Brother with Alzheimer's and dementia is getting angry with memory care staff. Can they force me to take him out?

Hello Sister to the Brother that was going to get transferred out of the area away from his family and he had become lethargic and she also now had the original place that he was staying at willing to take him.
You have been given all this advice from everyone, and days have past,
please let us know what happened. Much Appreciated.

erin, I'm glad you were able to do that with your dad; not everybody can; if my dad hadn't done - or had happen to him - what did, not sure what we could or would have been able to do; his grandson had been staying with him, keeping him at home for the past 2 yrs. but he had diminished to the point he wasn't going to be able to keep it up by himself

It worked beautifully,after I put him in an apartment with sitters.I took him out of the psych hospital AMA (against medical advice---the shrink was "way too busy to speak to the family"). I got the stinkeye from every medical professional afterwards---How dare I have an opinion overriding their authority! Just because I have spent 37 years working in Intensive Care units and 59 years knowing my father---how dare I?? I have his medical POA and know what I want for him,his wishes.Medical professionals are NOT infallible and my Dad is not their first priority---he was mine. I had enough experience in the field to have an informed,slightly jaundiced eye and this was increased exponentially on the patients'family side of the equation. I have been guilty of the suppressed sigh of impatience, the hidden eye-roll of irritation with the "family member" who wants to know or ask something that to "us" is self-evident.I have prayed many times for forgiveness for the sin of arrogance and lack of professional patience,badly hidden. If I ever work in this profession again( questionable after Dad's journey), I hope I will have real humility.

I hope it worked out. All of the transfers from one facility to another that I am aware of involved both places working together and co-operating. It sounds like they had two places that would accept this lady's brother.

The lovely (no irony) AL my Dad resided in decided he needed more supervision when his dementia erupted after a "psychotic break" when they transferred him via ambulance,against his strenuous objections,to an ER and thence to a psychiatric hospital. HE HAS DEMENTIA. His lovely GP(no irony) had never seen dementia in him,although I had been trying to tell his doctor Dad had major personality changes (the shrink diagnosed bipolar disorder/dementia) ,no short-term memory, fabricated memory,disorientation etc etc.His doctor kept telling me how intelligent Dad was and such a fluent conversationalist! Not the issue, Doc: he is genius level I.Q. and a writer with an incredible vocabulary, but HE HAS DEMENTIA.He was not aggressive,just obstreperous and verbally nasty (hello bipolar).They really wanted to get rid of his verbally nasty,aggressive ex-girlfriend,who was trying to micromanage his care,while his daughters (my sister and I) were living in Nashville,unaware of his diminishing capacity. I moved to his home in Texas just after the psych hospital admission.The AL were going to ship him to a behavioral Alzheimers unit 100 miles away,with enhanced care for unruly dementia pts,which sent an intake nurse who wanted him evaluated for a recurrent medical issue in a local hospital.While he was in the hospital, the behavioral unit declined to take him because of his idiopathic (cause unknown) anemia and the AL refused to take him back because he was discharged from their care.We were offered the choice of a rundown, Medicaid funded "nursing home" or Rusk, the Texas hospital for the criminally insane, with a locked "memory care unit".Sandbagged.Totally sandbagged.We reluctantly accepted the Medicaid warehouse for a month, as the lesser of two evils.I found him a beautiful Memory Care facility,which he still hated as too confining and institutionalised,then moved him to a private handicapped apartment with sitters,Home Health and hospice. Upshot: doctors are often woefully uninformed about dementia (one corrected me when I said Dad had dementia,if not actually diagnosed Alzheimers yet, "Oh,they're the same thing" Not according to the Alzheimers Association and 100% of the literature---don't let doctors intimidate you---they are not God-like,no matter what they're told.They make big, gross errors occasionally.)ALs and nursing homes have ten million laws dictating their conduct which they learn to circumnavigate by the behaviors cited by these letters and the above example---technically legal, but highly questionable morally.The people who advised you to drop your brother on the streets,to be dealt with by cops should be reported to every authority your CELA lawyer can find.The advocate has the power of the State behind them, but your own advocate can advise you of your legal recourse.The care facilities bully and hornswoggle you when they can, use medical terminology and care facility laws and patient rights you are unfamiliar with, to make you conform to their convenience. Educate yourself as to your and his rights---you have to learn to be proactive and self-defensive and wary when dealing with the medical bureaucratic edifice---exhausting sometimes. Good luck! Erin

To JDP1000 - tell that facility that you should let your father off in the street and let the police find him to go jump.

Pamstegma, I noticed that too, just finished reading all the posts. I hope everything worked out for her and her brother. Hopefully the poster will come back and let us know.

Two Sundays have passed since the original post. No further contact from the original poster, ajnalikat.

I strongly agree with contacting the advocate on the matter. In fact, I would've told the facility to contact the advocate as well as you, and that you have no way of moving this person within their timeframe. I personally would make a police report and report the incident as elder abuse, especially if they try to dump the patient on the street and leave them on their own. I've never dealt with anyone with end-stage dementia or Alzheimer's, but it sounds to me like the patient really needs to be in a facility that's able to handle the behavior. If you can't move the patient, just tell the nursing home you can't, but don't tell them in person or otherwise they may load up the patient and push them off on you. You're best off just to call them and let them know the patient can't be moved right now, and if they have anything to say about it, contact the patient's advocate. I would also contact the APS as well as an elder care attorney and tell them what's going on besides making a police report.

* Finally, they can't really 'force' you to do anything, you must agree to act on their demands. Next time they bother you, tell them to just call the APS or even the cops if they have a problem. When the cops come, just explain the situation

Not sure what you mean by a State Advocate. When I had an issue like that with my Mother I called the Ombudsman who is like a mediator who comes in and tries to find a resolution. If this is anything like when a hospital wants to release you. They have to have someone pick you up and take you. If you are not there until Tuesday what can they do? I don't think they can put him on the street - that would be elder abuse. I live in California and if you do also you should call the local Ombudsman.
Hope this helps a little.

You don't have to do anything. If the place he is in now feels that he is not appropriate for their level of care, they are responsible for finding him a place that is able to manage his level of care. Usually they look in a certain radius from where they are located and go by "first bed available".

If you found someplace that is willing to take your brother, although they "put the paperwork in motion", it can take several days for them to approve his admission. They have to contact the facility that he is in now to get an accurate assessment of his condition before they approve his admission. Let the facility that he is in now know that you have begun the process & that the new place will be contacting them very soon.

They can't kick your brother out on the street. They can threaten to do whatever they want to do---just remind them that these are the days of the internet and social media. It wouldn't take long for you to post a comment somewhere that the facility forced your brother out when he had nowhere to go.

Furthermore---let them know that you will contact the state if they do anything to threaten you or your brother. That usually puts them in their place.

Check your contract with the facility, they have to abide by that which is generally 30 days. But i would never move my mother if they told me to until i had another place. You really have to advocate for your loved one in these facilities and ensure they are protected. I am constantly all over them...in a nice way. HOLD THE FACILITY ACCOUNTABLE, THEY ARE ONLY AS YOU EFFECTIVE AS YOU MAKE THEM.

If he is no longer combative, why do they want him out? Just because? Sounds fishy to me. I would be tempted to take a picture of the place and describe the conditions and their inability or refusal to care for your father and ask if they would like you to post this on Facebook and start a negative advertising campaign against this place. Tell only the truth, of course, so there is nothing libelous in your statements. Would you like me to post this or would you like to give me the time I need to find a more suitable place? You make your choice and I'll make mine.

that's what they did with my friend's mom, got her stabilized again, then ended up not having to move her after all, was able to bring her back to where she was

Have you tried asking to have him medically evaluated in relation to the increase lethargy and anger. It sounds to me like a visit to the hospital may be in order. By the time they are done with him at the hospital, the few days needed to have the new placement at the Alzheimer's facility should be ready. (Also any hospital has a social worker who will help get it arranged.)

I am caregiver to my 88 year-old mom with dementia. Her safety and mine are first concern.
When you mentioned anger, I would immediately get a new assessment to balance out medications from a neurologist. Maybe you do t have access.
He needs to be calmer no matter where he is; kills me moving him is the first idea they think of.
Sending prayers you find a good solution.
Dementia stinks!!!!

Maybe try your local Dept. of Aging to see if there is a Ombudsman for you yo talk to. They are the people that will advocate for you regarding things.

From what I understand, unless you are your brothers legal guardian they can not force you to do anything. A way of looking at it is - what would they be doing if you weren't in the picture? If it remains in their hands however - they could find a bed in a not so great facility. I think if I were you I'd tell them you are aware they can't force you to do a dang thing but that you have a place - the day after - and that you'll move him then. I highly doubt they'll go to all the trouble to move him since your willing to do it but 24 hours past when they'd like.

Sounds questionable. I don't think they can legally discharge him without ensuring he has a safe place to go with this little notice. If this is a memory care facility, they should also know how to handle these issues, including requesting changes in medication, possible restraints or sedation to assist in mood management to protect personnel!
Hospitals do this all the time to prevent persons from pulling out IVs, trying to escape and becoming a fall risk, etc.
I sense the facility is looking at a financial reason for wanting to discharge...he requires more labor to care for???

My sister can also slip into this stage of dementia and by getting BETTER LABS not just going by a CBC, the deficeits can be corrected but ONLY IF YOU GET A DOCTOR THAT KNOWS THE CURRENT RESEARCH TO BE ON YOUR TEAM. Doctors are too busy to know the research and the solutions are already out there to prevent AND to remove the symptoms to where often the person is quite well again and everyone is shocked. Often it's just a UTI that's over treated with antibiotics that stripped the digestive track of beneficial bacteria which is needed for digesting food so nutrients get to the brain.

First of all, hire a Functional Medicine MD and have him prescribe supplements which will almost immediately stop the negative mood. Most cases of dementia are simply deficiencies . For scientifically proven evidence, read the research by William Walsh on Alzheimers and behavioral health . Medical doctors don't all know about amino acid therapies which are Medicaid approved and known to improve or reverse symptoms of dementia. There are many other scientists that are providing evidence that once the various deficiencies are corrected, the dementia dissapears or symptoms cut in half and the person becomes stable.
. Melatonin at night Early morning sun exposure, folate, B12, vit D, fish oil, zinc magnesium threanine... Phospatydlserine ... The list goes on and on for reversing these symptoms. Sometimes it's as simple as an electrolyte imbalance and getting 5 hours of solid sleep . Don't take my word for it. Just look for the research. Google words, reverse dementia natural nutrition sleep Alzheimers

I had a similar issue with my dad. I am in North Carolina and was told that my dad had to be out by a certain date as well due to his aggressive actions. I started looking but of course with his aggression issues it was hard to find a spot. They decided he should go to the "behavioral" unit to get his med's balanced out. They refused to take him since his white blood cell count was out the roof which might be a sign that an infection was at the root of his issues. When I told them I was having a hard time finding a bed they actually suggested I just take him out, drop him off on the street and let the police pick him up. Supposedly the behavioral unit would have to take him then.

In discussion with his gerontologist, she told me not to do anything. They could not force him out until THEY found him a bed. So I stopped looking and told them that I believed the law said it was on them to find us a bed. The Executive Director was livid.....but they stopped hounding me and started looking themselves. I found a place on my own but this gave me enough time to look and be satisfied with the decision.

You might check and see if they can really force you out without having a bed ready somewhere else.

If I were you and I only had to wait a day or two, there would be NO WAY they would move him. Call Elder ABUSE and report them. Then go to his room and do not allow them to even try to move him. Take the papers with you that you have a bed for him to go into and you only need 72 hours. Make a scene, the squeaky wheel get's taken care of, you are his only advocate, fight for his rights. Best Wishes to you and Him, you and your family deserve it, we do not live in a communist state yet, that I know of. Stand up for your and his rights. Who paid the taxes that are taking care of him and paying their paychecks?????

Alzheimer's, dementia and memory care are often provided in a secure assisted living or nursing home setting

Patients right will depend on setting IMCO

Nursing home residents have certain rights and protections under the law. The nursing home must list and give all new residents a copy of these rights.

These resident rights include, but aren't limited to:

The right to be treated with dignity and respect.
The right to be informed in writing about services and fees before you enter the nursing home.
The right to manage your own money or to choose someone else you trust to do this for you.
The right to privacy, and to keep and use your personal belongings and property as long as it doesn't interfere with the rights, health, or safety of others.
The right to be informed about your medical condition, medications, and to see your own doctor. You also have the right to refuse medications and treatments.
The right to have a choice over your schedule (for example, when you get up and go to sleep), your activities and other preferences that are important to you.
The right to an environment more like a home that maximizes your comfort and provides you with assistance to be as independent as possible.

Learn more about your rights as a nursing home resident.

For more complete information, see the publications Guide to Choosing a Nursing Home - Medicare Coverage of Skilled Nursing Care
----
Patients’ Rights in Nursing Homes
and Assisted-Living Facilities

When Congress enacted the Nursing Home Reform Act (NHRA)
in 1987, it made sweeping changes to the expectations of the
Medicare and Medicaid programs in their purchase of long-term
care services. The NHRA also specifically addressed a number of
residents’ rights issues, and provided protections to all residents
of nursing facilities that accept Medicare or Medicaid. In addition,
the NHRA required that a review of a facility’s compliance with
residents’ rights be included in the annual standard survey used
to determine overall performance and compliance with federal
regulations. It also requires facilities to protect and promote the
rights of each resident.
Many state legislatures jumped on the reform bandwagon, often
extending the scope of protections afforded to residents and ex-
panding the protection to settings other than nursing facilities.
The residents’ rights protections typically fall into the following
categories:
•
General rights
•
Admissions policies
•
Transfer and discharge rights
•
Access and visitation righ

Took a CNA class the other day on patients right and it said they have to give you 30 days. I'm in Florida but maybe you can look it up online to see if this is a state law or federal law.

If you show them the paperwork you have done to move him, and that the other facility promises to have a bed for him by Tuesday, perhaps they will grant him the extra day.

Just tell them you are not moving him until his new place is ready. They will probably fold on their demand.
Don

Call an Elder Law attorney in your state. Look for a Certified Elder Law Attorney. The will have CELA after their name. It will depend on the laws of your state but if a CELA calls they will likely find more time. It is not good to move those with Alzheimer's so you don't want to move him twice.

Can you speak to the state advocate ?

If he is a ward of the state, the state advocate will handle the move. Try not to interfere. What they are doing is legal when they have custody.