Do NH seek psychiatric care for non compliant residents? - AgingCare.com

Do NH seek psychiatric care for non compliant residents?

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Mom is in NH since last month. Didn't want to go but due to poor physical health and dementia we were forced to give up caring for her. At first, she loved the home and is quite healthy and was social. Over the last week, however, she appears to be getting near delirium. She was hospitalized last yr for 16 days in psych unit for delirium. Nursing home has asked for no visits or phone calls come us for a week and then only briefly in front of nurses station. Nurse told me if she continues to bother other residents they would ship her to Alzheimer's home. Why can't they take her to her psychiatrist one hr away. Can't she go back into psych ward from th NH? I would drive her. They are giving her reality treatment prescribed by their mental health specialist. Her behavior drastically went downhill after my evil sister visited her and told her she didn't belong there etc. now my good sister and I who took care if her 24/7 for te lat year and a half must sit at station and be punished a well. I am so sad and frustrated. I gave up y guardianship to public guardian in order to get mom help now I have no say so. I know she needs to see her psychiatrist. War am I to do. I have to take Xanax in order to sleep.. I love her so much!

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Turmoil among siblings is why there is supervised visitation. You all need to get counseling before you find yourself completely denied any visitation.
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I appreciate others experiences working or being in nursing homes, however
if a facility wouldn't want a family member with the power to direct/supervise their loved ones care in the facility---I would exercise my powers to remove them.
Nothing worse for a fragile, confused elder than to be in unfamiliar setting and no familiar faces (family members). Adding the feelings of desertion and rejection to these folks would not improve their health mental or other.

While we may not know exactly the level of care being offered in this case, I am
pretty sure this facility does not meet the highest score in this state. Unfortunately many, many nursing homes and assisted living facilities accept large numbers of patients for whom they have very little chance of providing good quality care. While excellent facilities do exist they are in the minority and we as a nation (supposedly a Christian nation) turn a blind eye to their plight.
I pray each evening for the elderly who are not receiving the good care they so
deserve.
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So sorry that you haven't been able to get very much support from your sister and that you have had to suffer the consequences of her actions as well as your mother.
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correction...

that was meant to be "harrassed the" psychiatrist (NOT "arrest a" psychiatrist)
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This explains a lot and demonstrates a very good reason why, when we don't understand the story as posted, we should ask questions and wait for the answers before going off the deep end analytically in a non-supportive manner, piling additional stress on the poster.

I can tell you that I was my mother's 24/7/365 caregiver but when my sister, who had NEVER in her caregiver, decided to wrest control of the situation, filed in court to prove my mom incompetent (which we already knew because we had a diagnosis of dementia from the psychiatrist) and be awarded conservatorship, her lawyers and my moms court appointed lawyers, arrest a psychiatrist to such an extent that he withdrew from the case and with no longer treat my mom no matter what. This with such a shame as he was the diagnosing and treating physician of record, and the one most familiar with her case from the hospital on word. Once my sister got control, she changed our mothers doctoring to a lame "geriatrician" who couldn't have cared less about my mom. But hey, the court said it was legal.

Tho not the same exact story, I can relate to Debrasue and tell you that when the courts get involved, many times your hands are tied behind your back and if you're not submissive to them, they can make your life hell as well as the life of your loved one.

Debrasue, I'm going to state again I don't know your financial situation. Getting a lawyer to help you is expensive which is why I couldn't navigate to system very well myself. But maybe when things settle down and everyone can see what your concern is for your mother, you could petition to re-acquire guardianship under the circumstances. It is really going to depend on how much longer your mom is going to live and what did the fight on your part is worth it.

In medicine, there are many specialties and there are subspecialties within main specialties. I'm sorry but the mental health specialist and/or psychiatrist working with mom and prescribing reality treatment do not sound like folks who are experienced in Alzheimer's, dementia or memory care patients, all of whom not only drift away from reality but don't have the memory to put any kind of training into practice. This is the reason why ongoing and dynamic mental evaluation and medication management of undesirable behaviors is the only way it never ends up for this type of patient, EVER...ALWAYS. PLEASE do some reading and educate yourself on this topic.
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My sister is evil because for the past 1 1/2 year good sister and I have taken care of mom 24/7. While Janet lived next door to mom and never donated 1/2 hr I took a bag spoof trash out for mom. She also removed mom from hospital 1 1/2 yrs ago against doctors orders prompting me obtaining emergency GUARDIANSip and one month later ful guardianship. I agreed to her demands of not being able to place mom in a N H without court order because I could not continue going to court. I already had POA given to me by mom 2007 freely before she became ill. She trusts me. Janet could not stand the fact that she did not get guardianship even though she took mom out of the hospital against doctors, in a gown and diaper in the middle of the night wo oxygen (one hour drive home) and no medication! For the past year and a half she continually told mom good sister and I panned to put mom in a home or psych ward, threatened to bash our faces in in front of mom, broke into moms home, penned brother in laws car in with her own promoting police call, continually manipulating mom and said she would remove her from a hospital gain given the chance. Good sister and I have taken mom to ER many times after falls and sat with her for hours. Janet rarely visited her in the hospital. Janet promised mom that mom would never go to NH but never helped. Other sister has not visited mom for year and a half. Although she passes moms house up to go next door to visit,mom. I have taken mom to all dr appts, hair, dog to vet, groomers, all grocery shopping for past 15 years. When mom asked Janet to pick up a loaf of bread for her, Janet would tell her she did not plan to go to town. She would not do a thing for her. Janet did go to the nursing a few times and although mom was very happy at first, Janet told her she did not belong there. Moms behavior became so agitated after Janet's visit, that the home ordered all visits to take place at station in order to get the evidence against Janet to get legal visit restrictions against her, not good sister and I. We have since learned after posting this info about mom that the NH was not giving mom her Adivan maintance meds as prescribed by psych. After I called and inquired if this was the case. She is now on correct dosage and we will see how this goes. I gave up my guardianship for a public guardian because doctors would not get involved with the court to get her the help she needed. Mom was going to fall and break something if she did not get help. She was very ill and now her physical condition has much improved. Janet may visit mom occasionally but only to cause trouble!
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I agree with what Ferris 1 stated. Also, someone with dementia would not be able to understand reality therapy or most kinds of psychological therapies.
I have worked as a therapist in several nursing homes and have never seen family visiting a patient at the nurse's station and that may be true about what Ferris 1 said about the pyschiatrist asking for a week of no visitation. What I'm wondering is are you having to do this beyond one week? Also, I'm wondering if this has something to do with your relationship with your sister. How can she be that evil if she is taking the time to come and visit your mother and how are you reacting to her when she comes to the nursing home?
If she continues with her behavior, the nursing home will more than likely send her back to a geropsychiatric unit where there is a psychiatrist to prescribe medication. Sometimes, from there, (if they have physically attacked a patient at the nursing home), they will send them to another nursing home, otherwise she would be coming back to the home.
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As a nurse, having family not call or visit for a week is standard practice both in nursing homes, psychiatric hospitals and hospitals depending on the diagnosis. Prisoners can only see visitors who have been approved to visit which entails a very, very lengthy questionnaire, then criminal background check. Not all prisoners receive visitors at all. Like I said before, there is much more to this situation than was given originally, and I would like more details. Staff at nursing homes would love not to have to watch visitors visit with their loved ones, so they can take care of nursing others. Yes, there are different levels in quality of nursing homes which can be checked out at each state licensing boards for complaints. Without us being there in person, none of us knows what went on, nor can we pass judgment on others, unless one is God.
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I think this is a poor placement for your mother from your recounting of events. I would get to an elder lawyer and bring any papers that removed you from the control of your mothers care. You should be able to remain her health advisor and POA even after a nursing home placement.

I absolutely hate the notion that patients are routinely stuck sitting in front of nursing stations most of the days (their final days and yrs) so as to "provide" staff an opportunity to supervise them. If they need more staff to allow the patients movement to different locations, rest in their own beds for naps and God help us be supervised getting some walking therapy---then it should be mandated that they have enough trained staff to provide them with proper care.

It doesn't appear this nursing home wants to help a patient with Alzheimers. They should work with the doctor from the facility or her doctor, to get a psychiatrist to evaluate her. If her mental and physical health is declining so rapidly, clearly adequate care isn't being provided. Too often the nursing homes will get "permission" from someone other than their doctor of record to use
sedatives to get a compliant patient. However, when additional medications are not properly prescribed in light of their underlying physical and mental problems--the mental health can be harmed.

Finally never leave a loved one in any nursing home, hospital or assisted living facility that tells the family not to call or visit for a week or longer. Even prisoners have visitation hours. Asking for the family to "abandon" the patient for a week or longer is such a RED FLAG that I would report this directly to
the state agency that regulated this home, my congressman, my state assembly person and state senator.

Good luck but get help to remove your mother to a better nursing home. Patient care is not priority one at her current home.
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Debrasue-As a nurse/social worker who specializes in mental health, I have never heard of giving a dementia patient "reality" treatment. There is stunted cognition in dementia (at least at various stages) therefore making "reality" an oxymoron. You being replaced by a public guardian says to me the Court has deemed you incapable of handling your mother's affairs (either financially and/or medically) so the fact the staff is asking you and your sisters to meet your mother in front of them seems logical. There are many facts you have left out, so I will defer until I know more, but can say your mother's psychiatrist can prescribe medications to settle her behaviors down so staff and other residents will not be disturbed as much. There are always outbursts from dementia patients and I still do not think you are telling us the entire story. The fact you are taking Xanax to sleep worries me as there are other non-habiting forming remedies to sleep. Have you tried Melatonin 1.5 mg or exercise? Maybe you could detail more...
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