Can memory care place conditions on a resident's return after an aggressive incident?

the sequencing of incident to ER to hospitalization (MediCARE) to rehab (Medicare) in a SNF along with the MD specialists being seen is absolutely the best use of insurance benefits and best way to get an evaluation on your dad. Maybe add in a geriatric psych consult, but those tend to hard appointments to schedule unless your dad is within a multi specialty gerontology practice at a teaching hospital.

That the MC did not send you something specifically as to your dads needing behavior mod, is, imo, is, in a way to your dads best interest. If MC were to send you a letter it will have details on the incident that was the tipping point and any other past behavior concerns (combative behavior wasn’t new) and it will go into his file. Should he need to find a other MC facility or even a SNF, and they review his file, he will be toast on being admitted. They way they have handled it to me show that they like your dad. They are wanting to work with him & you to find a path for him to be able to come back. I’m guessing he’s been there a while so staff know him and 90% of the time he’s a lovely resident.

it’s a fine line for the MC as they have the safety & security of all the other residents and the staff to safeguard. it’s probably going to be that he goes onto a new medications and will be on a 8-10 week evaluation as to their effectiveness and if work well enough to quell or manage his agressiveness. If he’s still at the rehab/SNF try to have him do a week on new meds there and then get him returned to the old MC with the understanding that the medication management needs a full 2-3 months. So he gets to stay there for sure for that period of time. And every 3 weeks you have a care plan meeting so no surprises or if he does have to move to a higher level of care you have time to find.

also the family member who feels everything (or almost everything) the MC did was wrong, have them stay away or have them always with a other more “nice” fam. If they show up and start haranguing staff and administration, it makes it look like the whole fam is crazy. Again I think the MC likes your dad, don’t give them a reason not too. Let us know how it goes,

Thank you all for your wisdom and advice.

To be clear, if the tables were turned, I would *not* be comfortable with a combative resident returning within hours of an incident, and I can easily understand the MC facility's point of view. A family member disagrees with most of the decisions the MC facility made: sending my dad out for evaluation, refusing to take him back that day and putting conditions on his return, etc. This family member thinks the MC facility overreacted, and this was the equivalent of "patient dumping." IMO, we were lucky not to have been given notice.

Good suggestion, @Geaton777, to review the contract. I think we'll need to research our options now so we're not caught totally unprepared if this happens again and the MC decides dad needs to leave.

They certainly have the right. Memory Care tends to be a pretty calm setting, and if there is someone who has serious behavior issues, they just can't have them there. They aren't equipped medically to handle that kind of stuff.

My mother's MC had a couple of residents who got violent, including one huge man who was like a wild animal when he went off. He was punching walls and windows(!), and the aides were almost helpless against his strength. Fortunately, I was there visiting my mom and got her out of the line of fire, so to speak. That man was gone within minutes and never was allowed to return, thank goodness.

There were a couple others who deteriorated to the point where their behavior was problematic, so they were removed as well. I don't know where they went, but that's behavior that requires more medical care than MC gives.

The goal is to keep everyone safe and happy in a Memory Care Assisted Living facility. If your father is going to threaten that safety for others, he will have to be medicated to a calm state before returning or he'll be asked to leave, and rightly so. Would you want HIM threatened by an aggressive resident? No, of course not. The MC is not going to increase their liability 1000-fold for the sake of one resident, thats the bottom line. You have no rights in such a situation, your hands are tied, really. Hopefully, the doctors will find the right anti anxiety meds for dad and they will keep him calm enough to return to the MC. If not, you'll have to find a Skilled Nursing Facility willing to accept him. It's a terrible situation to be in for dad, too, because him feeling agitated is not a good thing. Dementia is such a dreadful condition and so little is known about the human mind, still, that treatment can be tricky, I know.

When my mother's dementia advanced to the end stage, she was acting angry and aggressive herself most days. Hospice gave her Ativan which helped a lot, fortunately, so we were lucky in that regard.

Good luck to you and to dad. I hope he finds peace soon and that the MC takes him back in short order.

Yes, MC can do this. They are only a step up from an AL. Difference is they are a lock down unit with maybe a few added aides. They are not capable of caring for someone with these types of behaviours. They have to think of the other residents and his outburst probably causes agitation and anxiety for the other residents.

You may have to place him into LTC but he will need to be medicated.

I would start by reading the facility contract that was signed when he was first admitted. My opinion is that the answer is probably "yes", since they must protect the staff and other residenrts from a possible assault.