Why do skilled nursing homes with memory care units claim they specialize in caring for patients with behavioral issues, then discharge them?

Just my opinion but I think this industry is so regulated that they can no longer care for patients like your father. Restraints aren’t allowed, not even a bed rail. In the old days,
when Grandpa developed issues, he got locked in the attic. We can’t do that any longer.

Because there’s so much facilites cannot do, their only option is to release the patient. Knowingly housing a patient with violent tendencies could cost them their license if something tragic happens because of that patient. That doesn’t make it easy for the patient’s family. And it does sound like the doctors have washed their hands of your dad. Can he be re-evaluated by the psychiatric hospital? Like JoAnn writes, it may be to the point that to keep him and anyone he comes in contact with safe, he may need strong medications that zone him out. Not a happy solution, but it’s better than continually being kicked out of facilities.

There is a lot of discussion in the long term care industry about this, and legislation around it too. There are fewer things people can be involuntarily discharged for, but harming other residents is one of them. My husband had this issue, which was clearly a dementia behavior, but they didn’t care and kicked him out. I filed a complaint with the state of Michigan and the nursing home still got away with it.

I would suggest contacting your your state ombudsman, who may be able to help. This is a very difficult position for you to be in, so get some help as soon as possible. I am in my 50’s, know how to navigate the system, and still did not win this battle. My husband ended up in a facility 60 miles from home, where they also tried to evict him. He started declining and the behavior stopped, so he stayed there until he died 2 weeks ago.

Hoping this gets better for you soon, and that you all find some peace.

I assume the problems you are talking about involve violent behaviour since that is usually where facilities draw the line. Is this patient under the care of a geriatric psychiatrist and have they spent any time at a psychiatric facility? Nursing homes have to protect other frail, vulnerable people as well as their staff and unfortunately those whose outbursts can't be controlled may need a unit dedicated to violent patients.

There are probably two reasons: some of them do what used to be called lying, and others are probably so bound by regulations that they are unable to use any common sense measures to deal with the problem.

So, what are you suppose to do, huh. You can't have them in your home. These people are very strong when violent. Yes, surprised a Psychiatric facility can't find the right combo even if it means the patient ends up being doped up.

Sunshine45, my heart goes out to you. Other then sedation, I’m not sure what other options there are to have your loved one in a place that’s safe for all parties. Looking at it from both sides, facilities need to be safe for patients and staff. Families need a place for loved ones that is safe for them as well. Since this disease seems to give people super human strength at times, it is an issue where there may be no other choice but to subdue one person rather then risk multiple injuries to others. How awful it is to add yet another challenge to you. I’m so sorry.

This is what it has become due to lawsuits. I had relatives who had a father with dementia and he became very violent in the evenings when he started sun downing. Beat the H out of all of them regularly. They never put him in a nursing home until he became an invalid. It completely wore out everyone involved in his care.

If I'm ever faced with this situation and have to care for the person at home, there WILL be heavy sedation and restraints.

If he is a danger to himself or others, the state should bear the responsibility of his placement. Have you asked what they plan to do?

I have read articles in our paper (and not recently) about this very issue. They followed a few families who had this problem.

Just what are the families supposed to do?!?! Take the elder into their home?

It is so unfair to the families!

I just spent another night with spurts of confusion and violence with my husband. He is on seroquel and valproic acid for behaviors but he still moves through being docile at bedtime, then sleeping briefly and then the behaviors kick in and last anywhere from 9 p-2 am. The strengthe his exhibits for a 150 lb 84 year old man is stunning. I am almost always alone, and have had to call 911 4x in the last 2 months. Doing this is so, and the last one I refused to take him home as he repeatedly was released because he did not meet the criteria for admission. After five days and three nights of haldol, he was released to go home with 30 days of home health. It seemed that he was better with the new meds, but that is changing again. His PC referred us to a geriatric psychiatrist who is actually very close to us. I had seen a presentation by her in the Sr. Community we just moved out of, so I was excited. But when we began to make the appointment for the eval., I was told that though the initial appt is covered by insurance, all future appts., have a monthly fee of $80. I know that sounds reasonable, but we simply don have it. I have begun the whole Medi-cal process and am waiting now to be denied because we probably have too much income. Where we go from here, well, right now I do not know. I am certainly willing to place him in a facility, but again, there is no money for it. And I am so fearful of what his care would be like at most of them. But my 24/7 caregiver burnout is,honestly, On the brink of threatening my own psychological and medical wellbeing. He is my husband and has been a funny, handsome, good one who cared for me during my times of medical need. He deserves the best care now and I am no longer able to give that. Our future seems very bleak right now.