My dad was finally put in a memory care facility on 11/06/2014, seventeen days later he was sent by them to a Psych Ward Hospital to try to regulate his medication and find out why he so aggressive. He was told he would stay there anywhere from 2-3 weeks to a month. My mom was told she had to pay the full month fee of $5500. for the month of December for the facility. She did, but about 5 days later she was told they were returning her check and did not want my dad back in their facility. Can they do that without any notice. What do we do with him once he gets out of this psych ward?.
You definitely want to contact your local department on aging and get some suggestions. is better equipped to deal with more difficult patients. Also work closely with the doctors where he is at to see if there are medications they can prescribe that will make him more manageable at home if he should have to go home with your mom, or at least manageable enough to be able to get him accepted at another nursing home?
My heart goes out to you and your family. This is a difficult situation, without a doubt. For you and for those at the nursing home who would like to help but who's hands are tied. Good Luck.
I am hoping that the OP will come back and tell us what her father's psychiatric unit recommended for his ongoing care. This is such a nightmare for anyone it happens to, and so hard to manage. You can't sedate an aggressive dementia patient, you can't disproportionately restrain him, you can't reason with him - what are you supposed to do? I hear a lot of criticism about the inadequacies of provision but very few constructive ideas. It's desperate.
A further tip. My mom is currently in a NH. Each time she goes to the hospital, we release her bed (their suggestion, she's private pay). They have a low census, so it's not a problem for her to be readmited. Saves her quite a bit at $15,000 per month.
Thankfully, we found an Alzheimers/Dementia Care facility (Beaverton, Oregon) that seems better equipped to handle aggressive behavior than the last Assisted Living facility which had added a Memory Care wing as an afterthought.
The right combination of meds seems to be the key. My Dad still yells and curses sometimes, wants to leave (all the time), has crazy delusions, etc. but just not as severe. The doctor is still slowly tweaking his meds, trying to get the anti-psychotic dose as low as possible. He's been at this new place for two months and hates every minute of it. I feel guility (like most of us), but I know he's safe and I'm grateful the chaos has subsided, at least for awhile.
Take care of yourself - it really wears you down... Hugs!
I don't often say this, but your mother should make him a Ward of the State, cooperating with the Hospital Social Worker who handles a protective custody hearing. I know this is hard, but it is the safest option for everyone.
There are not nearly enough facilities, much less, those equipped to properly care for patients with aggressive behaviors.
There is question not only of other patient's safety, but the safety of staff, as well.
There are laws against Patient abandonment by medical professionals.
However, the nursing home did transfer him for evaluation to a psych facility, thereby transferring care responsibility to that facility.
Once he has stayed there the time they allow, he will need transferred to another facility, preferably one which has capability to properly care for someone with aggressive behaviors, who is also a "frail elder". Those might included Alzheimer's units, Memory Care Units, Dementia care units.
===Something that frequently happens to confused elders who are transferred between facilities: The more some are transferred, the faster their dementia conditions/symptoms can progress; they lose more ground, mentally, to where symptoms might progress to the point they are then beyond acting out aggressively.
Dementias are progressive, and go through stages; not all get violent or aggressive, but many do, though if the dementias progress, they can get beyond those awful behaviors--at least to the point it is no longer a problem for those around them. At that point, a regular nursing home might yet be capable of caring for him.
Speak with your County's Area Agency on Aging, to see if they can suggest OTHER facilities which are more appropriate for your elder.
The more quickly you can find one, the better.
A Social Worker should be involved--however, if you notice the person does not seem to be advocating very well for your Dad, find another one! You need someone who is capable of focusing on what is needed for your Dad: a proper facility.
At NO Time, EVER, should family members, who may also be fragile or vulnerable to aggressive elder, be Coerced into "Taking Dad Home" while you wait to find another facility!
If the elder is not safe to be around other patients and staff in a regular nursing home, he's Not likely to be safe in your family home, either. He needs professional level care in a proper facility--and it does not sound like the one he was in, had that level of ability.
The facility that has the patient last, is the responsible party.
It is a sad game of "hot potato", that families need to fully understand the consequences of:
IF you allow the facility currently holding your elder, to Coerce family into taking him/her home under your roof, to wait out a waiting list, etc. elsewhere, you will likely NEVER get further help to place Dad in a proper care facility, AND, you will be submitting your immediate family to behaviors that could cause you harm, physically, mentally, financially, and legally.
Once his aggressive behaviors are on his records, that follows him everywhere, and will likely be used as one of THE largest criteria to decide whether he will be allowed to be in any other facilities. It's not supposed to be, but it is.
For decades, it's been illegal to use physical restraints or drug restraints:
there's a very fine line between what is a restraint, and what isn't.
Violent or aggressive behaviors are not considered "normal"; they can endanger others or themselves, while behaving like that.
Therefore, use of some pharmaceuticals properly prescribed and dosed, could be appropriate, as long as it does not result in drugging the elder so deeply, they become a 24/7 bed-patient: the drugs should still allow the person to be up and get around, if able, and interact as best they can, at more normal levels.
Done properly, it is not a "drug restraint".
But those depend on the patient, as some Docs consider also, the patient's sensitivity to drugs, or other meds they are on, as liabilities to dosing psych drugs...in that case, some level of physical restraint is needed, or, a locked unit.
It seems dementia care units with small populations, more like a family homes, or with smaller units, are better for helping generally calm an agitated person. But as mentioned in other posts, the locked doors on even those, can drive agitation, too.
There needs to be a yard, perhaps, so the person is still safely locked in, but has a feel of outdoors, maybe...or staff who can walk them around the block. Or, family can visit to go for walks with them.
Bottom line: person is kept safe from harming themselves or others, and gets proper care.
My advice, therefore, is once your Dad gets placed in another facility, try to get him in as a patient with a good geriatric-psychiatrist that can follow him. If they will go to his facility to visit and evaluate him, that would be best. If not, then you or the agency will have to take him to app'ts. If the facility takes him, then there may be extra charges, but to get him through this phase of dementia and he still stay in one facility would be best for everyone involved, especially him.
Also look in the residency agreement you or your mother signed to move dad into the community. Most communities will give a 30 day notice...However, you might be responsible for private paying a third party sitter service to be with him 24 hours a day until he moves.
It's unfortunate this happens but sometimes medications need to be adjusted and sometimes you just need to find a different community.
If a community is saying that he should move, I wouldn't push them to much to take him back. They obviously feel his level of care is beyond their scope.
Take care.
Paying to maintain your apartment while you're in the hospital is standard. Imagine if you're renting a regular apartment and you go on vacation for three weeks. It wouldn't occur to you that you should ask your landlord to waive the three weeks rent while you're gone. It's really the same thing. In fact the AL is much more involved in your dad's life than his landlord would be, and they're maintaining that relationship, too (sorting out all the medications and doctor's orders he would have been discharged with, etc.).
Others are right when they say to stand your ground. Get the hospital's social worker involved and make it very clear that you cannot handle his behaviors at home. If his behavior can't be controlled with medication, he really needs a specialized unit where the staff is specially trained in dealing with potentially violent residents.
Discuss now with the psych ward what his options will be when it is time for him to be discharged. He has to go somewhere, after all; and they are the experts on what happens to patients leaving their care. This situation is incredibly difficult and I am sorry that you are having to face it. I wish I had something more useful than sympathy to offer.
Also, My (late)maternal grandfather had Alzheimers in 1976(when I was 9yrs.-old and my brother was 7yrs.-old). He was kept at home where my grandmother, mother, aunt, brother, and myself, could take care of him. So my younger brother were both the 'police' and 'fire department' depending on who my (late)maternal grandfather would be yelling for.
Family can take better care of someone, than any care facility.
Just as the facility can refuse to take him back, your mother can do the same. Simply tell the hospital that she is not able to provide the ongoing care he needs. The social worker at the hospital will have to find appropriate placement for him. Something similar happened with a friend of mine. The person receiving care had become impossible to be cared for at home because of behavior. After talking with a number of memory care facilities and non that would take them, the only option was a State psychiatric facility and they happened to have space available just when they needed it.
Good Luck to you and your mom...