My mother has been in a Memory Care facility since May 2022, but recently has become agressive. What are our options?

During her early-to-mid stages of dementia, my Mom was aggressive with family but reasonably calm and compliant with the Memory Care staff. I appealed to her primary care physician for medication to help calm Mom's hostility and paranoia with family interactions, but her doctor refused since neither she nor MC staff witnessed what we (the family) were seeing. Apparently Mom was all sweetness with them; however, once Mom was well into mid-stage and MC got on the receiving end of the aggression, the problem was swiftly addressed with low-dose (and now moderate dose) Seroquel, which has worked very well. I am ever thankful for medication which keeps her calm without sedation.

As my mother's dementia advanced, she too became a lot more aggressive, loud & outspoken than she'd ever been before. Of course I couldn't speak to her & ask what was wrong..........the DEMENTIA was wreaking havoc with her mind, is what was happening. She couldn't even put a sentence together at that point in her disease process. There's no rhyme or reason to 'why', it's just one of those things that goes hand-in-hand with a brain disorder.

Once mom got under hospice care, the RN was able to increase her dose of Ativan to a higher one and on a more frequent basis which did help her quite a bit. She was also taking Ativan before hospice came on board due to aggressive behavior due to Sundowning in the afternoons. She wasn't violent beforehand, however, that should be noted. Is your mom thought to be approaching the end of her life where hospice could be appropriate? What about her regular doctor, has s/he tried various calming meds (or any meds) to control this aggressive behavior as yet? To jump straight to a psychiatric hospital and a 1-to-1 aide (at huge expense) w/o first trying some basic sedative type meds like Ativan FIRST is odd to me. Unless that has been tried with no luck.

Any doctor who's familiar at ALL with dementia and comes into a Memory Care facility should be well versed with residents who act out aggressively once their dementia progresses. It's not like your mother is the first and only resident who's ever done such a thing. Once standard UTI testing and blood tests are done to eliminate organic issues being at the root of her behavior, then all that's left is to consider medication to calm her down.

If this were my mother (which it easily COULD HAVE BEEN) in her Memory Care ALF, I would speak with her doctor right away about getting her on calming meds or anti psychotic meds that are commonly used with dementia such as Seroquel, to see if they'd help her calm down a bit. I was in constant contact with my mother's medical pros to make sure they were all doing all that COULD have been done for her, to keep her calm and in decent overall health while she was in Memory Care for just under 3 years. She had A LOT of different issues that needed to be addressed, almost constantly, and fortunately, her medical team listened to what I had to say and took my recommendations on a lot of matters. Like when she was vomiting constantly & I asked them to switch her to Prilosec 2x a day, that did the trick & stopped the vomiting.


Wishing you the best of luck with all that's going on. I hope you can find a good resolution w/o having to have mom go into a psychiatric hospital. But if she does, it will likely prove beneficial in the long run.

(comments below, made without really knowing anything about her baseline condition, other than that she ended up in memory care unit)

'At the request of the facility, we have hired a 1-to-1 aide,'

See what her response is to that. Are you still able to talk with your Mom at all? Can you ask your Mom what is going on with her? Someone else mentioned checking for a UTI, good idea, as well as any other like condition. Unfortunately, these places can get busy with many problems, and their 'go to' is sometimes measures that work best for running the facility, as much or more than the specific needs of the resident. You have to bring your own judgement to the situation, you can't just delegate and be confident they'll 'get it', because they have more experience.

There might be other options, but since you have a facility that’s working with you to help your mother get the care she needs, go with it. They are professionals and have seen this many times before. Once her meds are worked out and psychiatric personnel are caring for her, that is most likely her best possible life. I’m sorry this has happened to you, but you are lucky to be advised by people who seem to know what they’re doing.

I have a 100-yr old Aunt with advanced dementia. She is receiving care in her home. My Aunt is taking a med for mood/depression because earlier on she was crying all the time. As long as nothing changes (ie no new aids, no new schedule) she is usually compliant and cooperative. If anything changes she becomes resistant, agitated, combative, and screaming no no no, etc. Also, if she has a physical need or rproblem, like hunger, being constipated, or having the urge for a BM (which she can still do on her own if we get her to the toilet). As others have suggested, make sure your Mom is checked for a UTI or any other possible physical problem (hemerrhoids, bed sore, etc.)

Medicate to compliance.

If this is a total change in behaviour make sure they have tested for a UTI, which can cause this type of thing. (They should know about this but it's best to make sure)

When you got a call about her acting out, why did you not have her brought to the ER? The Baker Act should have gotten her immediate emergency psychiatric care. The key words are a danger to herself or others

If she hasn’t had a thorough psychiatric evaluation yet, it’s definitely time to do it.

Ask the social worker in her present facility to recommend a referral for their psychiatrist or prescribing psychologist to do a work up where she is now.

It’s possible that with appropriate medication, your mother may be able to remain where she is now.

My LO was both aggressive and physically violent when she entered residential care, “our” facility was serviced by an excellent psychiatric practice.

She was prescribed a carefully chosen dose of medications that were matched to her age, symptoms, and body size, and also received “visits” from a gentle and persuasive psychiatrist from the practice, and within a couple mo ths, began to enjoy and benefit from her surroundings.

Painful for us and for her at first, but ultimately a good resolution. Hoping you and your mom will find the same.