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Mom is 92, a peach during the day but at night but has severe sundowning and walks the halls, enters others rooms, bangs on doors, writes on walls, wanders outside and occasionally is naked. Belligerent. She has no recollection. Facility is not equipped to manage her. A friend mentioned music which I will try, but the fact is I have to move her for the 5th time in four years to a memory care and there are only two in the area. Both are full and I am at my wits end. The facility is setting up a NPI interview which may help fast track her into one of the facilities if a bed becomes available. I am in the process of getting mom enrolled in Medicaid (she has no money). The facility has sent me a 30 day notification of removal. Any words of wisdom would be appreciated!!

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Check with an eldercare attorney and the Office on Aging and Adult Protective Services. I am not sure but I do NOT think they can push her out unless she has a place to go to. YOU SHOULD NOT, EVER GIVE IN AND ACCEPT HER AND TAKE HER HOME - IT WILL BE GHE END OF YOU. Seek professional advice how to handle this. And why is she not being given medication late in the day to make her sleep and stop the behavior?
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Just so you know, 25mg of seroquel is a starting dose and almost always needs to be adjusted upwards.

Have you talked to the doctor who manages her medications about her behavioral challenges and the fact that she's may need to move? I think a change or adustments in meds is in order.
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gladimhere Sep 2021
Just a comment, 25mg is the smallest dosage pill that is available. My mom started with 12.5 mg of seroquel, I got a pill cutter to give her the prescribed dosage. Over the course of three years, the seroquel gradually increased (by 12.5 mg each time) to 75 mg. Always once a day as prep for sundowning.
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You can outgrow a MC. They are not equipped to care for problem patients. Does Mom have a Neurologist. If so, he should be made aware of her behaviours so she can get medication to help her. I think your next step is Longterm care since you are thinking about Medicaid.
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What is your relationship with this - her 5th - facility….. They like her and share concerns? OR they are over her? I ask cause what might be a way to deal with finding a new facility is for mom to get hospitalized and neither you nor the current place (that sent her to ER/ED) will take her back from the hospital. So the discharge planner at the hospital then has to find placement for her. The scenario would be…. the NH thinks that mom is exhibiting something that requires an Emergency Room / Department evaluation. A TIA aka transient ischemic attack could be this as it’s somewhat subjective as to what seems to be happening visually but needs an EMS to the ER run for the elder to get hospitalized or under observation. Then when she gets the all clear, the NH refuses to take her back as they cannot meet the level of care needed. Now you as POA / family will get the call also to come & take her but you too refuse to go & get her as you cannot provide a safe environment for her and the care & oversight needed. Discharge planner has to find her a facility. Would this place maybe do this?

On the 30 day notice, there should be a CC at the bottom of the letter. Usually it gets CC to a probono legal aid, you might want to contact them as to any suggestions for placement.

If realistically you cannot find a new place and mom has worn out her welcome in any other facilities, AND if you do NOT come to get her, the MC will likely contact APS… then APS will seek an emergency ward of the state action for mom. So mom becomes under the purview of the guardian (judge usually assigns an atty or other professional guardian vetted by the state). Sometimes this can be best as they can find a spot for her and take care of filing Medicaid. If this happens, it does not have to be contentious between you and the court appointed guardian. Perhaps view APS and the guardian as being able to do what you cannot as they have all the resources of the State to use. If there has been no financial misappropriation that would be an issue for mom’s Medicaid eligibility, having her become a ward of the state may be something for you to think about.

Her going naked probably is the tipping point for the MC. Has there been any discussion on changing her wardrobe? There are clothing lines that are “adaptive clothing”, basically clothing they can’t get out of them…. They get called “anti-strip” or “stay dressed”. Silverts Clothing & Buck & Buck carry them.
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Tokamame Sep 2021
The current facility loves her during the day.
Ward of the state.....yikes, don't know if I can do that. But when the time comes you do what you gotta do. I'm meeting with the facility director tomorrow and float that by him.
Thanks for the clothing info.
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My mom was kicked out of MC as well. Yup her behaviors caused problems. She was hitting, biting, head banging, you name it. She was a danger to herself and others.

She was on hospice at the time. Hospice recommended a much smaller care home that take those that have been kicked out. That care home worked better for mom and would have been better for her from the beginning. And it was cheaper than the large corporation memory care.

Best wishes to you, this is hard.
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Tokamame Sep 2021
Is the smaller care home only available through Hospice?
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How does your mother spend her days? My mother’s MC has a policy of not allowing residents to sit in their rooms during the day And no TVs are allowed in rooms so they don't sit and sleep. There is a large TV in the common room so staff can watch the residents and rouse them if they nod off. There are 7 planned activities everyday to keep residents awake and engaged. The goal is to keep everyone awake during the day and tire them out so they will sleep at night.
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Myownlife Sep 2021
Actually, they probably need some day naps. It could very well be they don't sleep well at night, and if not, they need some rest in the day. Not all day, but a nap here and there.
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bad memory is.Caused by a lack of nutrients The b vitamins Is she eating too many sweets or not eating at all? I’m 95 and my appetite is dwindling because I don’t move around well. I have lost my sense of balance and must use a walker. If.
If she can walk well she should have a daily course of walking. Eat no sweets and a B supplement. I recommend Puritan Pride They make their own and are pure. Let everyone know so others can benefit
big pharma wouldn’t want this known since they love MONEY!!
Cancer also can be. cured by an alkaline diet. Acid feeds cancer
Diet is important
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TouchMatters Sep 2021
Dementia ISN'T a bad memory.
It is caused by brain cells dying and brain chemistry changing.
What are you talking about ?
Be careful - VERY CAREFUL - making blanket statements.
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I don't know which state you're living in but regardless of the area, I do not think that the facility is legally able to "put your mother out in the street". You may need to find a memory care facility that is out of the area to get good care for her. If you can drive to see her regularly, even if it's not daily, or even weekly, it is better than if the care is marginal.
Whatever you do ... do not take her home with you!
Keep looking and know that the deadline for her removal is flexible, especially if you're truly looking for a place for her.
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I don't know what the NPI interview is, but starting the Medicaid application is priority. Appeal the eviction letter from facility. That should allow more time to find an open bed. There may not be an open bed close by - might have to take what you can get until opening in your area.

I don't really understand facility trying to help you fast track her into one of the local facilities while, at the same time, serving documents to boot her out. Appeal. And submit copy of the appeal to your Ombudsman's office, too.

You might also ask the facility doctor to see about meds that might quiet her activities at night. It's very possible there is something for sleeping that might make things better and stay where she is.

How is current facility being paid for if she has no money and has no Medicaid. Did facility keep her and her midnight raids as long as she could pay and THEN decide it was time to move on when they knew the funds were depleted? If so, mention that in your appeal - she has been doing this for XX number of months and acceptable to facility as a self pay patient. Ironic it is no longer acceptable at the same time money ran out and would need Medicaid.
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I also feel that medical marijuana can be extremely helpful to you The tinctures are effective and dosage can be easily monitored. I’m sad that the facility is not equipped to handle this as it isn’t out of the ordinary behavior. I wonder if she was self- pay would they be as quick to ask her to leave. Another suggestion would be see if they keep her active during the day .. not constant naps. Wishing you all the best
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