What can I do when my Mom is causing trouble at the NH and ask to place her somewhere else?

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My Mom is losing it! She was hollering and yelling at night and when any of the staff at the nursing home would leave the room, she would scream or yell until someone came back. She could not be left alone and barely slept. Finally, the nursing home requested I approve sending her to an acute care hospital specifically for geriatric psychiatry. I agreed - she struggles with bi-polar and anxiety and has a Traumatic Brain Injury and dementia - she is 80. Along with her physical issues (including being blind) as well, she is a mess. She fought going - literally - and had to be restrained. During her 15 day stay, they adjusted her psychotropic drugs and put her on some new meds. She seemed to be responding well. She was released back to the nursing home with new med orders. She has been back a week and it is beginning all over again, but this time she is angry and horribly agitated - nothing is right and she is claiming abuse and a multitude of other things. I'm so afraid they will permanently request they send her back to a psychiatric facility permanently and from what I can see, they have every right too. What are my options? Do I have any? I have MPoA and she recently transitioned onto Medicaid after nearly 5 years of private pay to the nursing home.

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My Mom had a very bad day recently -- the same day the fungal infection on her backside was particularly nasty. Sunnygirl1 is absolutely right -- pain or any kind of infection (utis are notorious) can make dementia symptoms much worse. I hope to goodness that the pysch hospital knows that and has done all those kinds of tests, but it might not hurt to double check, and ask what tests were done. And double-checking the meds isn't a bad idea, either.

Hugs to you as you deal with this heartbreaking situation.
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Then, I would ask to have a conference call with the patient care coordinator and other team members and brain storm about her care plan. They certainly have seen other residents with this type of situation and they may be able to give you input.

When my loved one was rather anxious, scared and not feeling well, her AL met with me and we discussed the possible reasons. ONE of them is PAIN. There is another thread around here on it. Sometimes a dementia patient may be in pain and they cannot verbalize it, so they act out. So, make sure your mom gets a full physical to rule out infections, fractures, dental problems, ear aches, etc.

At the Team Meeting, the on staff nurse suggested we discuss Cymbalta with my loved one's doctor. She also had fractures and a lot of pain. It worked like a charm and she gained so much relief going on that med. It was a God send. There are various medications that might be tried, if the ones she is on now don't work. Good luck.
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Great information Sunnygirl1. I LOVE this nursing home she is in and frankly, they truly love her. She gets amazing care - they are staffed very well and attend to her every need. From some of the situations I've read about in NH's, I feel blessed to have such a wonderful place for her. They communicate with me constantly keeping me in the loop on all decisions - I live 2 states away. She is in Nebraska. The thought of her being in a psychiatric facility just breaks my heart. She was so happy up until this episode.
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Oh, I would double check with her chart to confirm she is getting the correct doses of medication. Someone might have dropped the ball. Confirm they are medicating her exactly as prescribed.
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It's my understanding that it might take a little while to get medications adjusted. Can they try to adjust them again? It would seem to me that they can eventually get her to a better place mentally. It's worth a try, since she must very miserable in her present state.

You say that now she is agitated and miserable, but that doesn't mean she's violent. As long as she is not hurting anyone, then why couldn't they just deal with it? Is there a Memory Care unit that may be better equipped to handle her?

Each state is different, but it's my understanding that if the patient cannot be accommodated in a Assisted Living or Nursing Home, they will be kept in a psychiatric hospital.

Do you think the Nursing Home is a good fit for her? Do you think that they are really trying to meet her needs?
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