Is a Psych consult in assisted living okay?

Sunnygirl, I'm so sorry about the fall and this new complication. She would need to be sedated, I'm sure. Your idea about getting the scans done at the same time is terrific if that can be arranged. This has to be so stressful for you, knowing that she is in pain from the fall and then having an uncooperative AL. Please keep us updated as things happen.
Carol

If her doctor diagnosed her with "significant dementia" I hardly think a consult with a psychologist about behavioral outbursts is needed. She should be seen by a neurologist to properly diagnose the type of dementia he/she thinks it might be, and perhaps an anti-anxiety med (low dose) might be needed PRN (as needed). However, outbursts are part of the symptoms of dementia and the storm blows over soon. The heat being turned on is another serious problem since heat will dehydrate seniors very fast and they (ones with dementia) don't know to ask for water. Get this rectified immediately!

If it is a functional assessment that should be fine. They may be trying to determine if she needs an increased level of care. But talk therapy would be of little value to someone with dementia. They would need to remember conversations with the therapist. And in my Mom's case that would be impossible.

sunny. My mother was admitted to a geriatric psychiatric hospital and tested by a psychologist to determine her level of cognition, memory, judgement etc. I have no problem with that and was not present. She has also been seen by psychiatrists. Vascular dementia (with paranoia) was diagnosed. She will also be tested by an OT to determine her level of physical function. Talk therapy is another thing, and I wouldn't see much of that being useful, but it may deal with some current issues. For example, my mother has been very resistant to taking any meds, and slowly they have convinced her to take them. How long that will last I don't know. Mother also has Borderline Personality Disorder (lifelong) which they are not trying to treat.

You said that this is a cousin who would not do this for you. Did she have some psych issues before she entered assisted living? I would request an account of the outbursts. I "made friends" with a coordinator at my mothers ALF and had regular though not that frequent contact with her which was invaluable and filled out the picture of mother's problems for me, along with the phone calls I had from mother. I care give at a distance. (((((hugs))))) for the often thankless job you are doing

selfadvocate - welcome - LO means loved one There actually is a thread for acronyms - somewhat humorous but also informative. :)

Sunny, about the heat, as we get older our skin thins which is our first defense against getting cold. Thin skin also causes bleeding quite easily. Old folks just get cold. If folks had their way here, the heat would be on all summer. Instead they are wearing heavy sweaters in the house. And, no the air conditioning is not on the majority of the time. I am always wearing shorts and T-shirt and dripping wet.

In the winter, they would like thermostat set to 80 or 85. Shorts season even in the winter at times. LOL!

I should clarify that mother was in an ALF when her problems increased so that she was eventually admitted to the geriatric psychiatric hospital. ALF staff were involved, as well as a community psychiatrist, part of a visiting group who were pulled in after a hospitalization (regular hospital) following the increasing behavioural/mental problems. Mother changed doctors off and on so her current general practitioner was not involved. It was a geriatrician on the hospital staff who recommended the visits by the psychiatric team. Dementias can be more difficult to handle when there is a long existing mental disorder is already present.

I see we cross posted about the LO.

LO = Loved One? It was good to confer with her physician before consenting to any further evaluation. Her physician is in the second best position to determine the benefit to her with you as her primary decision-maker. Good advice from SelfAdvocate.

So much helpful info. Thanks.

UPDATE. When I spoke with the GP yesterday by phone she told me that she would proceed with the brain scans immediately as soon as I was sure if Medicare and/or Medicaid would cover. So, this morning I called a local Neurologist, who specializes in Alzheimers and other brain disorders and spoke with their rep. They said if the GP will refer her to their office, they will check with her insurance and get the prior approvals and have them scheduled ASAP. I asked about a psych evaluation and they said to wait and if it's necessary, they will order it. So, now I'm not sure what to do.

I faxed a detailed letter addressing my concerns to the director this morning. I hope she's had a chance to review it.

I'm going to the ALF soon. I have to transport my cousin to the ortnopaedic doctor as their transport person is out this week. I intend to tell the Director what the Neurologist's office said and if the ALF still wants the eval, prior to the brain scans, I'll probably go along with it, ONLY if there is documentation of these outbursts they are describing.

My cousin is an only child. She is spoiled and has always gotten things her way. I would not be surprised if she has outbursts, but I haven't seen ANY since she got the full blown dementia and I have required her to do some things she did not like, such as wearing a bra, brushing her teeth, etc. She has been completely compliant with me, but I will believe what they report if they have it documented.

I wanted to give an update as of this evening. It looks like the psych eval will have to be put on hold for awhile. The orthopaedic doctor took more x-rays and says my cousin sustained a fracture to her spine! No wonder she's in such pain. (I have a question about the procedure the doctor is advising.) Meanwhile he prescribed her Percoset every 8 hours. I don't think they can do a evaluation while she's on narcotics.

This is turning out worse than I had expected. Now she needs an MRI for her spine, before the vertebroplasty can be done PLUS, she needs the MRI for her brain. I'm so confused. I'm going to just inform the doctors and let them and the insurance company decide who to handle it.

Meet with the head nurse at least monthly, go over meds and behaviors and activities. They do track attendance at all the activities and bus trips. One of the warning signs is less participation, which points to physical or mental changes, things slowing down.