Is a psychiatric evaluation required to get into most senior independent living places? - AgingCare.com

Is a psychiatric evaluation required to get into most senior independent living places?

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At age 87, Mom has undiagnosed dementia, and won't present herself for evaluation. She's in great physical condition. I live far away, and her next door neighbor, an RN, called and said that she was going to call social services for neglect because Mom's behaving erratically. The house is big, Dad died in January, and mom stays up all night, and freaks about intruders, and wants to sleep in the car. My saintly brother managed to snooker her into moving to his house - and it's taking quite a toll on his wife & kids, and he's having major stress symptoms. Mom has resisted our help every step of the way, but after a shouting match, she wants an apartment in a senior living place. She's very specific about not accepting Assisted Living. So, maybe we help her get into an independent senior living facility. Will most facilities require a psych evaluation? I feel she needs one, and that a move to independent living will end with her getting reported to social services, and cause her more disruption and suffering. If a psych eval isn't required, can you think of how to trick her into one?

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In order to have a psychological evaluation, the patient has to be cooperative. But, independent living does not require an evaluation, just you being able to pay for your apartment (I am finding out). Her actions could be a result of her grieving process, but if she is a danger to herself or others, she can be forced into a 72 hour hold for full psychiatric evaluation. I hope this ends well for your family and she gets the help she needs.
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I agree with the idea of getting her into a facility with different levels of care available. My mom is in a facility that has independent care (where she is), assisted living, a memory care (Alzheimers) unit and a skilled nursing unit, all under the same roof. So as your mom needs more care, you can move her from one part of the building to another.

When my mom moved into the facility 12 years ago, they required her doc to complete some forms, but she didn't have a full-blown psych evaluation.

In my mom's place, she gets two meals a day, housekeeping once a week and they take care of her apt. as far as any repairs go. She doesn't have any outdoor area to keep up. Her next door neighbor has an aid with her 24X7, even though she's also in independent living. So there are options available, but most of them are pretty expensive.

Good luck with your decisions.
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Oilcitygirl - You're another spouse! Glad to meet you. How old are you? My husband is only 68, but was just diagnosed.

Don't broach the subject of dementia with your husband again. If you need to, call it "getting older" or memory problems. Why not call it little strokes? My husband calls it ADHD.

The doctor won't talk to you, but you can talk to him or at least send him a letter. Would your husband agree to you signing mutual HIPPA releases, so you could each consult the other's doctor? When I talk about making plans for Medicaid, I say it's for if I have to go to a nursing home. It certainly could happen that way. We're all just one bad fall away from disability.

Laugh as much as you can. My husband responds well to being called a poopyhead. Think of something outrageous and funny to accuse him of, like having a romance with Angelina Jolie, or being a CIA spy -- whatever would be funny and make him feel a little bit proud of himself.

I think it's hard to care for a husband because we may love them, but we also kinda hate them. The more I can make myself have compassion, the easier it is to be nice and let things roll off my back. Hang in there!
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With the new privacy laws, docs will often not talk to family members "confidentially". If I broach the subject with my husband, he refuses to discuss it and if I persist he gets beyond angry. I see many changes in him in the last two years, progressively, but how do I handle it if a doctor won't speak privately? I am ten years younger than my husband and he often accuses me of dementia either to cover for himself or to provoke an argument, and his parents both died with symptoms of dementia, although they called it "little strokes" back then. So I believe he has a fear of this diagnosis. Every night I wonder who will be coming to the dinner table, the old hubby or this new one? What can I do for help to initiate a test?
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Any MDs out there?
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Start with her annual physical at primary care dr. Write him in advance confidentially and let him know your observations and concerns, set an appt and make sure they allow extra time for dementia evaluation. In my case dr did it and my mom was wise and fussed about his intrusive and "silly" questionsbut he just covered by saying he did to all patients of a certain age. He was really good. My mom was in denial but then he made her an appt with a geriatric neurologist and she had to go there too. They diagnosed the dementia and gave her meds.

This was the start.
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If she has dementia could you include visits to AL facilities that have linked dementia care unit access? Consider including them as part of your visits to senior living. Visit by yourself and then narrow down to 2-3 that would be appropriate for mom. Most of those will require her primary care doctor to fill out forms and typically will assign their own contracted nurse to per-evaluate.

It's hard, but I wouldn't allow her to make the final decision to senior living especially if she is already having memory trouble. You'll still have same issues with her having to manage the house, eating, cooking, cleaning, and sometimes these places are more for active seniors and therefore they have to still bre responsible for yard upkeep, gutters, watering, etc....I know because my in-laws moved to such a place and now can't keep up with everything and even though they hire out, they have frustration with it meeting their stds, etc. They would like to move again because my FIL has mobility and memory issues, but honestly, he just isn't up to another move to new surroundings.

As the dementia worsens and it will, you'll be faced with moving her again anyway and you will be traumatizing not only her but yourself and she'll have to make new schedules and acquaintances all over again.

Anticipate where her health needs are going and plan for that in your choice of living quarters.

PS. Good luck in convincing your mom. I missed my opportunity and next go round, I plan on eliciting drs and case workers to help tell her where she needs to go. I've already picked facilities. She wanted in home care, but it didn't last long because she fired them and is paranoid about anybody in the house. All are intruders in her mind, including her own children at times.
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