My loved one has had violent outbursts and is hospitalized. Facilities have refused to accept her. What can we do?

Leave it to the social workers and just be certain not to take her home. She may need to be medicated when she is placed; that is always a sad outcome as finding the right meds that don't over-medicate into non-reaction but do control outbursts is very very difficult to find, especially outside a medical unit. Just be certain you don't take her home, and that you insist that is not an option. I sure wish you luck. They may need to await special psychiatric placement. I am so sorry; this is a hard case for certain.

Some times, people wrongly asume that all old people will get dementia sooner or later. Yes, a large percentage of them do. However, many never develop dementia, only a moderate degree of normal decline of cognitive functions. Another misconception is that all dementias will have the same symptoms. The truth is that the symptoms of dementia vary according to the previous personality of the individual (borderline, paranoid, histrionic, psychopathic, narcissistic, dependent, schizoid, etc.), as well as to the presence of a preexisting mental illness (bipolar disorder, chronic depression, schizophrenia, schizo-affective disorder, OCD, etc.) or history of drug addiction including alcoholism. Usually, violent, unmanageable dementia patients, have a co-existing mental illness. They require psychiatric care and many times, psychotropic medications.

She probably should stay where she is now.

This woman with her violent outbursts must be "locked up" - and I ASSURE YOU THAT YOU WILL BE PRESSURED TO TAKE HER HOME. No matter what happens, and what threats come, the facility cannot release her if you refuse. They are bound by law to find a place who will take her. No matter what happens, NEVER GIVE IN AND TAKE HER WITH YOU. Your life will be ruined and be sheer hell. Be tough. She needs to be locked up for her own safety and that of others. Behavior like this must be stopped and controlled.

There is a dearth of behavioral facilities across the country particularly here in NJ. Most facilities (NH or MC) are not going to want to take anyone with a recent history of severe behavioral issues because of the liability they assume in protecting the other residents as well as their own staff. Even a two month "behavior good" history may not convince them to take the risk as behavior can escalate in hours and most facilities do not have the knowledge of staff on board who can make adjustments.
It is unfortunate that you and your family are going through this but it is not unusual (even prior to Covid.) I remember turning down two potential residents whose families desperately wanted them to come to our facility. I felt so powerless and sorry for them but I had 160 other residents I had to protect and our Medical Director, like most, was not a geriatric psych. Playing with behavior meds would have been long and risky for all involved.

Do NOT take her home. Engage the social worker at the current facility to find placement but be warned.... it may not be close to you or what you would choose but it might be the only thing available. Be at peace knowing that you are doing the best you can for her.
Wishing you peace and luck on this difficult journey.

If her behavior has improved and is staying consistently calm is this being recorded in her medical file? A facility will certainly read her medical files and this will be the proof you need to get her back in somewhere.

Need to get the doctor or hospital to write a letter covering her treatment and state that "she has been stable for ________ days with the following treatment plan." It will help overcome the issues of her unstable past.

My husband was in Memory Care for 2 months and was displaying violent behavior. The psychiatrist on the team recommended transfer to Geri Psych unit at nearby University Hospital. Covid restrictions were put in place, He developed urinary retention, fell out of bed and contracted Covid. While all this occurred they were adjusting his medications. There were no facilities that would accept him and with no visits allowed he continued to deteriorate rapidly. We took him out of Psych unit and he is now unresponsive and not eating but resting peacefully with family visiting and wonderful care from an inpatient Hospice unit.

My grandmother was in a nursing home for 5 years. The kind of one where all assets are signed over to them, they get control of social security, pensions, anything. Anyway towards the end around age 90 she bit the nurse caregiver in the breast. When I went to visit her at night after work, you could hear her screaming from her bed in the entrance was to the wing. I would try to calm her down. My dad had just dies a few months earlier. We were lucky they did not kick her out. But I assume they just let her die at that point. She was seeing angels and loved ones coming out of the ceiling.

Another possibility: They may be looking for a specific length of time without incident - 3 months, 6 months? They may have guidelines that must be met before accepting her as a patient.