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marianne1244 Asked March 2016

I was told my husband could not go into a skilled nursing home since he gets combative. Are there other options?

I'm full time caregiver with rapidly declining health faced with ongoing struggles to care for husband that is beginning to destroy my quality and husbands quality of life to the point that I no longer want to be here. He is in the hospital with possible pneumonia right now and had to be strapped down due to combativeness. He is very strong, 6ft 3 in tall. Over the last 4 years it has been getting harder each day.

BarbBrooklyn Mar 2016
Who is telling you he can't go to skiled nursing care? INSIST on a consult from a geriatric psychiatrist while he's in the hospital. Understand that you do not have to accept him to be discharged back home if you can't care for him.

If they say " oh, then he'll become e a ward of the state" reply, " that's great, that's exactly who needs to figure out his care".

Sometimes a little hardball is in order.

pamstegma Mar 2016
At the hospital there is a discharge coordinator and a social worker. Tell both of them you just can't do this anymore. They will help you get him to a safe place, possibly in memory care with good medications.

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brianmcdonald Mar 2016
Marianne - now is a perfect opportunity to address his combativeness. I'm quite surprised that the hospital has not already done so including a geriatric psych Eval. They usually are against any type of restraint unless potential danger to himself or others. I too recommend a psych consultation, a medication review, and discussion w social worker and case manager. Skilled nursing facilities are supposed to be able to handle all patients but they are not all created equal. Again the social worker can help find one that does accept what is termed "challenging behaviors". But those can be medically managed. Good luck you deserve and need a break. Also there are smaller residential homes specific for behaviors. But again manage the behavior first. -Brian

sscoale Mar 2016
The previous posts are exactly right. When my 90 year old mom was combative, argumentative, resistant and belligerent, we finally found a wonderful geriatric psychiatrist (in-network!) who put mom on a regimen of different meds and now mom is more social and calm than I remember her when I was a child. She's much more engaged and willingly cooperative with none of the "zombie-like" qualities some people are afraid will result. She has severe vascular dementia with no past or present memory but she now can enjoy the company of her family and friends. Please find a geriatric psychiatrist - MD - as soon as you can!

Rosebush Mar 2016
When my uncle needed placement from the hospital, the social worker gave me one choice in a neighborhood that was not so good and far from my home. She told me that she made one call and they had a bed available so she made no other calls. I chose to tour (drop in unexpected) on 3 places near my home. Went back to social worker the next day and requested that she call my first choice for bed availability. She wasn't too happy but I insisted. I was fortunate that they had a bed available and the place was 10 mins from my home and much nicer then the one and only option that was presented to me.

ramiller Mar 2016
I totally agree. Refuse to take him home. If you are at the point where you want to take your life ( and that is what I hear in your post ) then you MUST insist on a change. Tell the case manager at the hospital you cannot do it anymore. You have done your best now its time to allow others who are trained for this to take over. The doctors can give him something to calm him down and there are homes that will and do take people in his condition. Big hug to you. Hang in there it will get better once you get him settled. Stay in touch with us we will be here for you.

Eyerishlass Mar 2016
Have you spoken to your husband's Dr. about it? There are medications available that can help with combativeness.

gladimhere Mar 2016
Mariann, what is happening with your husband? You need the geriatric psych consult mentioned above! You CAN and MUST refuse to take him home because his necessary level of care is more than you are able to provide. The hospital and the staff then become responsible for finding suitable care for him. It may be a geriatric psychiatric hospital.

Serenity22 Mar 2016
Ill echo everyone else. You can refuse to take him home, and you should especially since your own health is in jeapordy. Hopefully that will force them to do a psych eval so they can place him appropriately and get him the medication he needs. Good luck to you, take care of yourself.

gladimhere Mar 2016
Just an additional note, Marianne, you are going to have to stand firm. Some hospitals will try everything to pressure you into taking him home. Including guilt, do not fall for it!

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