Moms behavior at ALF is not good. What can I do before they ask her to leave?

Talk with the administration and see what the next step would be if she cannot handle assisted living. DO NOT...I repeat, DO NOT take her back into your home.

At my folks' ALF, they agree to keep the resident there until they die IF they're on hospice care. Since you mention your mom IS under hospice care and acting out, perhaps the ALF should agree to serve her meals inside of her apartment now, at least until the medication kicks in and calms her down. Either that, or the hospice nurse should medicate her with some Ativan to calm her down right away, that is my suggestion. Aggression and screaming/hair pulling suggests she is in need of something like Ativan to relax her. Such a med has an immediate effect whereas Seroquel takes time to build up in the bloodstream.

Being she's under hospice care, I don't think further medical assessment is going to be approved, but I could be wrong.

Don't allow the ALF to threaten you with kicking her out! Tell THEM to figure out how to make it work with mom since she's under hospice care now. Meals in her room is a good start for now.

GOOD LUCK!

See how the Seroquel works. It may take a month to see any big changes.

An AL may not be a good fit for Mom with all her health problems. May need Memory Care or a LTC facility.

Has your mom seen a geriatric psychiatrist? Is that who is prescribing the Seroquel?

It is possible that mom needs a stay in a geri-psych facility to get her meds adjusted. Or, as noted above she may need a higher of care than AL is able to provide.

I struggle with this question. My mom lives in an assisted living with a lady with Alzheimers…she is loud, constantly after my mom to do things for her..mom has a bad back and is on a walker…..The lady can be mean. She is really upsetting my moms peace… with Lewy Body she requires a calm atmosphere. As a retired 27 yr clinical staff member I get the family problem…I witnessed this many times. If meds did not work our facility moved that person to a memory/dementia unit. It is important to allow others to have some peace also. Mom and I have talked about when/if she becomes disruptive to others daily {like the gal that is driving her crazy} my mom agrees she will move to memory care or a nursing home. Sorry…this is all so painful..

Some people are opposed to medicating an elderly person, but if that is what is needed, go for it. Maybe even something fast acting. Keeping others safe is more important. It's not like it would ruin her life, she no longer has the prospect of a good life.

I'd try to have a conversation with her hospice team - nurse, SW, chaplain - to be sure they have ruled out stuff like constipation or unrecognized pain. They probably have done that, before ordering Seroquel. Be sure that the nurse and SW know your concerns that she will be asked to leave and there is no 'plan B".
Often an ALF will insist that any patient who is disruptive has a 1:1 companion to 'supervise for safety". Your mother pays for this, of course. And it may or not be helpful while waiting for Seroquel to take full effect.
It may be that you will need to revoke her hospice enrollment so that she can be admitted to a geriatric psychiatric unit for assessment of behavior and management of it.
SW and nurse at hospice are always overwhelmed, but being politely pushing and asking them what steps you can do to help the process along works very very well.
Also, generous. seasonal gifting to all 3 shifts of staff at the ALF, and something to management as well, can't hurt.

Tullspot1234: Imho, perhaps your mother needs to see a geriatric psychiatrist.

They were happy enough to take her in and take your money so I would ask the Director why they now think you should be responsible for behaviour they were happy to deal with to get the income but not the hassle. If she had been easy to deal with then she would still be at home with you. Having said which it takes people time to settle and they will push every boundary possible to see what they can get away with whilst doing so. Unless there has been a decline in her cognitive reasoning, a sudden onset of dementia or similar your mother is perfectly capable of understanding and is basically being a toddler throwing a tantrum. Their management should be able to deal with this - misbehave at the dining table you get taken back to your room - assault the staff, you get taken back to your room or to really bring the message home call the local police and give her a warning. Of course this is not appropriate if she does have dementia, but then ALF is not appropriate they will not have the skills for the care needed - so it comes down to is this illness in which case find somewhere more suited to her needs (cognitive assessment may be necessary) or is it tantrum and attention seeking in which case remove her back to her room like a child on the naughty step until she cottons on that it isn't getting her any attention. Personally I think the best thing you can do it discuss with the director and support them in whatever they suggest - but not taking her back home.