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If you are a Skilled Nursing Facility with a Memory Care unit and claim you are specialized in managing behavior issues, then why discharge a patient who has these issues?


I understand there are some facilities who may not handle this but those are not the ones I am referring to.

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Just my opinion but I think this industry is so regulated that they can no longer care for patients like your father. Restraints aren’t allowed, not even a bed rail. In the old days,
when Grandpa developed issues, he got locked in the attic. We can’t do that any longer.

Because there’s so much facilites cannot do, their only option is to release the patient. Knowingly housing a patient with violent tendencies could cost them their license if something tragic happens because of that patient. That doesn’t make it easy for the patient’s family. And it does sound like the doctors have washed their hands of your dad. Can he be re-evaluated by the psychiatric hospital? Like JoAnn writes, it may be to the point that to keep him and anyone he comes in contact with safe, he may need strong medications that zone him out. Not a happy solution, but it’s better than continually being kicked out of facilities.
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athena1234 Oct 4, 2018
Did not understand why the NH would not put restraints or alarm on the bed or wheelchair as Dad was trying to get up or move, sliding fromhis chair so he needed to be watched constanly. also no cameras..this I understand could be privacy but the no alarm on the bed left my Dad on the floor below eye level from hallway monitoring for hours...at night due to no alarm...is this all legislation?...….using the alarm at least could call for help. looks like no one wants to be disturbed the staff?...it doesn't make sense to me to not employ the technologhy……..it looks like they expect the senior patient to behave..or they have lawsuits..a camera could tell immidiatly if someone has left their room in the long hallways I mean comeon!!!!!
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There is a lot of discussion in the long term care industry about this, and legislation around it too. There are fewer things people can be involuntarily discharged for, but harming other residents is one of them. My husband had this issue, which was clearly a dementia behavior, but they didn’t care and kicked him out. I filed a complaint with the state of Michigan and the nursing home still got away with it.

I would suggest contacting your your state ombudsman, who may be able to help. This is a very difficult position for you to be in, so get some help as soon as possible. I am in my 50’s, know how to navigate the system, and still did not win this battle. My husband ended up in a facility 60 miles from home, where they also tried to evict him. He started declining and the behavior stopped, so he stayed there until he died 2 weeks ago.

Hoping this gets better for you soon, and that you all find some peace.
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Zdarov Oct 4, 2018
Oh, what a challenging road you’ve been down. I’m sorry to hear you’ve lost him, god bless.
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I assume the problems you are talking about involve violent behaviour since that is usually where facilities draw the line. Is this patient under the care of a geriatric psychiatrist and have they spent any time at a psychiatric facility? Nursing homes have to protect other frail, vulnerable people as well as their staff and unfortunately those whose outbursts can't be controlled may need a unit dedicated to violent patients.
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sunshine45 Oct 2, 2018
Yes, it is due to violent behavior.  Actually, he was first in a psychiatric facility and got kicked out of there; which is very difficult to understand.  Then of course has been discharged from two separate nursing facilities due to behavior.  Others will not accept him.

The staff in charge at the facility where he is now, says he has to go because of violent behavior.  That doctors have not been able to regulate his meds.

My concerns are, how can someone actually get kicked out of a psychiatric facility?  Why can't this facility regulate his meds?
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There are probably two reasons: some of them do what used to be called lying, and others are probably so bound by regulations that they are unable to use any common sense measures to deal with the problem.
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sunshine45 Oct 4, 2018
I agree
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So, what are you suppose to do, huh. You can't have them in your home. These people are very strong when violent. Yes, surprised a Psychiatric facility can't find the right combo even if it means the patient ends up being doped up.
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sunshine45 Oct 4, 2018
Tell me about it. He was in a Psychiatric facility and they could not do nothing for him and discharged him.

Now every nursing facility discharges him.

It makes them look bad. Like they don't know nothing.
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Sunshine45, my heart goes out to you. Other then sedation, I’m not sure what other options there are to have your loved one in a place that’s safe for all parties. Looking at it from both sides, facilities need to be safe for patients and staff. Families need a place for loved ones that is safe for them as well. Since this disease seems to give people super human strength at times, it is an issue where there may be no other choice but to subdue one person rather then risk multiple injuries to others. How awful it is to add yet another challenge to you. I’m so sorry.
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sunshine45 Oct 4, 2018
Yes, I agree. Safety is most definately top priority for everyone. Especially in such vulnerable places as these.

Just thought these facilities would regulate much stronger protocols for individuals facing such illnesses. I'm certain mental facilities have protocols in place for such behavior to protect everyone around, why don't these nursing facilities have the same?

In a mental facility they deal with the issues accordingly. In a nursing facility, they just discharge them.
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This is what it has become due to lawsuits. I had relatives who had a father with dementia and he became very violent in the evenings when he started sun downing. Beat the H out of all of them regularly. They never put him in a nursing home until he became an invalid. It completely wore out everyone involved in his care.

If I'm ever faced with this situation and have to care for the person at home, there WILL be heavy sedation and restraints.
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sunshine45 Oct 4, 2018
I understand exactly what you are saying. In our situation, we got a lot of phone calls that our family member was falling due to weakness. Then to get the call he has become violent and has to be discharged, confusing.
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If he is a danger to himself or others, the state should bear the responsibility of his placement. Have you asked what they plan to do?
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sunshine45 Oct 4, 2018
The administrator says no other facility is will accept him due to his behaviors. She has discharged him to us. My husband is not able to care for him.

The ombudsman says she will try to locate placement for him. Hopefully.
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I have read articles in our paper (and not recently) about this very issue. They followed a few families who had this problem.

Just what are the families supposed to do?!?! Take the elder into their home?

It is so unfair to the families!
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sunshine45 Oct 4, 2018
Exactly

I thought they were the ones who were suppose to give them the help they need.

We received a lot of phones calls about family member falling due to weakness. Then we got the last call that he has become violent and that the doctor could not regulate his meds. Therefore, the administrator has discharged him to us. Oh, wow.

It is my husband's brother and he is sick. He can not care for him.
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I just spent another night with spurts of confusion and violence with my husband. He is on seroquel and valproic acid for behaviors but he still moves through being docile at bedtime, then sleeping briefly and then the behaviors kick in and last anywhere from 9 p-2 am. The strengthe his exhibits for a 150 lb 84 year old man is stunning. I am almost always alone, and have had to call 911 4x in the last 2 months. Doing this is so, and the last one I refused to take him home as he repeatedly was released because he did not meet the criteria for admission. After five days and three nights of haldol, he was released to go home with 30 days of home health. It seemed that he was better with the new meds, but that is changing again. His PC referred us to a geriatric psychiatrist who is actually very close to us. I had seen a presentation by her in the Sr. Community we just moved out of, so I was excited. But when we began to make the appointment for the eval., I was told that though the initial appt is covered by insurance, all future appts., have a monthly fee of $80. I know that sounds reasonable, but we simply don have it. I have begun the whole Medi-cal process and am waiting now to be denied because we probably have too much income. Where we go from here, well, right now I do not know. I am certainly willing to place him in a facility, but again, there is no money for it. And I am so fearful of what his care would be like at most of them. But my 24/7 caregiver burnout is,honestly, On the brink of threatening my own psychological and medical wellbeing. He is my husband and has been a funny, handsome, good one who cared for me during my times of medical need. He deserves the best care now and I am no longer able to give that. Our future seems very bleak right now.
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Glendaj2 Oct 4, 2018
I’m so sad to hear about your troubles with your husband.
Seroquel was given to my father to help him sleep, it worked for awhile then it didn’t. I started giving him an Ativan at night which seems to help a lot, he gets a half one in the morning to help him remain calm. I guess we here been lucky so far.
I have have discovered that when I try to make him stop doing something or to do something he doesn’t want to do gets him very aggressive in telling me that he wants to hit me, thank goodness it’s only been telling me! When I try to distract him with a snack or something it usually works and no anger. Getting him to do something he doesn’t want to do I will use bribes of something he likes to do after we are done with the thing he doesn’t want to do, I have to constantly talk about what we are going to do when we are done. Tiring but usually works.
The best to you and your husband, I will put you in my prayers.
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