What are the options when an Alz/Memory care facility says your loved one is high acuity and is too disruptive for them. Is it a psych ward? Sedation every day? Let me know you thoughts. Thank you.
Good she went to ER. Hopefully they can hospitalize her for a few days to observe the behavior? You dont want the ER to send her back out, when the MC is saying she needs treatment...they you are right back where you started
You say she’s been kicked out of MC. Where is she now? Or are you anticipating her eviction?
There’s no excuse for a MC facility not to have a plan for cases like this. Did this facility expect that all AD patients are always very passive, cooperative, even tempered? That’s not how AD works. A good MC facility will have contingency plans for incorrigible patients. They will also agree to reserve the patient’s room upon returning.
Shortly after my wife was admitted to MC she smashed all the family pictures, damaged the blinds, and left the room thermostat hanging by the wires. She would be abusive, make racist comments, and be impossible to manage. The staff suggested she be sent to a psych hospital to address her behavior. The facility had a psych hospital they worked with and with me along, actually drove her to the facility. In only 12 days she was back in her room in MC with a totally different attitude. She wasn’t over medicated. She was very functional and pleasant to be with throughout her remaining days. I’m a big fan of psych intervention when necessary.
THANK YOU! She is in the ER where she is being even tempered, so the doc isn't comfortable medicating her for symptoms she isn't seeing. the MC won't take her back without her being medicated appropriately. I do appreciate your input, because I was very confused to learn the MC didn't know how to manage a resident that was extremely aggitated-I imagine it is not uncommon.
Alzheimer's is not a mental or psychiatric illness. She's already in memory care. They are supposed to be prepared to deal with patients who are 'high acuity' and 'disruptive' due to their illness. That is why these places get the big bucks for every resident.
They can handle your aunt's condition. Memory care facilities don't like difficult residents who are challenging to care for, so they will make all kinds of empty threats to a family so the family will move them somewhere else. They won't kick her out.
She needs to be medicated. They may also need permission from her POA to medicate her.
If she has Alzheimer's and is in memory care, a psychiatrist isn't going to do anything that can help her other than prescribe some meds. Her own doctor or the nursing home doctor can do that.
This is a good point also. In my state, there is a state ombudsman/ ombudsperson you can call with any concerns about AL/ MC facilities. If that is an option in Chesla's state, it could be worth a call to the state and discuss the situation with the ombudsperson....
Yes, she needs to see a psychiatrist and be prescribed the right meds to calm her. Trust me, it doesn't feel good for anyone to be anxious and agitated all the time. With the right combo of meds, she should be able to be accepted back (?) one hopes--is she in the hospital? They can get the testing and such done there--but you have to kind of jump on the wagon and be a 'voice' that they listen to. (The Drs, not your LO).
My MIL has been taking tranquilizers for the past year. She's on several and some work better than others. But IF (big IF) she will not agree to take them--they sure don't help, sitting in the bottle on a shelf! She's at a place now where they need to pre-dose her--not wait until she's in a full rage. It's been a steep learning curve for my DH and his sibs.
Not even. A couple milligrams of liquid lorazepam a couple times a day in her drink will keep her under control right and proper. That drug's like a miracle.
In all my years caregiving I've never seen a case of dementia-related agitation and anxiety that didn't respond well to a nice, clean benzo.
As for your MIL. Why ae her meds even on a shelf where she can see them? Do they come in liquid form? If so then someone should be dosing her food and drink daily as prescribed without telling her.
The goal for meds is calming, not sedation. People still have this misconception that meds will make their loved one a drooling zombie.
That said, meds can be trial-and-error in the beginning. It can take time to get a dosage just right. And one med may not work as well as another.
But it’s worth it! It’s no fun for your loved one to be agitated either. They can’t control or rationalize what is happening in their brain. Like any medical issue, it’s an organ that needs medication to function. You wouldn’t tell a diabetic to just think good thoughts to get their glucose under control. A pancreas doesn’t care what mood you’re in! Same with brains. Happy thoughts won’t make your brain do what it no longer can.
The facility may be able to recommend an appropriate psychiatrist, or if aunt goes to hospital they may have a recommendation. If not, they should be able to tell you who to ask for advice. Because it will probably be a phone search, it is as easily done by family interstate as by you.
It’s important not to land yourself with too much responsibility just because you may be the one on the spot. The family also needs to tell you who (if anyone) has a POA, and if not who they agree will be the one to lead the whole thing. The worst option for you would be if they can’t agree on what to do and who will do it, so push them to get their act together. Don't look too willing to step in, it can make it very hard to step out. Good luck!
I think it could be psych ward for a while, medication change, stabilization, and then hopefully with that accomplished, the same memory care may accept the resident back in
sorry to hear this. I dont have direct experience, but others on the forum have mentioned that the facility itself can often recommend psychiatric hospitalization and what would be needed. Hopefully she was hospitalized in the right hospital where they can make the right assessment, treatment/ medication changes, and then discharge recommendations. Then hopefully , the same memory care place will accept her back. I agree this is all super tough. Hang in there, you did the right thing to post to this forum.
oh no, Can you give more details on what exactly were the issues? Have you tried to ask other MC/ Alz places if they will take your LO?
I'm interested to hear others' input on this topic. Does you LO already have a psychiatrist established? From what you mention, it seems like consulting a psychiatrist is a key next step to do. Is being kicked out definitive? or is there some chance the facility will keep your LO if some treatment/ medication is initiated?
Thank you for your note. She does not have a psychiatrist. We had to deceive her to get her away from her home and set her up in the facility. She is very stubborn and was trying to climb the fence to get out and disrupted the whole place. They ended up calling the paramedics who came and took her to the hospital. We have some blanks to fill in. You made some great points and I will update as I learn more. Thank you. This is tough.
There’s no excuse for a MC facility not to have a plan for cases like this. Did this facility expect that all AD patients are always very passive, cooperative, even tempered? That’s not how AD works. A good MC facility will have contingency plans for incorrigible patients. They will also agree to reserve the patient’s room upon returning.
Shortly after my wife was admitted to MC she smashed all the family pictures, damaged the blinds, and left the room thermostat hanging by the wires. She would be abusive, make racist comments, and be impossible to manage. The staff suggested she be sent to a psych hospital to address her behavior. The facility had a psych hospital they worked with and with me along, actually drove her to the facility. In only 12 days she was back in her room in MC with a totally different attitude. She wasn’t over medicated. She was very functional and pleasant to be with throughout her remaining days. I’m a big fan of psych intervention when necessary.
I wish you the best.
They can handle your aunt's condition. Memory care facilities don't like difficult residents who are challenging to care for, so they will make all kinds of empty threats to a family so the family will move them somewhere else. They won't kick her out.
She needs to be medicated. They may also need permission from her POA to medicate her.
If she has Alzheimer's and is in memory care, a psychiatrist isn't going to do anything that can help her other than prescribe some meds. Her own doctor or the nursing home doctor can do that.
Yes, she needs to see a psychiatrist and be prescribed the right meds to calm her. Trust me, it doesn't feel good for anyone to be anxious and agitated all the time. With the right combo of meds, she should be able to be accepted back (?) one hopes--is she in the hospital? They can get the testing and such done there--but you have to kind of jump on the wagon and be a 'voice' that they listen to. (The Drs, not your LO).
My MIL has been taking tranquilizers for the past year. She's on several and some work better than others. But IF (big IF) she will not agree to take them--they sure don't help, sitting in the bottle on a shelf! She's at a place now where they need to pre-dose her--not wait until she's in a full rage. It's been a steep learning curve for my DH and his sibs.
Good Luck!
Not even. A couple milligrams of liquid lorazepam a couple times a day in her drink will keep her under control right and proper. That drug's like a miracle.
In all my years caregiving I've never seen a case of dementia-related agitation and anxiety that didn't respond well to a nice, clean benzo.
As for your MIL. Why ae her meds even on a shelf where she can see them? Do they come in liquid form? If so then someone should be dosing her food and drink daily as prescribed without telling her.
That said, meds can be trial-and-error in the beginning. It can take time to get a dosage just right. And one med may not work as well as another.
But it’s worth it! It’s no fun for your loved one to be agitated either. They can’t control or rationalize what is happening in their brain. Like any medical issue, it’s an organ that needs medication to function. You wouldn’t tell a diabetic to just think good thoughts to get their glucose under control. A pancreas doesn’t care what mood you’re in! Same with brains. Happy thoughts won’t make your brain do what it no longer can.
It’s important not to land yourself with too much responsibility just because you may be the one on the spot. The family also needs to tell you who (if anyone) has a POA, and if not who they agree will be the one to lead the whole thing. The worst option for you would be if they can’t agree on what to do and who will do it, so push them to get their act together. Don't look too willing to step in, it can make it very hard to step out. Good luck!
Medication for agitation, delusions and/or paranoia can be adjusted so that there isn't too much "sedation", rather "calm'.
Can you give more details on what exactly were the issues? Have you tried to ask other MC/ Alz places if they will take your LO?
I'm interested to hear others' input on this topic. Does you LO already have a psychiatrist established? From what you mention, it seems like consulting a psychiatrist is a key next step to do. Is being kicked out definitive? or is there some chance the facility will keep your LO if some treatment/ medication is initiated?