't and even when they do, there aren't nearly as many, so harder to get in.

If she is under the income limit for Medicaid, she might get some in-home assistance. It won't be full time though - this would be helpful if she can't afford MC. There should be aides hired for the rest of the week as well. There's no question that she should NOT be living alone. If you can't move in temporarily with her, or she with you, she IS going to need in-home help. If you are working, perhaps a day care place then you only need to cover nights/weekends, yourself or with hired help.

Don't wait for this doc. Search for a place that might take her, even if its not ideal, you can try to find a better one later. Another way you might get assessment is through a care-giver agency. I tried hiring 1hr/day, to keep mom in her home longer, to check up on her and meds, and get her used to having them. Before starting, they sent a nurse to assess mom. Medicare pays for this. She brought the test to mom's. with 2 of us there, and we all were "comfy" in the kitchen. The nurse confirmed what I already knew (still nothing in writing - the facility did NOT need anything like that from a doc or anyone else.) But, if you feel you need that assessment, try that method. It might be easier to test mom at home and it won't be as "threatening" as perhaps a doc test.

Meanwhile, find other places with MC units. Ask questions (cost, add-ons, care provided, etc, and tour if you can.) Sooner is better than later. She should be in a safe place. Don't wait for this doctor. We had to come up with a ruse to get her to move. You should be able to do that - suggest she's moving temporarily so that you can have her unwanted "guests" evicted. Any number of reasons for a "temp" move can be used.

We had difficulty with a doctor at the time MIL moved into a NH. We did it anyway, then wanted to leave that GP and use the regular who visited the NH. Original doctor was very unpleasant and refused to hand over case notes. Other family members had trouble with him too, and we were told that friends were also in the process of moving to another GP. It seemed that his business wasn’t going well (not surprised), and he thought (correctly) that MIL going to NH would lose him another paying customer. It did provide a reason for the problem. The new doctor just took it from scratch, without her notes.

If it really is as simple as one letter from Dr which you cannot get then use a lawyer to write a request for the letter - yes I know it costs (in the UK it would be about £150 which I guess is around $200) but not many Drs would refuse that request.
I agree with all those who have said look for another facilitiy, wandering is a definite need for in, when considering memory care - anywhere that will not take her on the grounds she wanders (which is debatable with the circumstance you give) is not one I would consider likely to fulfil other needs either, it seems to represent a lack of care.

She needs to be diagnosed as having a neurocognitive impairment or dementia in order to get placement at a memory care facility. These are locked units so the wandering really shouldn't be a issue, lots of people with dementia wander a bit.

Tell them your mom is danger to herself that she not only can take care of herself but she is now having hallucinations and needs to be in memory care.

If that doesn't work, get a new Dr.

She could have a UTI or just be dehydrated, which causes hulucinatiins.

But, those memory places are not great to live, especially at this time with Covid.

Your mom would be happier living in her own home where she is familiar.

It really doesn't matter if she doesn't remember if she ate or not.

She'll eat when she gets hungry.

My 96 yr old Dad eats a little every 2-3 hrs.

You could install cameras in her home and tell her to call you instead of walking over.

She may have just had a dream or saw shadows.

You should deffiently talk to her about staying in her own home or moving to a facility.

Those facilities are not what they make make them out to be.

A good memory care facility will be able to handle wanderers. This is not an unusual condition for people with dementia. Get a new doctor who specializes in elder care. Check out the facility carefully. They should be able to tell you how they have handled the pandemic. Ask about their protocols and whether they are able to quarantine people who are contagious. My mother's memory care facility reports number of positive cases for staff and residents and also if there was a death (there was 1). Also be aware that during the pandemic you may not be able to visit as much as you want. My mother's facility has to lock down the facility for 2 weeks (no visitors) whenever staff or residents test positive, which has been happening more often in this second phase of the pandemic.

Change doctors! If she’s not seeing a Geriatric Dr., and a Geriatric Psychiatrist she needs to be ASAP! If she can afford a caregiver in the meantime during the transition please hire one. It’s just so dangerous to be home alone at this point.

You immediately start interviewing other doctors and get recommendations - get away from this one - keep looking until you find the right doctor and move her to the new one. Also keep details of what she is doing. And contact your local Office on Aging for advice and help. Do not give up.

Neurology. Get a referral to a Neurologist, who, in turn, will schedule radiological scans, [MRI,CT, and/or CTA], In 2021, scans are purposed to discern specifically what's happening inside brains.
And, on your own, look into latest research about Porphyromonas gingivalis which is indicated as potentially causing ... lots of unhealthly things.

Imho, a geriatric physician is required.

Was she actually rejected at a secured memory care with a locked door to the outside world? That seems unusual.

Or maybe she was rejected at an assisted-living style setting, which usually does NOT have a locked door to the outside world.

i don't see why the facility would reject her. there are plenty of residents at a NH that are "wanderers", if they think they will leave the building, they put a small ankle thing on so that when they get near a door, the door locks. the next time she goes to doctor or ER, tell them that she can't come home because you can no longer take care of her or just tell them she lives alone and cannot be trusted to be safe. wishing you luck.

She needs a secured unit. Is there a social worker at the hospital whose job it is, to help secure appropriate facilities for your LO?