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My father in law with Alzheimer’s is somewhat of an anomaly. He is physically healthy and quite strong but he is also combative with caregivers - not a good combination. His triggers are inconsistent and somewhat random also.
His memory care facility has sent him to a geriatric psychiatric facility numerous times only to receive him back and the combativeness continues.
Now Memory care is refusing to take him back this time. We are refusing discharge from the psychiatric facility but not sure what the next step is. Any advice is much appreciated.

My cousin with early onset dementia became aggressive and combative. She went into the psych ward of the hospital and stayed there for many months until she complied with taking meds AND they figured out the right one(s) for her. Then she was discharged.

Are you your Dad's PoA? Is anyone? If he doesn't have a PoA then this may be part of the problem -- there's no one really driving the bus.
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Amandalynn Jan 21, 2025
My mother in law is (this is my father in law) and my husband is helping her make decisions. My FIL is pretty much non expressive verbally except for a word here or there.
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Mother, though not having the problems your fil has was kept in a geriatric psychiatric hospital until they were able to medicate her properly. It would seem that that is the only solution for your fil. She was there 9 months.

As Alva says this may mean he appears over sedated, which is not desirable, but if that is what it takes to keep him from being combative, it is the solution. Sadly as we age our options becomes less, and often far from optimal, but at present it's all you have. Doctors don't perform miracles, but use the often imperfect tools available.

By all means refuse discharge and request that they keep trying medications, even if they overly sedate him. I am so sorry for all of you. Alz is a dreadful disease.
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Amandalynn Jan 20, 2025
It truly is a dreadful disease. They are working to make necessary changes to his medications and hopefully soon they’ll find the proper combination that will keep him from harming someone. We certainly aren’t expecting a perfect solution. Thanks for your reply.
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If different placement is necessary they will have to find it. It is of course impossible to consider any other discharge than one into care of several shifts, several caregivers.
Clearly no medications or medication cocktails have been found to help him, so that they are going to have to keep trying.

Unfortunately in some cases people require such deep sedation that they are for all intents and purposes almost completely out of it. Which is a tragedy. The aim is to get some sedation to prevent agitation while still have an awake and at least somewhat cooperative person. And that just isn't going easily to happen.

You are between the devil and the deep blue, and I am so very sorry. I hope SOMETHING SOMEHOW can be found to help.
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Amandalynn Jan 20, 2025
They certainly have not yet found the proper medications between the three facilities he has been in. He is a challenging case for sure and we will find out on a family conference call this week what the next step is.
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