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ohmeowzer Asked October 2017

What do they do in a geriatric psychiatric unit?

I placed my mom in LTC and she is now hitting and punching the staff when she has to get up and when she has to be changed and anything. She does have a UTI and they are talking about putting her in geropsych for medication adjustment. Is this normal? I’m scared for her to go to geropsych. I don’t understand why she is hitting and punching the staff so much. I can’t even not go over there or have a day off because of her behavior. Please help me feel better about Mom going to geropsych for a few weeks. Does anyone know what they do to the patients there ?

NYDaughterInLaw Oct 2017
Like any other ward in a hospital, the geriatric psych ward provides needed care to patients. Your mother's brain is malfunctioning. If your mother's heart was malfunctioning and she needed to be on the cardiac ward or in the ICU, would you and your sister have trouble accepting it?

MsMadge Oct 2017
A couple of points to consider are her current health and care providers

If she has dementia is she currently seeing a neurologist or psychiatrist- is she on anti anxiety meds and if so are these providers recommending the psych placement?

Who is treating her UTI now ?

What type of LTC facility is mom in now ?

Regular AL probably can't handle anything other than mellow dementia not behavioral problems

While it may be necessary for your mom to be hospitalized try to educate yourself about the geriatric facility - have other residents in her current facility been there and how are they now ?

It was very difficult for me about 15 months ago when my then 93 year old mom escaped her memory care facility and hit the nurse bringing her back inside

Facility threatened psych hold and I fought hard to prevent it as I'd seen others come back zombies and stroke out -

fortunately for us we were able to switch her med from seroquel to risperidone and she became more manageable albeit still a Viking

Please don't misunderstand and think that I would recommend anyone else not agree to the hospitalization if that is what is needed -

If mom had been on a higher dose of seroquel then we may not have been able to switch outside a hospital setting

Please let us know how this works out as no one solution fits all

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BarbBrooklyn Oct 2017
Lizi, such an insightful post!

Many folks hear "person is being remanded to psych facility" they immediately start to see images of The Snake Pit, or worse.

Modern geriatric psychiatry is about figuring out what meds
( antidepressants, anti anxiety agents, antipsychotics) that will help your loved one.

lizzywho61 Oct 2017
My Mom had a short stay in a geripsych floor of our hospital. Mom actually liked it there. It was pretty calm and peaceful. Lots of one on one attention from doctors, nurses, and psychiatrist. Her meds were in serious need of being tweaked. Her mood was stabilized. It was a very good learning experience for us. Later on we knew when to ask for an evaluation for further tweaking of meds as time passed.

For some it is hard to wrap your head around that your loved one is off to the psych unit. My little sister had a mini meltdown about the whole idea.

I was happy Mom was getting the help she needed.

jjariz Oct 2017
A stay in a geri psych unit is a typical step for an aggressive patient. The fact that she has a UTI gives you SOME hope that the stay there may be shorter than the typical 2-3 week stay. It's a scary situation for the family, but can be a good result.

Sunnygirl1 Oct 2017
You ask if being resistant to care and aggressive to staff is normal for those who have dementia. Well, I'm no expert, but, from what I have seen and read, it's quite common. The dementia may cause the person to not be able to process information, people or much at all, so, it's easy for them to become overwhelmed, scared and confused.

What type of facility is your mother in? I ask, because, in the beginning, my LO was in a regular AL. She did not want to get out of bed in the morning. Didn't want to bathe or go to dining room. This is not unusual for a dementia patient, but, the staff were not trained to work with her. If they had pushed her to get up, she might have become violent. They didn't but, called me, but, there are ways to work with a person under these conditions. It takes time, training and proper guidelines. I found that a Memory Care unit, was best suited as they had those things and once there, the problems were addressed. It ALSO helped that my LO went on medications for anxiety and depression. Those can also cause the patient to act unusual. I'd discuss it with the doctor and hopefully, in the hospital they can get medication that helps her. STill, I'd explore to see if she's getting the right level of care at her existing facility.

BarbBrooklyn Oct 2017
Oh, you poor thing! (and mom too, of course)

Was she combative at home and is that what led to her placement?

Can they wait on the geriatric psych placement until the UTI has been treated for a bit? The Psych people are not going to get an accurate baseline measurement of her behavior if she's in the middle of a UTI.

My mother's BEST care over the last 6 years of her life came from geriatric psychiatrists. I understand that not everyone has the same experience, but they seemed to be the only medical specialty docs that actually looked at the whole patient, body, mind and environment.

gladimhere Oct 2017
Do not be afraid of the geripsych unit. They will treat the UTI and then get her mood stabilized and figure out what med combo is going to work best for her. My mom, too, had to have a geriatric psych assessment. They figured out what meds would work to help with controlling her behaviors, the side effect, mom was more comfortable and agreeable.

Evermore99 Oct 2017
She should be tested for a UTI and if she doesn't have one, she definitely needs to be in a geriatric phsych ward. What are her impairments that she has to be in a facility? There are medications that can curb the hitting and punching without doping her up.

Countrymouse Oct 2017
The usual reason is that the staff are frightening her. I'm not saying it's their fault: she may be frightened of nothing at all, they may be doing nothing wrong in itself, but part of specialist dementia training is working out what triggers her outbursts and - not doing that.

For example. I've seen staff who should know better seize hold of a patient and manhandle her without introduction or explanation. Not hurting her, mind. Just not giving her a chance to understand what the heck is going on or providing any reassurance that all is well.

How much confidence do you have in the leadership and expertise of the staff in this facility?

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