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E
eeyore12 Asked January 2017

What happens if a nursing home patient becomes combative and unruly?

My hubby has schizophrenia, mild stage dementia and a host of health problems. When he has a mania episode he becomes angry, unruly and demanding. He was admitted from a psych ward to the nursing home and medicaid is currently being processed, there is no way we can afford him a private room at all and him coming home is not an option either. What can I do if anything?

anonymous326422 Jan 2017
You probably know this already but getting a proper dementia diagnosis may help the doctors keep medication side effects to a minimum. You may have to do extra research on your own. We found doctors (even the geriatrician) and nurses were poorly informed when it came to dementia and drug side effects. For instance if your husband has Lewy Body dementia, some medications given to calm Alzheimer's patients will agitate and upset him. Also we learned that dementia patients experiencing delirium (eg as a result of hospitalization or infection) should NOT be given Ativan as it can also severely agitate them to the point of violence. I imagine that trying to get a proper diagnosis and prescription regimen for a person with schizophrenia is even more complicated. I feel for you and your husband. That is a lot to deal with.

In the short term, chances are the nursing home will request your husband be admitted for psychiatric observation at the hospital till his behavior is under control, but it might be beneficial to ask for him to be evaluated by an experienced geriatric psychiatrist while he is there.

If there are things you notice that soothe your husband (quite at certain times, music or tv programs) don't be afraid to ask his NH doc to note that in his orders for staff. It is really hard to get everyone on the same page unless the doctor or another administrator makes formal notes, at least that's our experience. Best of luck.

pamstegma Jan 2017
You can agree to have him readmitted to the hospital. He may need a memory care facility or better medications.

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BarbBrooklyn Jan 2017
It sounds as though he may need to go back to inpatient psychiatric for a med adjustment.

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