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We have a family member that's in an Assisted Living Facility almost 200 miles from home. He has dementia and is on medications but sometimes the medicines do not work. Therefore, he has had some behavior issues.


My husband is the next closest kin to him and is not able to take such a long drive to visit with him. We want him closer to home but because his medications were not able to be regulated at times, he has kept this from happening?


Any suggestions?

There has to be a way .... sorry
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Oh haileybug I am so sorry for you and your husband but my advice would be to just accept that he is getting care somewhere.
If you are saying there is a psychiatric facility near you that treats long term mental illnesses and patients live there that could be an option but those places are so woefully underprovided.
So I have no advice for you but to accept things the way they are.
I have a mentally ill family member as well. But my family member refuses help of any kind and he is ok to live alone and is self sufficient. But there has been one time I had to call Emergency Psychiatric services (mobile response) when I sensed my family member was over the top anxious due to an increase in delusions.
You just don’t know when these situations will happen and can’t plan for anything because of the nature of the disease.
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haileybug Dec 31, 2018
Thanks Shane for taking time to respond to me. I appreciate your feed back.
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Haileybug you are stuck on stating those AL or NH specialize in “behavioral” issues. But some “behaviors” are more psychiatric by definition not “behaviors” exhibited by aging people with “normal” disease progressions of the elderly such as dementia, or Alzheimer disease which are the “behaviors” they specialize in.

Unfortunately your BIL appears to be exhibiting “behaviors” that are not generally normal “behaviors” in that setting. It sounds like your BIL has behavior problems associated with psychiatric issues - maybe he is undiagnosed bipolar disorder with aggressive tendencies, maybe schizophrenia with delusions or paranoid behaviors. Maybe a medical event occurred in your BIL’s case that exacerbated presentation of the conditions mentioned above. We here on this forum simply don’t know.

Has he ever been admitted to a psychiatric facility in the past to regulate his medications? Usually the pt is kept there for a period of time (a month or two) to determine what meds work for him. Then afterward the center that takes him has to provide staff to stay with him to insure he takes those meds. His meds are essential to him not relapsing. In a NH/AL you often have one RN or LPN giving meds to 30 people & most of those people will just take the meds without much fanfare. Of course there may be 5 of those 30 that give the nurse a hard time, and she/he may need to spend extra time or resources to assure the meds are taken, but generally this task gets completed.

The average AL or NH does not provide those services. They are not designed to provide that type of “behavior” issue management. Nor will they likely change to be able to do so. They “specialize” and are staffed to deal with those with dementia, & Alzheimer’s to name the two most common.

Maybe your BIL has a condition like a stroke or liver disease or something that caused his “behaviors” to lash out and harm others & so far no solution has been found?

Let’s reverse roles for a moment: what if your BIL was in an AL or NH, was minding his own business and going about his life there, and all of a sudden someone comes in their space (room,
et al) & threatens them verbally or physically time after time, or does things to other residents or staff that is threatening to them? You would want, no-expect facility mgmt to do something to keep the others safe, staff included.

I sense your frustration and anger, but at this point try to be thankful he is somewhere getting care AT ALL.

Your mantra of those facilities “specialize in behaviors” is too broad. Those are not psychiatric facilities- those facilities deal with those “behaviors” of acting out, violence towards others, verbal or physical threats.

I sense your frustration as well because treatment of the mentally ill in this country is woefully lacking.

Try to accept that he is currently being taken care of anywhere. Yes it may be inconvenient for family to visit. Yours is an execeptionally hard situation but it appears that the best possible options to care for BIL are being provided.
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haileybug Dec 30, 2018
You are so on point. Everything you have mentioned here is absolutely correct. You know exactly what I am speaking of. I understand what you are saying and thank you so much for your input.

The hardest part to understand is, he was in a physchiatric facility and got transferred to an AL. (the facility transferred him) Now these AL facilities are dumping him from place to place.

If AL facilities are not designed to give him the care he needs, then wonder why he is not in the correct place? We have one right here at home. Should that be the alternative?

What is your advice? THANK YOU SO MUCH :)
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WorriedinCali

You are on top of things. Thanks
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Hailey, I think we all are aware of the problem now and our answers won't change. These facilities have the right to turn him away.

Sorry but WHO is putting him in these facilities. You never answer this question. There has to be someone with a POA or is guardian. With Dementia he is not able to sign papers. Someone has to be in charge of his care. Is he on Medicaid? Someone has to be filling out yearly forms to keep him qualified. If this is not your husband, then WHO.

Also, what are his behaviours. A person in a wheelchair can move around in it. He can run into people. He can hit people. He can spit on people. There has to be more than you have told us.

I think after almost 3 years you are going to just have to except this is how it is. Two hours is not that far so visit when you can. In the meantime, as his Dementia progresses maybe his behaviour will be better and you can get him closer to home.

So sorry for your delemia.
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haileybug Dec 30, 2018
Thanks Ms. Joann

Sure facilities have a right to turn him away but why claim you are a facility that specializes in behaviors but turn him or anyone else away?

I sure hate to have to think that over 3 years that doctors still can not regulate his meds. Also, to know that his 87 year old mother could care for him but they can't?

Two hours really is way too far when you have had a triple heart bypass and other health issues.

By the way, if anybody knows my BIL it is my husband. I would definitely agree with him that a lot of his behaviors could be stemming from being isolated so far away from home.
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Haileybug, I have gone thru your previous posts, one going back to Dec 2016. In all the posts, you don't say who "they" are. One of your first post says the person is ur husbands brother. Was ur BIL in the service? And "they" are the federal government? If so, this changes things in some of our responses. Can't fight the government. He may still be in the service so until he is discharged they r in charge.

If this isn't it, then someone has to be his guardian. If so, they are in charge and sign off on paperwork.

As I said, you posted almost the same question in 2016, 2017 and 2018. There is lots more going on here than I think we are able to help with.
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haileybug Dec 29, 2018
Yes, I am referring to my BIL.
No, he has never been in the service.
Yes, we have been to going through this since 2016. (Trying to get my BIL closer to home)

My BIL was placed in an assisted living home in 2015 (he has dementia). We have tried unsuccessfully for 2 years to have him moved closer to home. The REASON he can not get into a nursing facility closer to home is because they are all denying him. He is on medicines to manage his behaviors but sometimes the medicines have failed him.

With this being said, I just feel like within two years of trying to locate a place for him, There's got to be "somewhere" for him to go. However, even the Memory Care with Locked Down Units that claim they "SPECIALIZE" in "BEHAVIOR CARE" are turning him away.
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Haileybug, not trying to be mean or rude here but this question has been asked and answered before. What are we not telling you? We all, have
said, there are reasons why this LO is where he is. He has behaviour problems that only a handful of facilities will take on. Their other residents need to be protected. If the family in charge of his care have POAs then they make the decisions. The only way anyone can override them is guardianship which takes time and money. And proof that the others are not making the right decisions when it comes to his care.

Really, I don't know what more as a group we can say. I think the majority of us have said nothing you can do. The person needs to be in a place that can monitor him for meds. If you can't find a place willing to take him near you with his behaviours, then there is nothing you can do.
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haileybug Dec 29, 2018
You are not being mean or rude. I am very thankful for your advice.

Here is what I am not understanding.

1) How many years does it take to get a person on the right meds?
2) If a nursing facility near our home town has a nursing facility with a Locked Down Memory Care Unit where they state "The nursing staff there specialize in behavior issues") Then why are they turning him away?
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haileybug, here's a very important question... is that family member self-paying at the nursing home, meaning paying out of his own wallet?

Or is that family member using Medicaid [which is different from Medicare] to pay for his care in a nursing home?

If he is self-pay, then check around to see what Nursing Homes are in your area, preview them. Some places may have a waiting list, thus you would need to place that family member on the list... sometimes there is a refundable deposit. Depending on where he is on the list, it could take months for a bed to become opened.

Now, if your family member is on Medicaid, and you are in the same State, you would need to wait for an open bed in a facility that accepts medicaid, again another waiting list. If you live out of State, then your family member would need to apply and accepted by the new State, and that could take time.

I wish caregiving would be easier, but it isn't.... [sigh]
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worriedinCali Dec 29, 2018
according to her other posts, there is also an issue with the family members behavior and rejection from facilitaties because medications to control behavior aren’t working.
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