We're in the midst of trying to take the next best step but rather quickly. My MIL is in a rehab center and needs to transition permanently to a nursing home. She has dementia or Alzheimer's and is very violently hostile at times. If she weren't so hostile, my wife and I would try to care for her ourselves. But, we feel we have no option but to go with a nursing home.
Given her history of violence toward caregivers, including at the rehab center, on top of what's believed to be some form of dementia, we've wanted her to be more fully evaluated. The rehab center has not followed our direction to transfer her to a hospital with a psych unit. There's a possibility that her aortic valve stenosis is causing vascular dementia that might be treatable - but we haven't even had the conversation because we can't get her to the right doctor.
So the big question is what's our first step? What's the difference between a hospital with a behavioral health unit, a behavioral health center, and a nursing home with a behavioral unit?
Our hope is that if we can get her behaviors under control, more nursing homes would be willing to take her.
Thanks to all for your help! We're Runragged!
She has been evaluated by a doctor who says he's a geriatric psychiatrist. He just hasn't done any good.
Sounds like a hospital with a psych unit may be the best bet. Even if she doesn't land in the lock down psych unit, there is a staff of psychiatrists who might be more available to the general wings/floors.
Are these behavioral issues new or longstanding? Is there previous history of mental illness?
In your place, I'd have her evaluated by a geriatric psychiatrist and see what can be done about the violent behaviors. It's going to be difficult to impossible to get a decent physical evaluation if she's violent and uncooperative.
In general, it's been suggested that she needs a behavioral unit at a nursing home. However, we'd like to see these behaviors properly addressed including any medical conditions that are making things worse, not just a bandaid solution.
Any advice?
Her treating PCP, internist, or perhaps even the doctor who scripted for her current placement could probably recommend a doctor and get an appointment for you quicker than you can on your own.