My MIL is in a nursing home with dementia about a month now. She has always been nasty, argumentative and combative. Now she's at a whole new level. She is refusing her blood pressure medicine and it's sky high. So far, we've dealt with her throwing out her clothes nightly and not changing into her bed clothes. Now I find out she hasn't had a bath and will not allow a nurse to help her change. She throws the nurses out of her room.
The nursing home wants her to go to a Geriatric Psych Hospital where I am sure they will restrain and force her to do these things. They say that she needs 2 weeks in a psych hospital but the home may not necessarily be able to hold her bed 2 weeks. My husband and I are a wreck. The home makes it sound like there is liability for them because she won't co-operate. I get that the bathing problem is huge. Right now she has a fungal infection on both legs. Can the nursing home force her to go to the psych hospital? Can they become so fed up that they simply evict her? We've closed up her apartment. And what happens if the bed is gone in the nursing home at discharge? Does she stay in the psychiatric hospital or go to a different nursing home if her bed is no longer available? Can they evict her and send her to us? I have medical issues and won't be able to handle her. We are meeting with the social worker and nurses tomorrow. I just had to reach out to see if anyone else has dealt with Geriatric Psychiatric hospitals.
Take a breath. You say you cannot have her in your home. Has she been tested for a urinary tract infection? If she’s not bathing, that’s a possibility. My mom had chronic ones. She needs to go to the geriatric psych hospital to be evaluated and possibly have her meds changed. It’s not a pleasant thought, but seriously, what other choice do you have?
My Mom being in a Geriatric Psych Unit was a positive experience.
No restraints were used. Her mood WAS stabilized with meds.
No, she was not an over medicated zombie.
Mom stayed in the unit for 10 days. It was a very peaceful place. Mom actually wanted to stay longer.
Regarding not holding her bed, they may not. It depends on several factors, such as insurance and money. If she’s private pay, maybe they would hold the bed because they don’t want to lose that income. If she’s on Medicaid they are obligated to hold it a certain number of days. However, if they just don’t want her there, they can get away with not letting her back in. That happened to my husband, and we had to scramble to find a suitable facility.
So so sorry you’re going through this, these are very tough waters to navigate. Whether she stays there or goes to a different facility, the in patient geriatric psyche stay would most likely benefit her and you. Good luck!
They will request that you not visit for everyone's safety. It is a process to figure out what will help her. With right meds the pros will be able to adjust them as needed, usually without a second psych assessment.
Yes they can evict MIL. My mom was. She was on hospice at the time and they recommended a smaller care home, less institutional and much more comfortable for mom. She did better there and died after about six months there. Mom was heavily medicated, but she had to be for her own comfort and safety. The care home mom was in was a bit cheaper each month and had a better staff patient ratio. And ALL of the residents there had been evicted from previous facilities due to behaviors. Maybe you do not want MIL to return to the place she is now. Maybe there is a better facility that will be able to better provide for her needs.
My mom also had to have a sitter with her on and off over the three years that she was living in facilities. The facilities also can demand that if it turns out that the meds do not have the desired effect. The sitters are private pay so care can get very expensive. Just a heads up.
This is very hard on our folks and the families. Sometimes it just has to be done. Call your Area Agency on Aging to find out about care homes in your area.
Always remember meds will work differently on different people with the same diagnosis. Seroquel works great for some and will make some worse. My mom could not take ativan, it had the completely opposite effect as intended.
It is so hard. I think of it this way:
My Dad lived for at least 80 years taking care of his personal hygiene.
with the onset of many little strokes causing vascular dementia, reasoning left town.
His recent evaluations, psych meds added and tinkered with have made it possible for him to live somewhere safe, where others are helping him be safe. He has gained 15 pounds because he is eating, he smiles more, and we can have a good conversation with him for at least 1/2 hour. He is not drugged, and he is not pulling fire extinguishers off the wall to protect himself now.
It is what is needed for some dementia patients so they can function with other people.
Our elder law attorney said, “No one can force you to take him into your home. Stop worrying about what might happen. Focus on what needs to happen now-one thing.”
I am glad you are meeting with the social worker at the NH. Just don’t allow them to tell you that you have to take your mother home. Let them tell you the options.
i want to add this. Even with dementia, delusions and aggressive behavior, I calmly talked to Dad about trying to walk out the door. I told him that if that happened, the sheriff would be called, and he would be taken to a behavioral unit for evaluation. And he might end up in a place with less freedom than he has now. He understood that, and has not left the building, although he did somehow remove his ankle alarm.
One being they do not have a lockdown unit to deal with combative patients or those who wander off.
They likely need the psych evaluation to have her placed in an appropriate, properly equipped facility.
their opinion came to release/discharge her to a particular type of nursing facility with routine observation. Is it legal, I don’t know.
If she ends up their, look at what type of services they going to provide that the other couldn’t. Did she present such symptoms or maybe they just didn’t want to deal with it any more . All I know is my uncle got discharged once; I call it booted from a nursing facility once. He ended up at another nursing facility and appeared to get along well there well with people and management. Try to look at it from all angles kind of like the 5W’s and a H: Who, What, Where, Why, When. The H is for How you are you going to come with your best decision based on the criteria given to you now resting on your shoulders. Hopefully you will come up with rationale decision that you feel good about given the circumstances.
UTI (urinary tract infection) as well as the fungal infection on her legs? Did she arrive at the NH with her legs infected?
If this is the case, the NH is liable for neglect medically, so they might be taking
the best route to cover their xxx.
Is this the first you have heard of this? (One month, behaviors, refusing meds, leg infection?).
Psychotropic drugs work differently on different people. And initial results may chang. Dosages may need to be adjusted or medication changed completely. It sometimes takes awhile to get everything adjusted.
A nursing home cannot keep a patient who becomes a danger to themselves or to others in the nursing home community.